Understanding Your Breast Understanding Your Breast Reconstruction Options:Reconstruction Options:

Pedicled FlapsPedicled Flaps

Frederick J. Duffy, Jr. M.D., F.A.C.S.Frederick J. Duffy, Jr. M.D., F.A.C.S.Clinical Assistant ProfessorClinical Assistant Professor

UT-Southwestern Medical SchoolUT-Southwestern Medical SchoolDallas, TexasDallas, Texas

LBBC C4YMLBBC C4YMFebruary 22, 2014February 22, 2014

22 year old african-american college 22 year old african-american college student with newly diagnosed breast student with newly diagnosed breast cancercancer

Prior history of HodgkinPrior history of Hodgkin’’s Diseases Disease Factors: college, eventual children, Factors: college, eventual children,

sexuality, scarssexuality, scars Chose tissue expander, eventual Chose tissue expander, eventual

latissimus flaplatissimus flap

The real world…The real world…

Even more complicated…Even more complicated…

40 year old diagnosed with breast 40 year old diagnosed with breast cancer early in her second trimester cancer early in her second trimester of pregnancyof pregnancy

Chose to remain pregnant…received Chose to remain pregnant…received taxol through pregnancy and taxol through pregnancy and eventual mastectomyeventual mastectomy

Subsequent prophylactic Subsequent prophylactic contralateral mastectomy and contralateral mastectomy and bilateral DIEP flaps bilateral DIEP flaps

Breast CA in Younger WomenBreast CA in Younger WomenWhy is the battle tougher?Why is the battle tougher?

Less informationLess information Less same age peer supportLess same age peer support Concerns about sexuality, fertility, Concerns about sexuality, fertility,

family, career are greatly heightenedfamily, career are greatly heightened

QuestionsQuestions

Should I reconstruct my breast?Should I reconstruct my breast? Am I a candidate?Am I a candidate? When (immediate or delayed)?When (immediate or delayed)? How many operations will be needed?How many operations will be needed? Will I need surgery on the other breast?Will I need surgery on the other breast? Will breast reconstruction impact on the Will breast reconstruction impact on the

ability to detect recurrent or other ability to detect recurrent or other cancers?cancers?

Reconstructive options Reconstructive options

TRAM FlapTRAM Flap

Latissimus FlapLatissimus Flap

Latissimus FlapLatissimus Flap

My AdviceMy Advice

Stay informed…you are your own best Stay informed…you are your own best advocateadvocate

Ask to see patient photos and talk with a Ask to see patient photos and talk with a patient who has had the procedure you patient who has had the procedure you are consideringare considering

Choose a surgeon who can offer you Choose a surgeon who can offer you allall the optionsthe options

I believe it is important for each patient to I believe it is important for each patient to feel comfortable with their surgeon…trust feel comfortable with their surgeon…trust your instincts!your instincts!

ResourcesResources

www.texaspsa.comwww.texaspsa.com

www.dallasbreastreconstruction.comwww.dallasbreastreconstruction.com

drduffy@texaspsa.comdrduffy@texaspsa.com

drmckane@texaspsa.com drmckane@texaspsa.com