When diagnosed with breast cancer, it's crucial that women are given the information they need to select the treatment option that's right for them. Too often, women feel pressured, afraid and ill-informed.
Lumpectomy vs. Mastectomy? Take Time to Make the Decision
When a woman is diagnosed with breast cancer, it is a huge shock, and naturally it feels like an emergency: She wants to get rid of the cancer as soon as possible and improve her chances of survival. But, in most cases the emphasis should be firmly on achieving the right outcome from a woman's treatment, which requires that she take some time to understand her options.
Long-term Breast Surgery Outcomes
Expanding on patient choice and how women need to be as well informed as possible, let's think about mastectomy. For some women there is no choice but to have one, but nowadays there are lots of options: a straightforward mastectomy, mastectomy with immediate reconstruction, or with delayed reconstruction. Most women don't know about this and they need time to understand the differences and think about what they want. Women worry that discussing aesthetics is about vanity; this is not the case-- it is part of the long-term outcomes.
There is a lot of emphasis these days on survivorship, and the right decision at the beginning of your treatment will ensure you feel much better at the end-- and for the rest of your life
How are medical teams helping women become better informed? At UCLH for example, with leading breast surgeon Jo Frank's team, if you are given a breast cancer diagnosis and treatment options you are never asked to decide at that point. You have an appointment with a clinical nurse specialist, look at photographs, feel implants and silicone breast forms, ask questions about the procedures, and then-- when you are ready-- you give your consent at a subsequent meeting with your breast surgeon.
Some women also have longer to think about their options because their treatment starts not with surgery but with pre-operative chemotherapy or drugs to shrink their tumor, which could make it possible for them to have breast-conserving surgery rather than mastectomy.
Girl Talk: A Pre-surgery Support Group for Breast Cancer
At UCLH's regional plastics unit they run a 'Show and Tell' session where women come together and talk about their experience of breast cancer, show their reconstructions and allow others to feel them. Women who are about to have treatment get so much out of these groups, and it shows how confident patients can feel after surgery. No surgeons attend the sessions though-- it's not about what the surgeons think about breast surgery, it's what the women themselves think.
Breast Cancer Support and Care in London
University College London Hospital is a designated centre for young women (up to age 24) with breast cancer, with extra support service facilities and a multi-disciplinary team. You also have The Haven in London-- a wonderful breast cancer charity with several UK centres and Future Dreams whose mission is to open a Future Dreams House in London to provide emotional and physical support and therapies to improve the life of anyone affected by breast cancer.
In 2019 the lease on the building that currently houses The Haven in London will expire, and Future Dreams House will be the new--more central--home to The Haven, providing a lifeline to women and their families who have been diagnosed with breast cancer, those who are undergoing treatment, coping with the issue of survivorship or tackling the devastating news that they have had a relapse. The focus is on providing women with support away from the medical environment and giving them the tools to cope with their diagnosis and with life after treatment.
Facing Breast Cancer Prepared: It helps to know what's available
When you undergo a mastectomy without reconstruction it is important to remember there is specially designed mastectomy lingerie, pocketed swimwear and breast prostheses that mean you can do everything you did before, and no-one will ever know. Partial breast shapers and the right lingerie can also help with asymmetry in the case of reconstruction.
The thing is, if you haven't had to face breast cancer before, you would have no idea what's out there. Knowledge is power.
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