Using abdominal fat tissue to reconstruct breasts after breast cancer surgery

Ms. Hoai had a benign tumor 10 years ago. Recently, a new tumor the size of a finger appeared and had surgery to remove the tumor at a clinic. A week later, she went to Tam Anh General Hospital in Ho Chi Minh City for examination. Doctor Huynh Ba Tan, Department of Breast – Head, Face and Neck Surgery, diagnosed Ms. Hoai with stage 1 breast cancer and prescribed a mastectomy. remove cancer, reconstruct the chest with a rectus abdominis muscle flap to help soften the chest.

The team of doctors from the Department of Breast – Head, Face and Neck Surgery injected a blue substance into the areola, then made an incision near the right armpit, took the blue-stained lymph node and the tissue behind the nipple and sent it for biopsy. During that time, the team continued to cut the right mammary gland and remove the right rectus abdominis muscle skin flap. The doctor created a tunnel from the abdomen to the right chest, threading the skin of muscle and abdominal fat onto the chest wall.

Immediate pathology results showed that the sentinel lymph nodes and retromammary tissue had no malignant cells. The surgical team decided to only remove the internal mammary gland, keep all the skin and nipples, and perform breast reconstruction with a rectus abdominis skin flap. After surgery, Ms. Hoai had her cancer cells removed and her breasts were fully reconstructed.

According to Dr. Tan, diagnosing a benign or malignant breast tumor requires a complete trio of clinical examination, imaging (ultrasound, mammography…) and pathology (biopsy). If we only rely on examination and ultrasound, it is difficult to detect cancers that appear in the form of microcalcifications or non-mass forms, and it is easy to miss cancerous tumors.

Depending on whether the tumor is benign or malignant, doctors have different treatment methods and surgical techniques. People with benign tumors have no symptoms of pain, are small in size, and may not need treatment. In cases where surgery is needed, the doctor will only remove the tumor. All malignant tumors, regardless of size, require treatment. Depending on the size of the tumor and stage of the disease, the doctor will remove the tumor and 1-2 cm of surrounding benign tissue or remove the entire breast.

Breast cancer treatment does not stop at removing tumors or mammary glands, but also ensures aesthetics for women. Breast reconstruction must meet both cancer safety and aesthetic requirements and not hinder supportive treatment (chemotherapy, radiotherapy…) and follow-up afterward.

There are currently two main techniques for breast reconstruction: reconstruction with breast implants and reconstruction with autologous tissue (rectus abdominis flap, latissimus dorsi flap…). Some cases may combine both. Breast reconstruction with the rectus abdominis skin flap is more difficult and requires a surgeon with a lot of experience and expertise.

Breast cancer patients detected early have a good chance of being cured and having their breasts reconstructed. Dr. Ba Tan recommends that women over 40 years old have breast cancer screening every year. Women in the high risk group for breast cancer (family history, BRCA gene mutations…) should be examined at an earlier age (before age 40). In a family where the mother has breast cancer, the daughter should be screened for cancer as early as 10 years old compared to the age at which the mother discovered cancer.