As founder and Executive Director of Facing Our Risk of Cancer Empowered (FORCE), the only national non-profit dedicated to improving the lives of individuals and families affected by hereditary breast and ovarian cancer, I speak with many women who are at high risk for breast cancer and who are considering risk-reducing surgery. I have also met many women who are delighted with their aesthetic outcomes after preventive mastectomy and breast reconstruction by the compassionate and skilled surgeons at the New York Group for Plastic Surgery. I was honored when Dr. Salzberg invited me to write a guest blog.
About 2.3 million women in the U.S. may be at increased risk for breast and ovarian cancer because of their family history. An estimated 940,000 people in the U.S. carry a BRCA1 or BRCA2 gene mutation, which can be inherited from either mother or father. Women with a mutation in either gene have up to an 85% lifetime risk for breast cancer, and up to a 50% lifetime risk for ovarian cancer.
These women have several options to manage their high risk for breast cancer, including increased surveillance, medications, and prophylactic bilateral mastectomy—the removal of healthy breasts. The decision to move forward with risk-reducing mastectomy, with or without reconstruction, is very personal and can be difficult. Women who are at high risk for breast cancer and who are considering risk-reducing mastectomy usually have time to consult with genetics experts to understand their risk, meet with surgeons to explore their options, and do research to determine which option is right for them.
In my 14 years of working in advocacy, I have seen new advances in mastectomy and reconstruction that have improved cosmetic outcomes, reduced operative and healing time, and reduced discomfort. Research on the safety of nipple- and areola-sparing mastectomy has led to more natural-looking reconstructed breasts and to more high-risk women considering mastectomy for risk-management based on these improved outcomes.
One advance in reconstruction in the last decade is Direct-to-Implant or “One-Step” surgery that was pioneered by Dr. Salzberg at the New York Group for Plastic Surgery. This method allows women who are undergoing reconstruction with implants to forego the discomfort of tissue expansion and complete their reconstruction in one surgery. Dr. Salzberg and his partner, have performed this “one-step” surgery for hundreds of women from across the country, and have taught the procedure to other surgeons so that more women have access to this procedure. These surgeries enable many high-risk women who would not otherwise have elected a preventive mastectomy to proceed with surgery.
Given the many choices for mastectomy and reconstruction, it makes sense for women to do their research and explore all their options before moving forward with surgery. Depending on their priorities, timeline, and desired outcomes, some women elect to travel to another city or state to have a particular type of surgery or see a particular surgeon. Fortunately there are great resources to help women with their decision making, including the outstanding resource, The Breast Reconstruction Guidebook by Kathy Steligo; the gallery of post-mastectomy photos on the FORCE website; and Show & Tell, the FORCE photo book that features positive and powerful images of post-mastectomy bodies. All these resources provide women with the tools to make the best decision that is right for them.
Dr. Salzberg has been an invaluable part of the high-risk breast cancer community for many years, and they share FORCE’s commitment to educating high-risk women about the options of reconstructive breast surgery. FORCE is honoring Dr. Salzberg is part of our national “Superheroes” fundraising campaign to support research, education, and advocacy for people with hereditary breast, ovarian, and other cancers.
I am thankful to the New York Group for Plastic Surgery for supporting FORCE in our mission to educate women and improve lives. They are generously kicking off their Heroes campaign with a donation of $2,500. I hope that grateful patients and supporters of Dr. Salzberg will consider donating to FORCE in their names by going to the FORCE Superheroes link on this website’s homepage, or going directly to http://www.firstgiving.com/fundraiser/salzberg-koch/heroes.
For more information or support for hereditary cancers,
please visit the FORCE website (http://www.facingourrisk.org/index.php).