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29 March 2024

‘Reconstruction’ surgery is no longer a luxury

Published
By Majorie van Leijen

Breast reconstruction is more and more becoming a part of breast cancer treatment.  Although cancer treatment is primarily about survival, a logical second step is that of recovery. And for many women this means recovery of the full body.

"I wanted the breast cancer to have as little impact on my life as possible," tells Linda Berlot, an Italian 44-year-old who was diagnosed with breast cancer last year. Fortunately, the cancer was detected on time and she survived the disease. However, she lost both her breasts.

"I had the chance to do the breast reconstruction right after the treatment. I did not hesitate and took the chance immediately. I wanted to become as normal as possible, as quickly as possible."

Dr. Francisco de Melo has been at the forefront of breast reconstruction surgery. Having treated hundreds of breast cancer patients in his home country Portugal, he has now shifted his efforts to Dubai.

According to the surgeon, breast reconstruction should be considered part of the breast cancer treatment. "As breast reconstruction is not life-saving and it is cost-demanding, institutions often consider it as a luxury. But it is not anymore.

"Diagnosis of breast cancer is earlier and earlier, technologies have improved and life expectancy is much longer for people diagnosed with cancer. Cancer can be cured."

The realization that there are good chances to survive breast cancer has resulted in a new mentality towards its recovery, believes the surgeon. "Not only can cancer be cured. People can retain their lives."

Retaining life after breast cancer is experienced differently from woman to woman. Whereas some women choose to live in peace with the absence of breasts, others cannot imagine living without.

"I am from Brazil and I like to wear nice clothes and feel good about myself. I am very grateful that I had the opportunity to get my breasts back. It contributed to my well-being," tells Roberta Rees, who recovered from breast cancer a couple of years ago.

The loss of one or more breasts can be traumatic for a woman, thinks Dr. de Melo. "It may influence the intimate life of a woman. The partner very often plays a role in the decision-making. There are cases where the loss results in divorce."

Nevertheless breast reconstruction has come a long way, he explains.

"For the past 20-25 years we have been trying to put in people's minds that reconstruction is part of the breast cancer treatment. Nowadays we work together with all doctors involved. This enables us to plan the procedure much better. In case of chemotherapy the reconstruction can take place immediately, but when radio therapy is required the surgery needs to be postponed."

Including breast reconstruction as part of the cancer treatment has financial implications too, as general plastic surgery is usually not included in the basic insurance package. As part of the cancer treatment, the choice to reconstruct does not need to depend on financial logic.

"I was very grateful that my insurance company covered the costs of this treatment. It would have taken me many years to have it done without this coverage," says Roberta.

"I believe it should be covered. It is part of the recovery."

“At Daman we take the breast reconstruction surgery as a vital part of a mastectomy procedure for those with breast cancer,” says Dr. Alfons Grabosch, health support manager at the national health insurance company Daman.

“We believe it has a tremendous positive effect on the patient’s emotional well-being and self-esteem, especially that the psychological aspect is believed to contribute greatly towards the healing process.

“The definition of ‘health’ from the World Health Organization confirms this, where they define health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

"Removal of the breasts has a real impact on a woman," agrees Linda.

"But reconstruction is a highly individual decision. It is not just about looking good."It is about feeling good. This feeling can differ from person to person. For me the appearance is important, but that might not be the case for everybody. It is important to feel as good as possible after having experienced cancer.