A Plastic Surgeon’s Perspective on Breast Cancer Awareness

A Plastic Surgeon S Perspective on Breast Cancer Awareness

It’s Breast Cancer Awareness month and I’d like to share some thoughts with my patients.

Over the years I’ve been very fortunate and I’ve treated over 4000 patients in Westchester, Manhattan and Long Island for both cosmetic and reconstructive issues. I’ve treated patients from age 14 to 92. I’ve treated actors, models, Olympic athletes and other doctor’s families. I’ve even treated 52 other doctors, four of whom are Plastic Surgeons themselves.

I tell you this because I consistently find that so many of my patients who have had breast surgery- more so my cosmetic patients, but occasionally even my breast cancer patients- are complacent with their follow up, and this is independent of age, intelligence, or even having a doctor in the family!

Breast augmentation, breast lift and breast reduction patients have the same risk of breast cancer as everyone else. The differences lie in the fact that after surgery your breast is simply different than a non-operated breast. Breast cancer detection, especially self-exam, changes after surgery. That’s not a bad thing, just something you and the doctor doing your breast screening need to be aware of.

In fact there’s some literature to suggest that“breast cancer, when found in a patient who has had breast augmentation, is often found at an earlier stage!”

The biggest issue is that the breast after any surgery just feels and acts different than a non-operated breast and it’s important to understand these differences. I see many post-surgical patients during the year who feel something ‘unusual’ in their breast. They’re smart enough to come in and in all but one case this year I was able to assure patients, with physical exam alone, that their finding was normal. One other case required a simple sonogram.

What You Need to Know About Breast Cancer and Breast Surgery

As a Plastic surgeon specializing in breast surgery, I deal with patients who have had previous breast surgery all the time. Most internists, gynecologists and even breast surgeons are simply unaware of the normal changes in the way a breast feels after common breast procedures. I mean no disrespect to my colleagues in other specialties, but just as it’s inappropriate to see a plastic surgeon for your annual Pap smear, your GYN shouldn’t answer any significant concerns about your post-surgery breast. I recently saw a patient with a ruptured implant after a needle biopsy was attempted on possibly a normal physical finding. Sometimes, after any sort of breast surgery, what may seem appropriate to you or even another physician may be incorrect.

Again, none of this is bad!!!

The point simply is that after breast surgery your breast is changed. The appearance changes and that, hopefully, is a good thing! The feel of your breast also changes and that’s normal too.

I remember a patient early in my career who was about to have a biopsy for a small lump felt in the center of her breast that was too close to her implant to allow a needle aspiration. It was one of my previous saline breast augmentation patients from several years prior. This patient was thin and, when I examined her there in the hospital, I felt the pea-sized lump behind her nipple that was the source of concern. It was clear to me that this was the little tab that closes the valve in the center of the saline implant. I manipulated the tab a bit back into its correct position and, voila, no more lump. This wasn’t a stroke of genius on my part, but I do use, feel, handle and manage implants all day long so I understand the way things are supposed to feel. I wouldn’t expect a General Breast Surgeon to recognize this.

Similar issues exist with Breast Reduction or Breast Lift patients, even without implants. Part of this surgery involves reshaping the breast tissue giving it a more desirable appearance. These procedures are also common, and while healing results in a breast that looks a lot better, the physical exam of the breast changes. This again is not a bad thing and just something patients need to be aware of. You are your best advocate and, if you’re aware of these changes, then you’ll know the right questions to ask.

Some Facts About Breast Cancer

As far as breast reconstruction is concerned, it is important to remind patients of some important facts:

  • Breast Cancer can reoccur in a breast that has had a lumpectomy and radiation.
  • Breast Cancer can reoccur in a breast that has had a mastectomy.
  • Of all the risk factors for breast cancer, none is greater than already having a history of breast cancer yourself- in the same or opposite breast.
  • It is normal for your normal non-operated breast to feel different than your surgical side.
  • Even though your breast cancer treatment may have included radiation, this alone can change the physical examination of your breasts significantly.

Each year I see people- younger and older, educated and not-so-educated, even relatives of doctors- who don’t follow their breasts appropriately. Do it.

It all starts with an education and a level of awareness that sometimes defies logic. You and your families will never fully understand the heartaches you avoid just by being ‘AWARE’. It’s my goal to help you avoid any issues and, should something ever be found, to help you find things as early as possible so you can have the best outcomes.

As a reminder, I am always available for my patients. If you are one of my cosmetic patients I provide follow-up visits for life without charge. I implore you that if anything is ever found of concern in your breast after breast surgery, let me or another plastic surgeon take a look first.

If you have a question, feel something unusual, need a little reassurance, or just want to be instructed about how to examine your breast then come on in. It’s my pleasure to see you in Yonkers, White Plains, Long Island or Manhattan.


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