Ask almost any woman what her life was like for the first few days after hearing the words “you have breast cancer” and most will acknowledge a certain degree of chaos. An enormous amount of serious information needs to be understood and processed, much of which only exacerbates the emotional roller coaster. Fear, uncertainty, and confusion are a few of the emotions women have to sort through, while making some very important decisions, quickly.
Even though it takes days, weeks and sometimes months to know exactly how she wants to proceed after receiving a breast cancer diagnosis, all too often a woman finds herself surrounded by a team of health care providers — from oncologists to breast surgeons to social workers — who want to “map out a plan” right away. According to at least one advocacy group, too often women are not informed about the choices they have for breast reconstruction post mastectomy, the final step to restoration for these women.
How the BRAVE Coalition Campaign Began
Around five years ago, healthcare professional and breast reconstruction advocate Christine Grogan founded BRAVE — The Breast Cancer Restoration Advocacy and Education Coalition. The group seeks to inform women facing breast cancer of their reconstructive options following mastectomy. In the whirlwind following a diagnosis, too often women are inundated by the information necessary to vanquish the disease, but not so about their options following mastectomy. To help women understand not only the power of breast reconstruction on their post-cancer mental well-being, but also that the operation can be even done at the time of mastectomy or shortly thereafter, covered by insurance, Grogan started BRAVE.
“It’s really about getting awareness out there that women should get a plastic surgeon, a board certified plastic surgeon, at their time of diagnosis,” Grogan told The Plastic Surgery Channel. “It was depressing to learn about how many women had no idea what, where or when board certified plastic surgeons would be available to help them get through their breast cancer campaigns.”
It’s been 10 years since her diagnosis, but Katie Holmes remembers the phone call as if she just had hung up from it.
“From the moment you get the call that you have cancer, you don’t think of life beyond cancer,” shares Holmes, the Executive Director at BRAVE. “You think of the moment, that you want it removed and actually start making final plans for your life, get things in order.”
Today, with the benefit of hindsight and knowing much more about what women with breast cancer have available to them, Holmes wonders how much her life might be different today.
“I look back on those days and those 48 hours to make a decision, there’s a lot of confusion and distress,” she explains. “If you don’t know the information regarding breast restoration and what your options are before, it’s just too much to process in those moments.”
Reconstructing Breasts with Aesthetics in Mind
There is a curious notion surrounding the femininity of women who have undergone breast cancer and requisite mastectomy. A perception exists that these women paid for their defeat of cancer with their breasts. In some ways it may even be a sign of power; the missing breasts representing the battle the warrior woman waged and won over cancer. The vacancy on their chests may seem a testament, and some survivors even get elaborate tattoos to cover where their breasts once were. What few know is women after mastectomy can have their breasts, femininity and former selves restored through breast reconstruction.
Dr. Robert Whitfield is a board certified plastic surgeon in Austin. While his practice covers a full spectrum of plastic and aesthetic procedures, he considers breast reconstruction, notably those at the time of or shortly after a mastectomy, a special part of his practice. The appeal for Whitfield is to create an aesthetic breast reconstruction, or utilize all of plastic surgery’s latest technologies and techniques to give a woman post-mastectomy beautiful and natural breasts again. Behind the procedure is the idea that no woman should have to live on without her breasts, and they’re going to look and make her feel great.
Through a combination of techniques, Dr. Whitfield is able to treat a post-mastectomy patient not unlike a typical breast augmentation patient. Measurements will be made, 3D imaging utilized, and a long-form discussion will be had to select the right implants, decide to not use implants in favor of a patient’s own tissue, or a bit of both.
“A woman unfortunately develops breast cancer, has a mastectomy, and may need both breasts removed – bilateral mastectomies. She is by far the easiest patient for me to get size, shape, symmetry and projection,” Dr. Whitfield explains. “I can use a moderate to larger size implant to give them a better size, shape, symmetry and projection almost as if they had a desire to have a breast enhancement procedure with their reconstruction.”
The process can also help keep women on top of their diagnosis. Going through a consultation regarding her new breasts is an experience that provides hope; the future beyond the disease is being discussed, planned, and ordered, so that when she is on the other side, she’s whole.
Know Your Rights
While it is a law that insurance carriers cover breast restoration following surgery, a majority of women are never given this option. The Women’s Health and Cancer Rights Act (WHCRA) was enacted in 1998 and it requires insurance plans that cover a mastectomy to also cover breast reconstruction up to four months after mastectomy surgery. This important mandate gave women choices without undue financial burden. Even so, 20 years later and most women don’t know about it.
BRAVE and surgeons like Dr. Whitfield are doing what they can to change that.