Angelina Jolie recently went public about her decision to undergo a preventative double mastectomy with hopes of helping women at risk and empowering those who are uncertain on which path to take.
Dr Moradi (who works as a reconstructive surgeon at the Breast Care Institute (BCI) at Westmead hospital and Royal Hospital for Women) urges women who are considering preventative mastectomy to understand that most breast cancers are survivable, and all woman are candidates for breast reconstruction. If you have the luxury, take your time in coming to a decision. Remember, knowledge is power: before you remove a breast, be sure you are fully informed and have discussed every reconstructive option with your surgeon.
In his work at the Royal Hospital for Women and BCI Westmead, Dr Moradi deals with many gene positive women but also a large percentage of high-risk women that undergo mastectomy and reconstruction. These women, like Angelina, are in the best situation because they won't need radiotherapy so their reconstructive options become easy.
According to Dr Moradi, Jolie would most likely have had an infra-mammary crease incision to perform a nipple sparing mastectomy with biological lower pole mesh and tissue expanders placed. They would have then inflated her tissue expanders over several weeks to her desired size and then changed over to permanent silicone implants. Jolie says "It is reassuring that [my kids] see nothing that makes them uncomfortable. They can see my small scars and that's it. Everything else is just Mommy, the same as she always was."
When embarking on their breast reconstruction journey, a patient needs to be treated holistically in a multidisciplinary clinic that specialises in all aspects of the patient's care, not just the operation. These clinics have specialist breast care nurses, oncologists, radiotherapists, cancer surgeons, physiotherapists and reconstructive surgeons all focusing their resources to ensure the best outcome for the patient.
According to Dr Moradi, women who are considering the procedure as a preventative method should be seen in a cancer multidisciplinary clinic so they understand all the options available to them. In every case, Dr Moradi's goals for breast reconstruction are to provide women with renewed confidence by giving them better breasts after cancer than they had before.