When a woman loses her breast to cancer, it’s a sign of disease that cannot be hidden. Still, choosing breast reconstructive surgery can be a difficult decision.
“When breast cancer patients who must have mastectomies consider reconstruction surgery, they wonder whether it will delay chemotherapy or radiation treatments. They worry that complications such as an infection might interfere with their treatment,” says Jayant Agarwal, MD, assistant professor in the Division of Plastic Surgery at the University of Utah School of Medicine and a Huntsman Cancer Institute (HCI) investigator. He is also a member of HCI’s multidisciplinary breast cancer group. In an article which he co-authored, published by The Breast Journal in July 2010, Agarwal reported results that allay those fears.
Analyzing outcomes for more than 5,000 breast cancer patients from various regions of the United States, Agarwal and his colleagues found no risk to survival from reconstruction after mastectomy. In fact, overall survival in patients who chose breast reconstruction was significantly higher than in patients who did not.
Agarwal’s research ideas grew from working with HCI patients. “From personal observation rather than strict scientific investigation, it appeared to me that quality of life improves in patients who’ve had reconstruction."
Agarwal and his colleagues, including Saundra Buys, MD, medical director of HCI’s High Risk Breast Cancer Clinic, used information from the Surveillance, Epidemiology, and End Results (SEER) cancer database at the National Cancer Institute (NCI). A national study such as Agarwal’s can help create broad changes because it examines a large number of patients from a wide range of age and demographic groups. Agarwal offers the hope that the results of his study will help provide a firm factual basis for discussing breast reconstruction with cancer patients—not just at HCI, but for doctors across the nation.
Also, data from this and similar studies will encourage HCI and other NCI-designated institutions, among the nation’s leaders in cancer research, to conduct prospective studies to find out more about how reconstruction and survival relate to each other. “This study revealed the statistics, and now we need to go deeper to find the reasons,” says Agarwal.
Since this study was published, Agarwal and colleagues have continued looking at the effects of reconstructive breast surgery on patients. One study looks into the relationship of the surgery to breast cancer survival by narrowing the focus to patients who died specifically from breast cancer as opposed to other conditions such as diabetes or heart disease to make sure that the higher survival rate holds true. Another study looks specifically at the relationship of reconstructive surgery to distress and depression, two important quality-of-life issues.
“Breast reconstruction is really part of the comprehensive care of breast cancer patients,” says Agarwal. “At HCI, reconstructive breast surgery is well integrated into the efforts of the breast multidisciplinary team, and this makes communications, outcomes, and overall patient care that much better.”
Million-Dollar Donation Funds Cleone Peterson Eccles Center for Breast Health
In October 2010, the George S. and Dolores Doré Eccles Foundation donated $1 million to Huntsman Cancer Institute (HCI) for completion of the Cleone Peterson Eccles Center for Breast Health. The center will be located in the expanded hospital at HCI, due to open in late 2011.
Leigh Neumayer, MD
“For our patients, the Center for Breast Health will place all breast diagnostic and clinical facilities in the same area,” says Leigh Neumayer, MD, co-director of HCI’s multidisciplinary breast program. “Our patients will no longer need to go to a different part of the hospital for follow-up mammograms and ultrasounds.
“Breast cancer radiologists will work in close proximity with oncologists and surgeons so on-the-spot consultations among members of the cancer care team will be much easier,” she adds. The center will also expand on HCI’s current mammography, ultrasound, and stereotactic biopsy equipment while increasing the number of exam rooms for clinic appointments.
“This generous gift in honor of Mrs. Eccles will provide a more convenient and beautiful location to provide the breast care services for which HCI is known—risk evaluation and reduction, early detection, and treatment of breast cancer,” says Saundra Buys, MD, the multidisciplinary breast program’s other co-director. “It will now be easier to provide the compassionate care that helps ease patient fears.”