A survey conducted in the main Italian breast units reveals the doubts of women who have undergone a mastectomy and fears of returning to the hospital. Oncoplasty operations performed together with the removal of the tumor are privileged
Should I go back to the hospital for breast reconstruction? My axillary lymph nodes swollen after the vaccine, what does this mean ?. Better to get the third dose of the vaccine or the flu shot ?. There are many doubts about women who have been affected by breast cancer and who have undergone a mastectomy. In the terrible year of the pandemic, breast reconstruction operations decreased by 5 percent and doubts and fears grew enormously. The 75 specialists in plastic surgery, breast surgery and psycho-oncology belonging to the main Italian Breast Units participating in the Donnaxdonna project (an awareness initiative on breast reconstruction after cancer coordinated by the Beautiful After Breast Cancer Italia Onlus association) have collected the concerns of their patients in a volume (available in the main Italian breast units and browsable on the website www.beautifulafterbreastcancer.it) and monitored the activities in the thirteen breast units among the most important in northern, central and southern Italy.
The operations
In 2020, total breast reconstructions slowed down compared to 2019: they were in fact 2,935, with a decrease of 157 fewer operations (- 5%). They increased for immediate reconstructions, that is performed together with the removal of the tumor and with the use of prostheses: 1129, compared to 980 interventions in 2019 (+ 15.2%) while the immediate ones with the insertion of temporary expanders are were 1130 compared to 1402 in 2019 (-19%) and those with the use of 135 tissue flaps, almost similar to those of 2019 which were 134. In the same year, mastectomies without breast reconstruction increased, passing from 805 to 826 in 2020 (+ 2.6%) and deferred breast reconstruction operations, i.e. performed after tumor removal, also decreased: 541 operations in 2020 compared to 576 operations in 2019 (-6%). Conservative surgery has also decreased, requiring minor remodeling following partial removal of the gland for smaller tumors (first level oncoplasty) or more complex breast remodeling with cancer that includes healthy breast surgery for symmetry ( second level oncoplasty). The cases of level 1 oncoplasty have in fact increased from 2551 cases to 2462 in 2020 (-3.5%) and second-level oncoplasty operations from 437 in 2019 to 362 in 2020 (decrease of more than 17%). The operating rooms of many hospitals have not stopped. We have favored oncological cases by postponing benign tumors, as indicated by the European guidelines, explains Marzia Salgarello, president of the Beautiful After Breast Cancer Italia Onlus (Babc) association, director of the plastic surgery department of the A. Gemelli University Hospital Foundation in Rome. Immediate breast reconstruction techniques were favored, the only type to record an increase in interventions in 2020. It is considered the gold standard for patients who need a mastectomy and whose benefits far exceed those of the same surgery performed at a later time. With the arrival of Covid we were able to sharpen our wits and refine this type of technique by positioning the prosthesis over the pectoral muscle in such a way as to achieve better results, reduce hospitalization times and post-operative discomfort.
October 9, 2021 (change October 9, 2021 | 19:54)
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