Partial Mastectomy An Option For Some Patients

By Ronni Gordon - Beth Israel Deaconess Medical Center correspondent

After a mammogram in 2009 revealed that Marybeth Chung had a tumor in her right breast, she was relieved to learn that it was benign but worried that surgery would leave her looking different on each side.

"I thought it would leave me somewhat disfigured, and that did make me anxious," said the 40-year-old lawyer, who lives in Dover with her husband and their two children, ages 4 and 6.

Chung had a type of breast disease called fibroadenoma, with a painful lump that grew to more than four centimeters.

Her surgeon at the BreastCare Center at Beth Israel Deaconess Medical Center, Dr. Ranjna Sharma, shared her concern about the aesthetic outcome and suggested Chung consult with a plastic surgeon.

That's where Beth Israel Deaconess plastic surgeon Dr. Samuel J. Lin made a difference.

After Dr. Sharma finished removing some of the tissue around the lump, Dr. Lin stepped in and reconstructed the breast using Chung's own tissue.

"I'm so glad they gave me this option," Chung said. "The outcome was amazing. My breast looks the same as it did before the surgery.  Because of the reconstruction, I have been able to put my experience with breast disease completely behind me.  I don't think about it all."

While it is probably harder for women who have had cancer to put the experience behind them, reconstruction after a lumpectomy or partial mastectomy stands a good chance of improving their outlook.

"This is about making the patient whole again," Dr. Lin said. He wants more women to know about the options that he believes fill a need. "Patients don't realize this is available."

According to Dr. Lin, the term "partial mastectomy" applies to a continuum of surgeries starting with a lumpectomy.

In a lumpectomy, the surgeon removes only the breast lump and some normal tissue around it. If there is cancer at the edge (called the margin) of the piece of tissue that was removed, the surgeon may need to go back and take out more tissue. Radiation treatment is usually given after this type of surgery.

With a partial mastectomy, the surgeon removes more of the breast tissue than in a lumpectomy (up to one-quarter of the breast). It is usually followed by radiation therapy.

Dr. Lin says that reconstruction after this kind of surgery is being done at specific centers around the country – including Beth Israel Deaconess – and more are joining those ranks.

"In the past, this technique has been popularly termed oncoplastic reconstruction," he noted. "It's the concept of using available local tissue – fat and skin – to reconstruct breast defects."

According to Dr. Lin, the technique employs an array of procedures, either using the existing breast tissue to reconstruct a defect, or from transferring fat and skin from the armpit area or the latissimus muscle (a muscle in the back). In some cases, patients who need to have a lumpectomy and would also benefit from a breast reduction have that option as well.

Dr. Lin calls the decision on whether to have reconstruction a "very individual process."

"I see patients who have had a varying amounts of breast tissue removed who are concerned about reconstructing the area," he says. "Much of what we do as plastic and reconstructive surgeons is about improving a patient's quality of life.  It is very rewarding to restore a patient's sense of their own as a whole person."

If you would like to make an appointment at the BreastCare Center at BIDMC, please call 617-667-2900.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.