Reconstructive surgery an important discussion for cancer patients

Oct. 10—HERMITAGE — The options for reconstructive surgery following breast cancer treatment have come a long way.

That means that patient education is very important when it comes to weighing those options, said Dr. Brodie Parent, a reconstructive plastic surgeon with UPMC.

"It's never too late for reconstruction," he said.

Parent was one of several guest speakers who presented information related to breast cancer on Saturday at UPMC Specialty Care in Hermitage.

The event was hosted by UPMC Horizon and UPMC Jameson hospitals and included information in recognition of Breast Cancer Awareness Month, plus free mammograms and resources about UPMC's services for women.

Attendees also learned about safe sleeping for infants, a doula program that UPMC Horizon is planning, and a new clinic for women with polycystic ovary syndrome.

Parent discussed "Rebuilding after breast cancer: A plastic surgeon's perspective."

He meets people experiencing some of the worst moments of their lives but said that being able to help him is very gratifying.

Reconstructive surgery can help patients feel better about their bodies; it has psychological and aesthetic benefits, he said.

Having surgery as soon as possible is ideal for getting the best outcome, but he understands that some individuals are hesitant to go under the knife.

A big part of his job is making sure that his patients have all of the necessary tools and information that will help them make an informed decision.

Some patients choose not to have any kind of reconstructive surgery, or they might use a prosthetic.

Most of Parent's patients opt for reconstructive surgery soon after completing cancer treatments.

It usually takes more than one appointment to put a plan into place, he said as he showed a flow chart with all of the different options.

There are two types of breast reconstruction surgery: placing implants or using tissue from another part of the body to rebuild the breast.

Implants are the most common, and the procedure takes about 3 to 5 hours.

A tissue expander is put into the chest and inflated with salt water. The next step is replacing the expander with an actual implant, which can be filled with silicone or saline..

Most patients prefer silicone implants because it results in a more natural look, Parent said.

Having implant surgery is less invasive than moving tissue from one body part to another, but there are potential drawbacks.

There's a 10 percent chance for silicone implants to rupture within 10 years, and they increase the risk of infection by allowing bacteria to enter the body through ducts in the breast.

"Remember, it's a piece of plastic," he said, noting some people are uncomfortable with the idea of silicone in their body.

Some patients might need another surgery down the road since implants don't change with the aging body.

There have been rare cases of blood cancer being caused by textured implants, meaning the surface of the implant is not smooth.

Textured devices are banned at all UPMC facilities, Parent said, adding that the problem can be resolved be removing the implant in question.

He's also been keeping an eye on reports of implants causing squamous cell carcinoma, a type of skin cancer. There have been 16 cases reported worldwide.

"But you're more likely to get struck by lightning," he said.

Some people have reported what's believed to be implant-associated symptoms, like fatigue and inflammation, but that is also rare, Parent said.

Parent is preparing to publish a paper soon about infected implants and salvage measures. He's been working with beads that dissolve in six weeks and contain antibiotics.

"I've had really excellent salvage rates," he said.

For the other post-operative option, he said that taking excess tissue from a body part like the abdominal area and moving it to the chest is a very long process.

"It's a gauntlet of an operation," Parent said.

It requires at least three days in the hospital with careful watch over the patient to avoid complications like delayed wound healing and bulges.

Cost is another concern for patients, especially since medical debt is the leading cause of bankruptcy in the United States, he said.

Health insurance companies must cover all stages of reconstruction after a mastectomy.

He also touched on procedures that involve cadaver tissue, 3D nipple tattoos and entering the breast through the nipple in order to avoid the appearance of scars.

Other speakers were Dr. Michael Cowher, who discussed "What you need to know about breast care: A surgeon's perspective," and Dr. Uzoma Iheagwara with "From screening to treatment: A general overview on breast cancer radiation treatment."

The Mercer County Breast Cancer Support Group meets from 6 to 7:30 p.m. the second Wednesday of the month at the Specialty Care center, 875 N. Hermitage Road. There are no meetings in January and February. Enter through the back of the building. Face masks are required and social distancing will be practiced. Info: Contact Donna Darcangelo at 724-981-3429 or darcangelo@roadrunner.com or visit the group's Facebook page.