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Breast Reconstruction Northwest Spokane, WA

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Plastic Surgery Northwest’s board-certified plastic surgeons have trained and worked at some of the most prominent plastic surgery centers in the country.

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Breast Cancer Surgical Treatments

Breast cancer is one of the most common forms of cancer in the United States. Approximately 1 in 8 women in the United States (12%) will develop invasive breast cancer over the course of her lifetime (see www.breastcancer.org). There are many ways to treat breast cancer, and the conversation about your treatment may include discussion of chemotherapy before or after surgical treatment, and radiation. When considering surgical treatment of the disease, however, the two options for treatment of the breast are mastectomy and lumpectomy. Learn more from the breast reconstruction specialists in Spokane, WA, at Plastic Surgery Northwest.


Mastectomies are performed to remove all of the breast tissue, including your tumor. Lumpectomies remove only the tumor and a small amount of surrounding normal breast tissue. Lumpectomies are always followed by radiation to eradicate any residual cancer cells. The breast surgical oncologist often recommends one of these two options to the patient, but sometimes either option is available. After mastectomy, breast reconstruction may be performed in multiple steps, encompassing 3-4 procedures over approximately one year. The stages consist of:

  1. Building the breast mound to restore the volume of a breast on your chest
  2. Revising the reconstructed breast for improved contour and procedures to improve symmetry between your breasts
  3. Building the papule of the nipple
  4. Tattooing the areola

There are two ways to build the breast mound: implant-based and tissue-based.


Lumpectomy, the removal of a tumor with a small amount of surrounding normal breast tissue, is the other form of surgical breast cancer treatment. This is sometimes called “breast conserving therapy.” After lumpectomy, the breast is treated with radiation to eradicate any residual cancer cells. Although treatment with lumpectomy and radiation does not remove all breast tissue, this treatment may result in changes to the breast appearance. These changes are most noticeable in women with smaller breasts, or tumors that are large in comparison to the volume of the breast.  Large tumors or lumpectomies in small breasts result in significant distortion of the breast or deformities. Unfortunately, radiation therapy changes the breast’s ability to heal from future surgical endeavors and can limit the reconstructive options available if a patient has a poor aesthetic outcome.

Plastic surgeons can reduce the risk of a poor aesthetic outcome by rearranging the breast tissue after lumpectomy to fill the resulting hole in the breast.  This procedure is known as (breast) parenchymal rearrangement.  The parenchymal rearrangement is typically performed 5-10 days after the lumpectomy, in order to allow pathologists to determine that the entire tumor has been removed before reconstruction is undertaken.  It is common for a patient to undergo a breast lift or reduction to their healthy breast to preserve symmetry after parenchymal rearrangement is undertaken.  This procedure on the healthy breast may be performed at the same time as the parenchymal rearrangement or after radiation is complete, depending on the specific medical and social issues in each person’s case.

Recurrence of Cancer or Cancer of the Opposite Breast

Recurrence of breast cancer is rare.  However, if it occurs, the options for reconstruction are impacted by the treatment choices that were made for the original cancer treatment.  There is also a risk of breast cancer occurring in the opposite breast.  This risk is typically low, often thought to be less than 0.5% per year for many patients.  The options for reconstruction of the opposite breast are also influenced by the original treatment decision.

It is common to require radiation for treatment of a recurrence.  Radiation increases the risk of capsular contracture (hardening of breast tissues) if a breast was reconstructed using an implant.

If a patient has previously undergone lumpectomy and radiation, mastectomy will be required for treatment of a recurrence and reconstruction typically involves bringing in tissue from non-radiated areas of the body due to the poor healing capacity and inability to stretch of the previously radiated skin.

If a DIEP or other abdominal tissue flap was previously used for breast reconstruction, the surgeon may not use the lower abdomen again for this purpose because the blood vessels from this area may only be used one time.
In each case, the plastic surgeon will discuss options for treatment with you before settling on the choice that best meets your needs and goals.  Do not hesitate to ask questions during or after your visit.

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Implant-Based Breast Reconstruction >

Tissue-Based Breast Reconstruction >

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