Breast Reconstruction: Upon Diagnosis… Michael J Bass, MD, JD www.drmichaeljbass.com 859-543-1024.

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Presentation transcript:

Breast Reconstruction: Upon Diagnosis… Michael J Bass, MD, JD

Disclosures None I need some

Support Provided By Lifecell – AlloDerm – Strattice

Lecture Layout Dr. Michael Bass – state of breast cancer in the U.S., preoperative analysis, timing of care Dr. Monica Hall – implant-based versus autologous breast reconstruction Dr. Theresa LeVan – autologous fat grafting breast reconstruction Dr. Michael Bass – satisfaction surveys and outcomes analysis

Part 1 Layout Incidence of breast cancer Trends in breast cancer Risk by age Preoperative assessment Preoperative considerations

Incidence of Breast Cancer CDC 2008: 210,203 breast cancer diagnoses – 40,589 deaths White > Black > Hispanic > Asian > American Indian Kentucky: :100,000, third quartile among states

Diagnosis Trends in U.S.: Decreased by 1.2% per year among white women. Remained level among black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander women. nds.htm

Mortality Trend in U.S.: Decreased by 2.0% per year among women overall by: – 2.1% per year among white women – 1.4% per year among black women – 1.5% per year among Hispanic women Remained level among American Indian/Alaska Native women and Asian/Pacific Islander women.

Risk by age Expected Survival Before Diagnosis 10 Years20 Years30 Years Current Age

Preoperative Analysis Color – skin and nipple areolar complex (NAC) Breast shape Ptosis of NAC and breast tissue Volume

Preoperative Analysis Patient measurements – BMI – Height – Weight – Suprasternal notch to nipple, clavicle to nipple, nipple to inframammary fold, breast base diameter

Preoperative Analysis

Preoperative Considerations Type of breast cancer – DCIS, Invasive Ductal, Lobular, Medullary, Tubular, Mucinous (Colloid) Neoadjuvant chemotherapy Radiation What treatments have been started

When To See A Plastic Surgeon Immediately after the diagnosis is made Patients gain comfort in reconstructive counseling Photos, biometric analysis, and coordinating care with other physicians from the very beginning Women’s Health and Cancer Rights Act of 1998 (29 U.S.C. 1185)