Making decisions

After breast surgery, you may choose to live with your new body shape, wear a prosthesis or have a breast reconstruction. It is a good idea to discuss the different options with your breast surgeon when you are considering a mastectomy. Sometimes it is difficult to decide what you want. You may feel that everything is happening too fast, or you might be anxious to get started.

Know your options – Understanding the available options, possible complications and costs can help you weigh up the options and make a well-informed  decision. You don’t necessarily have to choose between the options – you may start off with a prosthesis, then decide later to have a breast reconstruction.

Keep in mind that not all options are suitable for all women. Many women can have a reconstruction, but there are some situations where your surgeon may advise against it. This might be due to the type of breast cancer or treatment you had, because you need further treatment for the cancer or due to your general health. Talk to your doctor about what is possible for you.

Record the details – When your doctor talks to you about breast surgery and reconstruction options you may not remember everything you are told. Taking notes can help, or you might like to ask if you can record the discussion. It is a good idea to have a family member or friend go with you to appointments to join in the
discussion, write notes or simply listen.

Ask questions – If you are confused or want to check anything, it is important to ask your breast surgeon, breast care nurse and prosthesis fitter questions. To help you understand the different types of surgery and prostheses that are available. This will help you think through the information you need to make your decision.

Consider a second opinion – You may want to get a second opinion from another breast surgeon or plastic surgeon to confirm or clarify your specialist’s recommendations or reassure you that you have explored all your options. Specialists are used to people doing this. Your general practitioner (GP) or specialist can refer you to another specialist and send your initial results to that person. If you decide on a breast reconstruction, you can then decide which surgeon you would prefer.

It’s your decision – Choosing to wear a breast prosthesis or have a breast reconstruction is a personal choice. Although it’s useful to talk to other people, try not to feel pressured into a decision based on what they think. You also have the right to accept or refuse any of the reconstruction options offered to you.

BRECONDA is an online breast reconstruction decision aid that has been developed specifically to help guide you through the decision-making process about whether breast reconstruction is the right choice for you.

You can call Cancer Council 13 11 20 and ask to speak with a Cancer Connect volunteer who has had a breast reconstruction or wears a prosthesis. Your breast care nurse or counsellor can also help you think through the issues.

What to consider when deciding on a breast prosthesis or reconstruction

• Take time to understand what a prosthesis or reconstruction involves so your expectations of the end result are realistic.
• Talk with your breast surgeon about the best time to have the procedure. You may choose to have a reconstruction at the time of your mastectomy or some time in the future.
• If you decide to have a delayed reconstruction or not to have a reconstruction at all, you can choose to use a breast prosthesis to create the look of a natural breast.
• If you decide not to have a reconstruction, talk to your surgeon about how your chest will look after the surgery and where the scars will be.
• If you are referred to a reconstructive surgeon, ask to see photos of their work and to talk to some of their previous patients.
• If you are offered more than one type of reconstruction, you will need to weigh up the benefits and drawbacks of each. Consider the impact of the side effects and the length of recovery. If only one type of reconstruction is recommended, ask your doctor to explain why other options have not been offered.
• If you live in a regional or rural area, your breast prosthesis or reconstruction options may be limited. For more options, you may consider travelling to a major city centre.
• If you have a partner, you may want to talk about the options with them and ask them to come to appointments. You can also talk to friends, family or other women who have had a similar experience to you.