The Complete Guide to Breast Cancer Awareness, Prevention, and Reconstruction

October is Breast Cancer Awareness Month and at Barrett Plastic Surgery, we’re as dedicated to being an information resource as we are to helping survivors reclaim their pre-cancer physiques.

Not only do Dr. Barrett’s breast reconstruction surgeries produce natural-looking results, he has also met with top experts in his field to get answers to all your breast cancer-related questions. Whether you’re interested in prevention techniques or have gone through recovery and are ready to get your curves back, we’ve got something here for you.

You probably already know that a healthy lifestyle is one of the top ways to reduce your risk of cancer. The following is a no-brainer, but we’ll say it anyway: exercise vigorously for more than 150 minutes a week, spend less time sitting, eat more of a plant-based diet and consume less red meat. Smoking–even second-hand–can increase your risk factors dramatically, as can excessive alcohol, according to Dr. Janie Grumley, director of the Margie Peterson Breast Cancer Center at Providence St. John’s, in Santa Monica.

It’s also important to give yourself monthly breast self-exams. Unfortunately, says Dr. Grumley, everybody remembers the method taught by those hanging shower cards of old. Almost everything feels like a lump when you do those tiny circles, so it’s important not to panic. The time to call your doctor is if you notice a lump or other breast change that is new and worrisome, especially if it lasts more than one full menstrual cycle or seems to get bigger or more prominent.

You’ll also want to get yearly mammograms beginning at the age of 40. If you have a family history of early-onset breast cancer, you will likely need to get mammograms before that point; follow the advice of your doctor. If you’re over 35 and seeking a breast augmentation at Barrett Plastic Surgery, Dr. Barrett will request a mammogram so that you have a baseline for comparison in the future, even if you’re not considered high-risk.

The advent of cheap and easy DNA tests–like 23andMe–has made it easier for people to determine if they carry the BRCA gene that can lead to early-onset and more aggressive types of breast cancer. Dr. Grumley warns that it’s a mistake to view a negative result as a “get out of jail free” card, however, if you have a family history of breast cancer. “These inexpensive tests don’t do the full workup of all the mutations of the gene,” she says. If you’re in this situation, seek the advice of a genetic counselor just to cover all your bases.

So in summary, you can decrease your risk of a cancer diagnosis by:

• Exercising for 30 minutes a day, 5 days a week
• Being less sedentary
• Eating more plant-based foods
• Eating fewer animal products
• Doing a monthly breast self-exam
• Getting yearly mammograms, beginning at age 40 (earlier if you’re high-risk)

Getting a second opinion if your genetic testing kit shows a negative for the BRCA gene–if you have a family history of breast cancer.

What To Do If You Find a Lump

If you find a lump during your self-exam, the best doctor to call is one who has done a breast exam on you before, like your gynecologist, primary care physician or a nurse practitioner in their office. It may take some time to get an appointment and then an additional few weeks to order imaging. While it’s tempting to panic during this “hurry up and wait” period, it’s helpful to remember that cancer doesn’t change overnight. You have time to do your homework or get a second opinion.

For those folks living near Los Angeles, we want you to know about a terrific option available to you if or when you find a worrisome lump. The Breast Health Clinic at the Margie Peterson Breast Center is basically an Urgent Care for breasts. You don’t need a referral from your primary care doctor; you can simply pick up the phone, call 310-582-7100, and say, “Hey, I have a breast lump, I’d like to be seen.” While you’re there, be sure to have them show you the right way to do a breast self-exam.

To hear more about the latest news in breast cancer from Dr. Barrett’s interview with Dr. Grumley, check out Podcast Episode #16 Urgent Care For Breasts: It’s A Thing!

Options for Reconstructive Surgery

Dr. Barrett understands that the journey to recovery for his breast cancer survivors is a long and challenging road. His goal is to help patients restore their feminine curves in a way that best suits their body type and personal aesthetic goals. Dr. Barrett will take as much time as necessary to assess your reasons for surgery, the results you hope to achieve and your current stage of recovery, in order to create a customized surgical plan. Following are the three reconstruction options he’ll help you choose from.

Implants

Silicone or saline implants are most frequently used for breast augmentation surgeries to create a fuller and perkier breast. They come in a range of shapes and sizes, so they are highly customizable. Implants are a terrific option for women who have undergone a double mastectomy, as they can help to create a symmetrical shape and a balanced overall appearance. Dr. Barrett may also recommend implants for women who don’t have enough body tissue for a tissue transfer reconstruction.

The benefits of implants include:

• Predictable, reliable outcomes
• Breast symmetry
• Being easily customizable
• Low risk of complications
• Relatively short recovery time
• Long-lasting results

Autologous Tissue Transfer

The tissue transfer process involves using natural tissue from an area of your body where there is excess fat and attaching it to your breast area in order to restore volume. The donor site for the tissue is typically the abdomen, thighs or buttocks. This procedure is incredibly effective for creating breasts that look and feel like they belong to your body. They will age with the rest of you and they come with a low risk of complications.

With a tissue transfer reconstruction, you can enjoy:

• Completely natural results
• Real body tissue instead of synthetic substances
• Low risk of complications
• Low maintenance

Fat Grafting

This procedure is often used in combination with the other two, to provide a more sculpted look while still appearing natural. As with the tissue transfer, the process uses excess fat from another region of the body, but fat grafting involves injecting small amounts of tissue into targeted, localized areas. Using fat grafting in combination with either implants or tissue transfer allows Dr. Barrett to essentially “fine-tune” your results to your exact tastes.

Will Insurance Cover It?

Whether your reconstruction is performed immediately after your mastectomy, or years down the road, your health plan should cover it. The 1998 Women’s Health and Cancer Rights Act requires all health plans that pay for mastectomies to also cover prostheses and reconstructive procedures. Medicare covers breast reconstruction, but Medicaid coverage varies from state to state, and you can always call our office at 310-598-2648 if you’re unsure.

As far as maintenance goes, insurance also covers procedures that may be needed later in order to revise and refine your reconstructed breasts.

Do Implants Cause Breast Cancer?

In 2019, a class-action lawsuit was filed against a company that makes textured silicone implants due to links between their implants and the development of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). This t-cell lymphoma, which develops in the capsule around textured implants, is very rare (1 in 3,000) and is decidedly not breast cancer. Just to be on the safe side, however, their implants were recalled and most breast augmentation procedures these days utilize smooth implants, rather than textured.

In Dr. Grumley’s experience, “Breast implants themselves have not been shown to cause breast cancer. But [they] can make it harder for us to detect. [They] obscure a lot of the breast tissue that we really want to have a good look at. And that makes it very hard for us to…decipher.”

To further elaborate on the subject, Dr. Barrett brought in Dr. Ritu Chopra, a fellow board-certified plastic surgeon who has been doing research with Allergan for years to determine the safety risks of their implants. In Podcast Episode #8 Dr. Ritu Chopra Talks Safety, Dr. Chopra and Dr. Barrett answer all your questions about Breast Implant-Associated Illness and Breast Implant-Associated Anaplastic Large Cell Lymphoma.

2020 has been a powerful reminder that we are all in this together. By raising awareness through education and transparency, Barrett Plastic Surgery is committed to being a safe place for women–and men–to get the answers and care that they need. Don’t know where to start? Schedule a virtual consultation and get all your questions answered at DrDanielBarrett.com/virtual-consultation.

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