In 2012, cancer deaths worldwide flared to a staggering 8.2 million, up by 11 percent in five years. The biggest spike in the cancer death toll was due to breast cancer, according to “GLOBOCAN 2012”, the report by the World Health Organization’s International Agency for Research (IARC), which covers 28 cancer forms in 184 countries. Breast cancer fatalities reached as many as 522,000, increasing by as much as 14 percent from 2008 to 2012. It is the top cause of death among women globally.
What has been causing this dramatic increase? A change in lifestyle, says David Forman, head of the IARC Section of Cancer Information. “A shift in lifestyles is causing an increase in incidence, and partly because clinical advances to combat the disease are not reaching women living in these regions.” The lifestyles of the more cancer-prone countries—more industrialized nations, “leads to a rising burden of cancers associated with reproductive, dietary, and hormonal risk factors.”
For developing or less-developed countries, the rate of cancer deaths is higher because their tumors are not detected, diagnosed and treated early enough, adds Christopher Wild, IARC director. These deaths accounted for as much as 65 percent in new cancer cases in 2012.
Last year, Angelina Jolie made headlines when she revealed her ordeal and the tough choice she faced regarding her mastectomy. Having a family history of cancer, Angelina underwent a preventive double mastectomy which happened in phases for several months.
What has also got the web buzzing were Angelina’s choices regarding breast reconstruction. People are curious as to what they are to do after the surgery – can things be brought back to the way they were before? If not, how much closer to normal can life be like? What are plastic surgeons capable of restoring?
To get a clearer picture of the situation, we interviewed Dr. Benjamin G. Herbosa, MD, FPSGS, FPCS, FPAPRAS, FICS, FACS, FIPRAS, a diplomate of the Philippine Board of Surgery and also a diplomate of the Philippine Board of Plastic Surgery.
Smart Parenting: Can post mastectomy breast reconstruction be done here in the Philippines? What are the surgical procedures that doctors can perform?
Dr. Benny Herbosa: Of course, that is what we've been doing.. We can make something close to what the original breasts were like, but they will never be exactly the same. Since there are many options in breast reconstruction, we definitely can restore volume, size and shape, although they will be a bit less accurate, in terms of how the original pair of breasts looked.
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We can also do autogenous (using the patient’s own tissue to repair the damage done by the mastectomy) or non-autogenous procedures like implants, as well as large volume fat tissue transfers and/or transplantation.
SP: Is it possible to save the breast tissue or nipples after a mastectomy? If not, is it possible to reconstruct them? Can breasts be reconstructed to look as they were before or even better?
BH: Nipple sparing can be done depending on the breast cancer stage (for early stage and small lesions) and breast cancer type. We use skate flaps or free nipple transfers from the opposite breast (both are forms of tissue grafting). We also use full thickness skin grafts from other parts of the body that are designed to look like nipples. Breasts can be molded and shaped to look better if not larger.