The scars from a mastectomy are not only physical but emotional. And the American Society of Plastic Surgeons said 70 percent of breast cancer patients who are eligible are not informed of their options. One option is donated human tissue.

It can now allow many survivors to move on physically and mentally. The sweet sounds of the violin helped Donna Bramante Indelicato get through one of the roughest times of her life. A recurrence of breast cancer forced her to have a double mastectomy.

"It was devastating. I felt like a primal part of who I am as a woman had been removed," Bramante Indelicato said.

She wanted reconstructive surgery. Doctors ruled it out because she lacked the tissue needed to hold an implant in place.

"It just reminded me over and over again of my cancer," she said.

After more than four years she found another option -- surgeons used a material made up of donated human skin. They sewed it to surrounding muscle and the chest wall to hold the implant in place.

"Actually create a pocket around the implant, so we can keep that implant on the woman's chest where it belongs," said Dr. Amy S. Colwell, a plastic surgeon at Massachusetts General Hospital in Boston.

The tissue matrix acts as a frame for new tissue to grow on and around.

"Your body incorporates it. You have blood vessels in your dermis, in your skin, that if there's a collagen matrix there, it will invade it and it will become part of your body," Colwell said.

Study results show this technique can be safely used in certain patients immediately after a mastectomy, which could eliminate the need for a second surgery.

"It brings tears to my eyes, but my daughter said, 'Mom, you look like all the rest of the moms now,'" said Bramante Indelicato.

There is some risk the implanted material will be rejected by the body.

BACKGROUND: Over 254,000 women in the United States face breast cancer each year, according to the American Cancer Society. Surgery is usually the first line of attack against the cancer. Thanks to advances in surgery, women now have the option of surgery that removes only part of the breast tissue, which is referred to as breast conservation surgery, lumpectomy or segmental mastectomy. Some cases still require a mastectomy to achieve the best results. Many women who undergo a mastectomy choose to have reconstructive surgery to rebuild the shape and look of the breast. Breast reconstruction is done by a plastic surgeon.

Some breast reconstructions can be performed at the same time as the mastectomy. An advantage to this approach is that chest tissues are not damaged by radiation therapy or scarring, and the final result ends up looking better. Delayed breast reconstruction is a better choice for some women who need radiation to the chest area after surgery, since radiation therapy after reconstruction surgery can lead to complications.

The American Society of Plastic Surgeons recommends patients seeking breast reconstruction look for a physician who:

Has completed at least five years of surgical training with a minimum of two years in plastic surgery

Is trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction

Operates only in accredited medical facilities

Adheres to a strict code of ethics

Fulfills continuing medical education requirements

Is board certified by The American Board of Plastic Surgery

NEW OPTIONS: While there are many options for breast reconstruction, including saline-filled implants and tissue flap procedures -- which involve using tissue from other areas of the body -- some women don't have enough tissue left in the chest after surgery to hold heavy implants or tissue transplants in place. Doctors are now using synthetic mesh and other methods to solve the problem. Recently, doctors have started using a product made of donated human skin called AlloDerm for this purpose. Regulated by the FDA, the tissue matrix helps extend and support natural tissues to hold implants in place. Since human cells are removed from AlloDerm before it is used, the risk of disease and rejection by the body is very low, experts say.

Additional Information:
Valerie Wencis
Public Relations
Massachusetts General Hospital
vwencis@partners.org
http://www.breastreconstructionmatters.com