After a mastectomy, some women decide to
wear a breast form (prosthesis). Others prefer to have breast
reconstruction, either at the same time as the mastectomy or later
on. Each option has its pros and cons, and what is right for one
woman may not be right for another. What is important is that
nearly every woman treated for breast cancer has choices. It is best
to consult with a plastic surgeon before the mastectomy, even if reconstruction
will be considered later on.
Various procedures are used to reconstruct the breast. Some use
implants (either saline or silicone); others use tissue moved from
another part of the woman's body. The safety of silicone breast
implants has been under review by the Food and Drug Administration
(FDA) for several years. Women interested in having silicone
implants should talk with their doctor about the FDA's findings and
the availability of silicone implants. Which type of reconstruction
is best depends on a woman's age, body type, and the type of surgery
she had. A woman should ask the plastic surgeon to explain the risks
and benefits of each type of reconstruction.
Rehabilitation
Rehabilitation is a very important part of breast cancer
treatment. The health care team makes every effort to help women
return to their normal activities as soon as possible. Recovery will
be different for each woman, depending on the extent of the disease,
the type of treatment, and other factors.
Exercising the arm and shoulder after surgery can help a woman
regain motion and strength in these areas. It can also reduce pain
and stiffness in her neck and back. Carefully planned exercises
should be started as soon as the doctor says the woman is ready,
often within a day or so after surgery. Exercising begins slowly and
gently and can even be done in bed. Gradually, exercising can be
more active, and regular exercise becomes part of a woman's normal
routine. (Women who have a mastectomy and immediate breast
reconstruction need special exercises, which the doctor or nurse
will explain.)
Often, lymphedema after surgery can be prevented or reduced with
certain exercises and by resting with the arm propped up on a
pillow. If lymphedema occurs, the doctor may suggest exercises and
other ways to deal with this problem. For example, some women with
lymphedema
wear an elastic sleeve
or use an elastic cuff to improve lymph circulation.
The doctor also may suggest other approaches, such as medication, manual lymph
drainage (massage), or use of a machine that gently compresses the arm. The woman may
be referred to a physical therapist or another specialist.