Prevention
Modern medicine is increasingly transitioning towards preventive care. This shift towards prevention has also been observed in breast cancer care in recent years, particularly with the discovery of the BRCA gene. Subsequently, multiple genes and risk factors have been identified. Depending on these factors, a personalized screening strategy can be chosen. Therefore, it is crucial to understand these genetic and risk factors.
Diagnosis
I was diagnosed with cancer ... This website serves as a portal designed to assist you and your loved ones in accessing personal information and finding solutions to your concerns.
The primary goal of this website is to offer guidance and support to patients as they navigate their journey toward recovery and improved quality of life. The "Diagnosis" section of our website is divided into two main categories. Firstly, under "Anatomy and Physiology," we provide fundamental knowledge about the breast. Secondly, in the "Tumors and Disorders" section, we delve deeper into various breast-related conditions.
Moreover, we aim to provide information to women who may be concerned about potential breast issues but are hesitant to seek immediate medical advice. Knowledge and information can often offer immediate reassurance if a woman is able to identify the issue herself and determine that no specific treatment is necessary. Conversely, we also strive to educate women who have received a diagnosis of a serious breast condition, such as breast cancer, and wish to approach their doctor well-informed and prepared.
Treatment
The treatment for breast cancer should immediately include a discussion about reconstruction. Our foundation has no greater goal than to raise awareness of this among patients and oncological surgeons. By making an informed decision beforehand, we avoid closing off options for later reconstruction while still considering the oncological aspect. Of course, survival is paramount, and the decision of the oncologic surgeon will always take precedence.
The "Reconstruction or not?" page contains all the information you can expect during an initial consultation before undergoing tumor removal. This page is comprehensive, and your plastic surgeon will only provide information relevant to your situation.
"Removing the tumor" details the surgical procedure itself. This is the most crucial operation because effective tumor removal remains paramount. We guide you through the various methods of removal, a decision often made by a multidisciplinary team comprising oncologists, radiologists, pathologists, radiotherapists, breast nurses, gynecologists, oncological surgeons, and plastic surgeons.
The "Breast Reconstruction" section includes information and illustrations of the different reconstruction options along with corresponding steps.
Revalidation
Those treated for cancer often need a long period to recover.
Cancer is a radical illness with a heavy treatment. Often, people have to deal with psychosocial and/or physical problems afterwards, such as stress, anxiety, extreme fatigue, painful joints, reduced fitness, lymphedema... This can have a major impact on general well-being.
There are rehabilitation programmes offered by most hospitals. We cover some of the major topics here.
Quality of life
Quality of life is a key factor in coping with breast cancer. Therefore, it is important to find coping mechanisms that work, which will be different from patient to patient. For some, it may be finding enjoyment in activities they engaged in prior to diagnosis, taking time for appreciating life and expressing gratitude, volunteering, physical exercise... Of prime importance, studies have shown that accepting the disease as a part of one’s life is a key to effective coping, as well as focusing on mental strength to allow the patient to move on with life. In this section we are addressing some topics that patients experience during and after treatment and we are providing information to address them.
Nipple Problems
Bi/trilobed nipple
In this condition the nipple forms in two or three parts instead of just one. Under local anaesthetic, the two or three parts can be released and brought together as one. There is some scarring and the resultant nipple can feel quite rough until this settles. Postoperatively the nipple is protected from pressure for 3-4 weeks.
 |
 |
| Fig. 1 | Fig. 2 |
 |
|
| Fig. 3 | |
Fig1: a trilobed nipple before correction.
Fig.2: a bilobed nipple before correction.
Fig.3: same bilobed nipple after correction.
Small or inverted nipple
An inverted nipple is one that lies flat or below the surface of the skin. It is caused by tightness in the ducts or surrounding fibrous tissue. In some cases, erection still causes the nipple to protrude, in more severe cases it does not. This condition would normally happen during puberty. Where the nipple goes from being normal to retracting, it is essential to establish that this is not being caused by a breast cancer. A mammogram may be requested prior to surgery.
The treatment has two components. The first brings the nipple back to its normal position. A small incision between the nipple and areola allows access to the ducts which can be loosened. If this is not enough, some of the ducts can be cut. The second stage aims to keep the nipple out while the scar tissue forms. The Niplette suction device may prove useful. A nipple piercing may be unacceptable in some social circles, but can be extremely useful in keeping the nipple out. It can be discarded after 1 to 2 years.
After surgery the nipple must be protected from pressure for 3-4 weeks. Scarring is minimal.
 |
 |
| Fig. A | Fig. B |
 |
 |
| Fig. C | Fig. D |
Figure: An inverted nipple (a, b) can be brought out and held in place by a nipple piercing (c, d).
Oversized areola and nipple
This a purely cosmetic problem and opinions vary greatly as to what is the ideal size. There are variations between races and the only guide is what looks right for the individual. Approximately, for a Caucasian woman, an areola should be between 3.5 and 5.5cm.
Treatment can be performed under local anaesthetic. A doughnut of excess areola is removed. The resulting scar is very subtle as it is hidden along the edge of the areola. Healing takes approximately 2 weeks.
Hypertrophic nipple
Overly developed Montgomery tubercle (areola bumps)
In this condition, the pigmented sebaceous glands around the nipple can become dark or prominent. They can be removed surgically, but it is better not to be overly aggressive in their treatment.
Montgomery tubercles (arrow)
