UW Health Breast Center Offers Mastectomy, Reconstruction in One Procedure

Dr. Samuel O. Poore, UW Health Breast CenterMadison, Wisconsin - A surgical innovation now being offered at the UW Health Breast Center offers women with early-stage breast cancer further options of having immediate breast reconstruction following mastectomy.


The operation, called Deep Inferior Epigastric Perforator (DIEP) flap reconstruction, combines breast removal and reconstruction into one surgery. It uses microsurgery and the patient's own abdominal tissue to reconstruct the breast while sparing the abdominal musculature unlike other traditional methods of breast reconstruction.


"Nine months ago, I was struggling with a recurrence of ductal breast cancer," said Kim Hoffmann, one of the first patients to undergo DIEP flap reconstruction at UW Hospital. "Now I'm attending boot camp and feeling better than ever."


Hoffmann said she chose DIEP flap reconstruction because it is a muscle-sparing surgery.


Three surgeons are involved in the procedure. One surgeon removes the cancerous breast and leaves a skin envelope. Two other surgeons remove tissue from the abdomen and then reconstruct the breast using the abdominal tissue.

"DIEP flap reconstruction works very well and is at lower risk for complications compared to implant reconstruction because the patient’s own tissue is used," said Dr. Samuel Poore, one of the two UW Health plastic surgeons who work together on microsurgical breast reconstruction.


Poore and Dr. Ahmed Afifi work side by side to remove abdominal tissue and use microsurgery techniques to locate a two-millimeter artery that supplies blood to the tissue. The tissue is then transferred to the chest to reconstruct the breast. The artery is connected to one in the chest to provide blood flow to the new breast tissue.


"On one hand, the surgery is challenging and can last up to 20 hours," said Dr. Lee Wilke, surgeon and medical director of the UW Health Breast Center. "On the other hand, DIEP flap reconstruction can provide a better long-term outcome for patients because it minimizes tissue and muscle destruction, preserves abdominal strength and is very cosmetically pleasing."


Poore and Wilke say that not everyone is a candidate for DIEP. The best candidates are patients with early-stage breast cancer or early-stage recurrent cancer; women who are high-risk; or those who test positive for genetic mutations that can lead to cancer.


"Over 50 percent of the patients I see are strong candidates for the surgery," said Poore. "About one quarter are women at high risk for breast cancer who have decided on prophylactic mastectomy and reconstruction."


Poore said that when Hoffmann was diagnosed with recurrent early-stage ductal breast cancer, she was an ideal candidate for DIEP flap reconstruction. Hoffmann agrees it was the right choice for her.


"I feel great, better than I've felt for a long time. And I’m grateful for the fabulous doctors and surgeons at the UW," said Hoffmann.

Date Published: 10/03/2011

News tag(s):  cancerbreast cancersamuel o pooreahmed m afifilee g wilke

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