事件记录
Dr. 琼斯: 毁容,肢解. These are words that are the way some women feel after mastectomy, 乳腺癌的大范围手术. What can we offer women who have had this surgery, to help them recover their self-image?
乳腺癌诊断后的不同选择
Dr. 琼斯: About a quarter of a million women will be diagnosed with invasive breast cancer in the US this year. 有些人会选择规模较小的手术 乳房肿瘤切除术, 但 many will choose a larger surgery in their hope for a cure. And the percent of women choosing mastectomy is increasing. Al虽然 we're grateful for the treatments that can cure breast cancer, mastectomy can leave a woman and her body image profoundly changed. 范围's Seven Domains of Women's Health team is in the office. 我 Dr. 阿加瓦尔, a breast reconstructive surgeon at the Huntsman Cancer Institute, and we're going to talk about 乳房再造手术. 所以,博士. 阿加瓦尔，跟大发娱乐说说你的训练吧. How is it different from a breast cancer surgeon, the person who did the mastectomy?
Dr. 阿加沃: Well, I'm a plastic and reconstructive surgeon so my role is to try and rebuild. After a patient undergoes a mastectomy by the breast cancer surgeon, I work with the patient to try and then rebuild the breast. 这可以是身体的任何部位. As a reconstructive surgeon, our goal is to try and restore form and function for a patient.
乳房切除术后的乳房重建
Dr. 琼斯: Can you do the reconstruction at the time of the mastectomy, or are there advantages of doing it immediately versus delayed?
Dr. 阿加沃: 你可以在那个时候做重建. 大发娱乐经常, 事实上, 同时开始重建过程, in the same operative setting as the mastectomy surgery. 有时, it's a staged operation in which the first stage is started at the time of mastectomy and then the subsequent stages occur in the future. And sometimes, you can complete the entire reconstruction all in one setting.
There are advantages and disadvantages to doing it all at once. Some patients like the idea of just having one operation or, 至少, having one operation where the majority of the surgery is done. Some patients like waking up from the operating room with the start of a creation of a breast, 而不是一觉醒来胸膛平坦. The downsides are it does add surgery time and does add 复苏 time to the operation, 但, 在一般情况下, we're starting to see an increase in the number of patients that are having reconstruction that is initiated at the time of mastectomy.
Dr. 琼斯: 正确的. So women actually use to think of reconstruction as something that came to them six months or a year later when they felt like they were cured of their cancer and they were really ready to go on with the next step of their life. But now 我认为 women are expecting to walk out knowing that they're going to feel a little bit more like themselves.
Dr. 阿加沃: 我认为这是真的. 我认为, 在过去, reconstructive surgery was often considered something that was not part of the cancer care process of a patient. 今天, reconstructive surgery and the role of a reconstructive surgeon are really integral into the entire comprehensive care of a cancer patient.
乳房再造新技术
Dr. 琼斯: 正确的. 所以大发娱乐的新组织，新材料改变了什么?
Dr. 阿加沃: The types of surgeries we do and the technologies that we have have improved. We don't quite have the 3D printing of a breast down yet, 虽然大发娱乐可能在不久的将来到达那里. 但是质量, 植入物, 植入材料, and the ability to use 组织s from different parts of the body has really improved dramatically over the past 15 years.
Dr. 琼斯: So we're using some of the woman's own 组织s for some of the breast, 还有一些植入物, 或组合?
Dr. 阿加沃: 两个场景. 所以病人可以 植入物 只是,他们 组织 only, or a combination of implant and their own 组织. And that sort of depends on their body, their choices, and what may be the best option. And that often requires a discussion with their surgeon.
单和. 双乳房切除
Dr. 琼斯: 好吧，老实说，博士. 阿加瓦尔, 作为一个女人, 我个人对乳房切除术的恐惧, 有或没有重建手术, 会是不对称的吗, that I'd have one normal breast and one plastic breast, 我就会失去平衡. 我觉得我的胸脯已经出卖了我, and I wouldn't want to have breast cancer in the other breast. So I might ask you as if I were your patient to just do them both, 所以做吧, 当大发娱乐结束时, 它们可以看起来一样，也可以是一样的. 你收到更多的请求了吗? 这听起来是不是很疯狂？?
Dr. 阿加沃: 这并不疯狂. In fact, we're getting an increasing number of requests for bilateral mastectomy and reconstructions. 这是一个非常个人的选择, 这不是每个女人都会做的选择, 这不是一个容易的选择. 我认为有很多因素在起作用. 到目前为止，恐惧是最大的因素. 就像你说的那样, patients are worried that they might develop cancer in their other breast, or they're always going to be nervous and can't sleep at night and so they want to be free of that fear. And that's a real consideration when we consider doing a bilateral mastectomy.
我会说, 虽然, 就像任何手术一样, 你要做好准备，你做的手术越多, 恢复得越多, 就越有可能出现问题. So think carefully, talk to your surgeon, talk to your family before you make these decisions.
Dr. 琼斯: Fears of cancer and fears of disfigurement may lead women to avoid 乳房x光检查 或者在发现肿块时寻求医疗大发娱乐. There are many more options for women as they face the challenges of breast cancer, 和挑战, 还有乳腺癌治疗后的生活. Dr. 阿加瓦尔, 感谢你的大发娱乐，并考虑大发娱乐的选择, 感谢您加入大发娱乐的视野栏目.
更新日期：2021年6月17日
最初发布日期：2015年10月22日