Breast Cancer is a devastating diagnosis to get. Fortunately for modern medicine, the survival rate for breast cancer patients has significantly increased. In the Hong Kong private sector we are in a privileged group to have immediate access to treatment that improves the prognosis. The shortcoming of the Hong Kong private medical sector is that in many cases the patients are not treated in a multidisciplinary team. As this is a complex diagnosis with both emotional and physical health implications, it should be treated holistically to ensure the best outcome of the patient. 

Often the time from being diagnosed with a breast tumour and having surgery to remove the tumour and breast tissue, called a mastectomy is very short. As a patient you are required to make dramatic choices of what is available to you.The choices are to have the removal and let the scar tissue heal or have reconstruction at the same time. If you agree to reconstruction you have a choice of TRAM flap and implants. 

Removal of the breast has a pyschosocial affect on the patient with regards to self perception, body image and sexual well being.  These issues will affect the emotional state of the patient while battling the health issues of the disease. 

Most women are happy with either TRAM flap reconstruction or reconstruction with an implant. 

Both have a risk of side effects. TRAM flap removes part of your abdominal muscle that stabilizes and supports the back, while implants have a risk of capsular contracture. 

A multi disciplinary after care of patients going through the mastectomy is important. It is important to find the right team to help you get the best results. You will need:

A Surgeon: Performs the therapy and helps you decide on the risks and which outcome is best suited to you.

An Oncologist: Decides on a regime of chemotherapy and radiotherapy if necessary 

Physiotherapist: Helps to mobilize the arm, mobilize the scar tissue, reduce swelling, improve circulation, start gentle exercises when appropriate, educate you on lymphedema and lymphedema massage

Counselor or Psychologist: Help to work through the stages of bereavement to acceptance. Help to manage the family and expectations and anxieties

Occupational therapist: Provide compression clothing to reduce the risk of lymphedema which can occur to up to 5 year or more after mastectomy