Surgical hope for breast cancer women

Reconstruction is an important part of surgery

British surgeons are learning new techniques to meet the psychological needs of breast cancer patients.

A new breed of surgeons skilled in both removing tumours and plastic surgery is being trained by the Royal College of Surgeons.

It should mean more women with breast cancer can benefit from natural looking surgery using the latest techniques.

It's a reasonable expectation for patients that they want to have as good a cosmetic outcome from the breast cancer surgery as possible

Tim Davidson, consultant breast surgeon

One patient said it helped her maintain her sense of femininity and lessened the sense of loss and grieving associated with breast cancer.

In the past, breast cancer surgery has focused on the removal of tumours regardless of the cosmetic effect.

This meant many women wearing inserts in their bra or suffering the psychological stigma of lop-sided breasts.

"We are now in an age when patients' expectations are much greater," said Tim Davidson, consultant breast surgeon at the Royal Free Hospital in Hampstead, London.

"It's a reasonable expectation for patients that they want to have as good a cosmetic outcome from the breast cancer surgery as possible."

Taboo

Cosmetic considerations are now an integral part of breast cancer treatment, he said.

"In years gone by there was always a great taboo about someone who had a mastectomy because it meant they had an asymmetry problem," he told BBC News Online.

"With modern reconstruction techniques, patients have a very close symmetry between the two breasts and avoid the need for wearing a prosthesis inside their bra."

Rebuilding the breast is no longer the preserve of the plastic surgeon, with a new specialism arising, known as oncoplasty.

The Royal College of Surgeons has been running training courses in the discipline for both breast surgeons and plastic surgeons for two years.

The Department of Health now funds ten new oncoplastic surgeon posts in England.

But some women are still missing out on the latest surgical techniques.

"Around 10% of women undergoing a mastectomy have immediate breast reconstruction, but unmet demand in women under 65 for reconstruction lies anywhere between 50 and 70%," said Mr Dick Rainsbury of the Royal Hampshire County Hospital in Winchester.

The problem is often a geographical one as not every breast cancer unit provides a breast reconstruction service.

Sometimes patients have to undergo surgery in one hospital and be referred to another to have the breast rebuilt.

"As we go through this training process, more and more breast surgeons are accomplished in breast reconstruction either immediate or delayed and that demand will increasingly be met," said Mr Davidson.