Regaining breasts lost to breast cancer - Breast reconstruction surgery at Tobu Hospital
March 26, 2019 News
Regaining breasts lost to breast cancer - Breast reconstruction surgery at Tobu Hospital
Breast cancer surgery can cause you to lose breast swelling.
"Breast reconstruction" is another operation to recreate a new breast that has been lost or deformed during breast cancer surgery.
Tobu Hospital in, mammary gland Surgery after the surgeon has performed the surgery for breast cancer, forming Surgery physician (Masuda Clinic: director Masuda Ryuji) is clean as much as possible scar, bearing in mind that less noticeable in charge of the breast reconstruction surgery I will.
Breast reconstruction methods can be divided into "primary reconstruction", which is performed at the same time as breast cancer surgery, and "secondary reconstruction," which is performed after a certain period of time after breast cancer surgery, depending on the timing of surgery.
The number of operations is "one-stage reconstruction", which completes reconstruction in one operation, and "second-stage reconstruction," in which a tissue expander (skin expander) is first inserted, the chest skin is stretched, and then reconstruction is completed. There are two types, "reconstruction".
This hospital is an accredited facility of the Japan Breast Oncoplastic Surgery Society, andunder the coverage of health insurance, you can undergo primary and secondary reconstruction with an Allergan expander and primary and primary reconstruction with implants.
Timing of Breast Reconstruction
Performed at the same time as breast cancer surgery [Primary reconstruction]
| Primary primary reconstruction | Silicone implant is inserted at the same time as breast cancer resection and completed in one operation |
|---|---|
| Primary and secondary reconstruction | At the same time as breast cancer resection, a tissue expander (TE: tissue expander) is inserted, and at a later date, TE is replaced with a silicon implant at the partner Masuda Clinic to complete the procedure. |
| Advantages | ・ No feeling of breast loss ・ Short hospital stay ・ In the primary and secondary reconstruction, there is time to ponder the reconstruction method while inserting the expander. |
| Disadvantages | In primary and primary reconstruction, there is no time to ponder the reconstruction method |
Performed after a certain period of time after breast cancer surgery [Secondary reconstruction] * Not performed at this hospital
| Secondary primary reconstruction | Reconstruction completed in one operation the day after breast cancer resection |
|---|---|
| Secondary second phase reconstruction | Completed by inserting TE at a later date after breast cancer resection and replacing TE with implants and autologous tissue at a later date |
| Advantages | ・ You can concentrate on the treatment of breast cancer ・ There is time to ponder information gathering and reconstruction methods ・ Reconstruction can be performed at a different facility from breast cancer surgery. |
| Disadvantages | ・ Frequent surgery (at least 2 times) ・ Inpatient surgery costs will increase |
Breast reconstruction surgery methods
Surgery can be broadly divided into autologous tissue reconstruction, in which the tissue of one's body is transplanted, and implant reconstruction, in which an artificial object made of silicon or the like is inserted.
Reconstruction of self-organization
A method of transplanting adipose tissue from the abdomen or back into the breast. It is suitable for those who do not want to use artificial materials, those who have a relatively large breast when using an abdominal flap, and those who do not have a relatively large breast when using a back flap. This method is not implemented at this hospital.
Implant reconstruction
It is a method of inserting a silicone artificial breast (implant) and is generally used in combination with a tissue expander that stretches the skin and muscles of the chest. Since it is an artificial material, it is a little hard and lacks warmth, but it does not burden the body, and the operation time and hospitalization period are short. It is not suitable for those who have a history of radiation therapy at the reconstructed site or who have a high possibility of postoperative treatment.
Basic flow of breast cancer treatment
Note) Insurance coverage for reconstruction after conservative surgery is limited to cases where cancer is left behind, lymph node metastasis, or recurrence is found. * This flowchart shows the basic flow of breast cancer treatment. Depending on the patient, preoperative / postoperative therapy may be added.
Health insurance covers breast reconstruction
High-cost medical treatment system is also available
In July 2013, some breast reconstruction procedures using implants were covered by insurance, lowering the hurdles for patients to bear the costs. The following is an estimate of the cost of performing mastectomy (without axillary dissection) and reconstructive surgery using implants at our hospital.
Those over 70 years old
| Target person | Medical expenses burden | High-cost medical treatment system | Actual window burden | |
| Active income earners | Taxable income of 6.9 million yen or more | About 240,000 yen | → | About 240,000 yen (Not covered by the high-cost medical treatment system) |
| Taxable income of 3.8 million yen or more | About 170,000 yen | |||
| Taxable income of 1.45 million yen or more | About 86,000 yen | |||
| General | Taxable income of 1.45 million yen or less | 20% burden Approximately 160,000 yen 10% burden Approximately 80,000 yen |
→ | 57,600 yen |
| Low-income earners | Resident tax exemption (low income II) | 24,600 yen | ||
| Resident tax exemption (low income I) | 15,000 yen | |||
Those under 70 years old
| Target person | Medical expenses burden | High-cost medical treatment system | Actual window burden | |
| Annual income of about 11.6 million yen or more | About 240,000 yen | → | About 240,000 yen (Not covered by the high-cost medical treatment system) |
|
| Annual income of about 7.7 million yen to 11.6 million yen | About 170,000 yen | |||
| Annual income of about 3.7 million yen to 7.7 million yen | About 86,000 yen | |||
| Annual income of about 3.7 million yen or less | 57,600 yen | |||
| Resident tax exemption | 35,400 yen | |||
* 1 Low-income earners II
All household members are (1) tax exempt from municipal inhabitants tax, or (2) people requiring nursing care under the Public Assistance Act.
Persons who do not need protection due to reduction of Ceiling Amount of self payment and Dietary Standard Obligation Fee.
* 2 Low-income earners I
All household members fall under "Low Income earners II" and their household income is below a certain standard.
Message from Dr. Nishitani
 Chief Breast Surgeon Shin Nishiya |
Breast cancer surgery results in physical changes such as loss of the breast and deformation, which affects the quality of life of patients. While completely curing cancer is of course important, there has been a great deal of interest in maintaining breast cosmetic appearance in recent years. |
Masuda Clinic Surgery: Message from Dr. Masuda
 Masuda Clinic Plastic Surgery/Dermatology Ryuji Masuda |
My name is Masuda, and I work at Masuda Clinic Plastic Surgery and Dermatology. I opened a clinic in Kohoku-ku, Yokohama City in 2014 that offers same-day surgery. I have been involved in breast reconstruction since before I opened my clinic, and even after opening my clinic, I have continued to perform reconstructive surgery to help breast cancer patients. |