Who is eligible to have breast reconstruction?
Women who have had or plan to have a mastectomy or lumpectomy may be a
candidate for breast reconstruction, even if the surgeries took place
years ago.
Does insurance cover breast reconstruction?
Breast reconstruction surgery is considered part of the
cancer treatment. The Women’s Health and Cancer Rights Act of 1998 requires that
insurance plans covering mastectomies also cover breast reconstruction.
Under the law, insurance mastectomy benefits must cover reconstruction
of the breast that was removed by mastectomy; as well as breast lift,
augmentation or reduction of the other breast to make the breasts look
symmetrical after the mastectomy; any external breast prostheses that
are needed before or during the reconstruction; and any physical complications
at all stages of mastectomy, including lymphedema. Contact your insurance
carrier to determine the specifics of your plan.
When should I consider breast reconstructive surgery?
Timing is based on personal preference, other medical conditions, and
cancer treatment. Reconstructive surgery can be immediate and done at the same time as
the mastectomy, or delayed and done any time after the mastectomy.
Immediate breast reconstruction offers many advantages, including the possibility
of fewer scars, fewer surgeries and the possibility of waking up with
a reconstructed breast(s). Many patients feel relieved when they wake
up postoperatively with breast(s), and many experience fewer psychological
issues, such as depression, than those who wake up without having had
reconstruction. Delayed reconstruction may be the best option for some
patients if they need
radiation or ongoing cancer treatments. Your surgical team can help determine the
best time for your breast reconstructions.
Who should be involved when considering breast reconstruction options?
The decision whether to have reconstructive surgery is deeply personal.
It is important to see your plastic surgeon soon after your diagnosis
so that a plan can be developed that results in optimum balance and function
on both sides. Some women feel that having reconstructive surgery helps
restore their femininity. They are also able to forego an external prosthesis
(a form that fits inside the bra).
A multidisciplinary approach involving all of your physicians-including
your plastic surgeon, general surgeon and oncologist-as well as your significant
other or family member is recommended. The highly-skilled surgeons, nurses
and technologists at the
Southeast Georgia Health System Breast Care Center follow this comprehensive approach, delivering care that coordinates with
cancer treatment and focuses on the woman as a whole.
How long does it take to recover from reconstructive breast surgery?
Most women report that they are able to return to normal activities within
six to eight weeks, but additional recovery time may be needed before
attempting strenuous exercise.
What to expect after breast reconstruction?
Remaining patient is difficult but necessary throughout the recovery and
healing process after breast reconstruction.
- Patients commonly experience soreness and fatigue for one or two weeks
after implant surgery. After a flap procedure, recovery may take longer
than two weeks.
- It can take up to two years for tissue to fully heal after surgery. Surgery
scars may fade but never fully go away.
- Reconstruction does not restore feeling to the breast, but it is possible
for some feeling to return after a period of years.
- Patients are advised to receive regular MRIs to ensure silicone gel implants
aren’t leaking. Silicone gel implants may leak without causing symptoms,
which is why patients should have their first MRI one to three years after
surgery and follow-up MRIs every two years after that.
- Speak with your doctor about when you can begin exercising or engaging
in physical activities, including heavy lifting, sport, and some sexual
activities. Most women are able to return to these kinds of activities
between four to six weeks post-surgery.
- Speak with your doctor about wearing bras post-surgery. Depending on the
type of surgery, you may be advised to wear a different type of bra. It
is normal for underwire and lace bras to feel uncomfortable after reconstructive
surgery, especially if they rub against surgery scars.
- There may be an emotional adjustment period after breast reconstruction.
Every woman is different and some women that undergo breast reconstruction
may struggle with the emotional effects for years. Speak with a mental
health professional about the emotional adjustments of surgery.
Speak with your doctor right away if you notice skin changes, lumps, pain,
leaking, swelling or other symptoms.
Who performs mammograms?
Your mammogram will be performed by a mammographer registered by the
ARRT. The Radiologic (Mammography) Technologists at the
Breast Care Center perform over 1,000 mammograms each month in an effort to save lives by
early detection of breast cancer.
At what age do I need a mammogram?
Women ages 40 and over should have a Screening Mammogram annually (once
per year) (see guidelines by the
American Cancer Society and the
National Cancer Institute. Your doctor may recommend a slightly different routine- be sure to discuss
this with your doctor.
If you have breast pain, nipple discharge, discover a lump or change in
the breast, or have any other abnormalities of the breast, your doctor
may request that you have a Diagnostic Mammogram. If you have no new problems
that you are aware of with either breast and you are over 40 years of
age, then you should have a routine screening mammogram. If you do have
any problems with either breast, it is very important that you discuss
that with your physician before your mammogram appointment.
How often should I get a mammogram?
Women should begin having yearly mammograms at the age of 40. If you are
at high risk of breast cancer or have a family history of breast cancer,
it is recommended to being annual screenings earlier than at age 40.
Do I need an order from my physician to have a mammogram?
What is the difference between a screening mammogram and a diagnostic mammogram?
A screening mammogram is an x-ray image of the breast that is performed
for women with no symptoms and no new changes to the breast since their
last mammogram. It is usually performed with two images of each breast,
one from top-to-bottom (craniocaudal), and one from side-to-side (mediolateral
oblique). Sometimes more images will have to be taken in an effort to
obtain clear, adequate pictures and to ensure that all breast tissue is
included in the picture. After your screening mammogram is performed,
you can dress- there is no need to wait after the exam. Your exam will
be read by a board-certified radiologist (a doctor that specializes in
interpreting x-rays), a report will be typed, and you will receive a letter
in the mail with your results. Your doctor will also receive a copy of
your report. Occasionally, the radiologist will request that you return
for more pictures to clarify any questions they may have.
