Not all mastectomies are created equal. In fact, there’s a new one available, dubbed the Goldilocks mastectomy, that could simplify the mastectomy and reconstruction process for some patients.
Instead of having a mastectomy and then a reconstruction, the procedure offers another option to people with breast cancer. (Reconstructions can involve more than one surgery.)
Atlanta-based physicians Dr. Grace Ma, a plastic surgeon, and Dr. Heather Richardson, a breast surgeon, created the procedure, which reconstructs a breast mound from cutaneous mastectomy flap tissue and eliminates the need for additional flap or implant techniques.
The procedure isn’t amputation of the breast, nor is it a full reconstruction. During the surgery, all the breast tissue is removed and the remaining redundant skin and tissue are used to reconstruct the breast. The new breast is usually smaller than the original.
It can be performed on one or both breasts, and does not require any additional surgeries. There are no implants or devices used in the procedure.
The surgical removal of the breast gland under the skin means that no screening mammograms are required, and most patients will not need radiation (depending on the type or stage of cancer).
It also means less pain and a shorter recovery time compared with a traditional breast reconstruction.
The name came from, well, the tale of Goldilocks. The technique incorporates the simplicity of not having reconstruction and only having a single surgery with as little discomfort and down time as possible. Yet it preserves as much of the patient as possible. This third option is somewhere in the middle. Or, as Goldilocks said, "Just right."
Richardson and Ma acknowledge that formal reconstruction can take a toll on the body. It requires recreation of fullness where the breast used to be by adding artificial material, such as an implant, or by moving tissue from somewhere else in the body. As a result, the donor site may be tighter or weaker from missing tissue or muscle that was removed. Not to mention that the site is at risk for infection. And some candidates just may not be able to medically handle longer procedures.
"While removing the breast tissue entirely without reconstruction is a simpler option, very few women are eager to have 'nothing' where a breast used to be," they said in a statement.
Ideally, a doctor decides. Generally, patients with extremely large breasts or sagging breasts have the best outcome. People with smaller breasts may not be candidates.
Dr. Judy Boughey, a breast surgeon at the Mayo Clinic, said more women are choosing mastectomies because doctors are willing to spare some skin and their nipples.
This isn’t the only advancement in breast cancer removal and reconstruction. Researchers are looking into a new way to destroy tumors by freezing them with a probe through the skin — something known as cryoablation.
That could give patients another alternative to the Goldilocks surgery and all similar procedures. Who knows? Maybe there could be a fairy-tale ending with all the new developments in this field.
The surgeons will present information on the procedure this May at a meeting of the American Association of Breast Surgeons.
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