This can be for a number of reasons including motion, the need for more
compression, or clarification of a finding or change in the breast.
A diagnostic mammogram is performed to determine the cause of a problem.
Often this is for breast pain, nipple discharge, to clarify a finding
in a screening mammogram, or a lump or change felt in the breast by either
your doctor or during your breast self exam. The number of pictures of
each breast will vary for a diagnostic mammogram depending on your symptoms.
After a diagnostic mammogram, you will wait while the technologist shows
your films to the radiologist. The radiologist may request more images
or a breast ultrasound, or may confirm that no more pictures are needed.
You will learn the results of these tests before you leave our facility.*
Your doctor will receive a copy of the report.
*Results are preliminary. Specific hours are reserved for
diagnostic mammograms.
What is the mammogram procedure?
A mammogram uses a low-dose x-ray beam to produce an image of the breast.
At the Breast Care Center, we use
digital mammography, providing a faster experience. There is no film involved so images show
up on the computer screen immediately. You will face the x-ray machine
and the technologist will position your breast on the machine.
The technologist will then lower a plastic plate onto the top of the breast
until the breast is adequately compressed. Everyone tolerates the exam
differently; while compression can be uncomfortable, compression is a
very important part of getting a clear image for the radiologist to read.
You should always communicate with your technologist to let them know
how you're feeling or if you are unable to tolerate the compression. The
entire exam usually lasts for about 10 to 15 minutes with only a few seconds
of compression for each breast. It is very important that you do not wear
deodorant or powder on the day of your exam. If you forget, your technologist
will provide you with wipes to clean the deodorant or powder off of your skin.
Why is compression so important?
Breast compression is necessary in order to:
- Even out the breast so that all of the tissue can be visualized
- Spread out the breast tissue so that small abnormalities won't be covered
up by normal tissue
- Allow the use of a lower x-ray dose since a thinner amount of breast tissue
is being imaged
- Hold the breast still in order to eliminate blurring of the image caused by motion
- Reduce x-ray scatter to increase sharpness of the picture
Can I get a mammogram with breast implants?
Yes, you can still safely have a mammogram with breast implants. The technologist
will perform around eight pictures instead of four. Four pictures will
be taken with the breast implant included in the picture, using only a
light compression. The second set of pictures will be taken without the
implant in the picture. The technologists are trained to safely perform
mammograms on individuals with breast implants.
How to prepare for your mammogram:
Do not schedule your mammogram for the week before your period if your
breasts are usually tender during this time. The best time for mammography
is one week following your period. Always inform your doctor or x-ray
technologist if there is any possibility that you are pregnant. Some people
choose to take an ibuprofen before the test. While some find mammograms
to be very uncomfortable, a mammogram will not damage your tissues. Mammograms
can cause some redness or bruising, especially if you tend to bruise easily
or take blood thinners.
Do mammograms show all cancers?
While
digital mammography is very effective in
detecting cancer, there is no method for detecting 100% of cancers. That is why it is so
important to follow up with your physician regarding the results of your
mammogram, and for other breast health issues. In some cases, your doctor
may request that you have
other types of studies performed.
How do I get results for my screening mammogram?
You will receive your results in the mail and a report will be sent to
your doctor. During registration, be sure that we have your correct mailing
address. The letter that you receive will describe your results to you.
There are several parts of the letter that are required by state and federal laws.
How do I get results for my diagnostic mammogram?
You will receive results for your diagnostic mammogram immediately following
your test. In some cases, your doctor may choose to give the results to you.
I received my letter in the mail, what does it mean?
Normal follow-up
Your exam was normal or benign (not cancer). It is recommended that you
return to your routine annual mammogram schedule. However, if at any time
you develop any changes in either breast, please check with your doctor.
Additional Images required (call-back)
If you need additional images after your initial screening mammogram, you
will be alerted by the
Breast Care Center or your physician's office to return for more imaging. You will also receive
a letter from us describing the results of that test. The need for additional
images does not necessarily mean that there is a serious problem, but
it should not be ignored.
Further testing needed
After a diagnostic mammogram or ultrasound, we'll let you know if additional
testing is required.
Reminder Letter
We'll let you know when it's time to schedule your next annual screening
mammogram. If you've already made your appointment then you can disregard
this letter and we will see you then! Otherwise, first obtain an order
from your doctor then schedule your mammogram.
Short-interval Follow-up
This letter describes an area in your breast that is probably benign but
should be followed up within three to six months, just to be sure. A short-interval
follow-up does not necessarily mean that there is a serious problem, but
it should not be ignored.
How long until I receive the results of my mammogram?
You should get your results within 30 days. If the X-ray picks up any abnormalities,
you may be told to get another mammogram or other form of testing.
For more information about breast cancer, breast care, and national guidelines go to:
Are mammograms safe?
Yes. Like an X-ray, mammograms produce only a tiny amount of radiation exposure.
Are mammograms painful?
Every woman experiences the mammogram procedure differently. Some women
report feeling discomfort or small amounts of pain during the procedure,
particularly during the X-ray portion. However, the X-ray procedure only
takes a couple of minutes to complete. After the mammogram, most report
that they don’t experience lingering pain, but it is possible to
feel sore or tender for the rest of the day.