Making decisions

If you need breast cancer surgery, you may choose to remain flat, wear a breast prosthesis or have a breast reconstruction. It is a good idea to discuss the different options with your breast surgeon, a reconstructive (plastic) surgeon and/or a breast care nurse. Sometimes it is difficult to decide what you want. Take what time you can before making a decision.

Know your options – Understanding the available options, possible complications and costs can help you weigh up the options and make a well-informed decision. Seeing photos of a flat chest, reconstructed
breasts and prostheses will help you understand what to expect. You don’t necessarily have to choose between the options – you may start with a prosthesis, then decide later to have a breast reconstruction or go flat.

Keep in mind that not all options may be suitable for you. There may be some situations where your surgeon advises against having a reconstruction. 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 first talks to you before and after breast cancer surgery, you may not remember everything you are told. Taking notes can help. If you would like to record the discussion, ask your doctor first. 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 questions of your breast surgeon, breast care nurse and prosthesis fitter. Try to prepare a list of questions before appointments. This will help you think through the information you need to make your decision.

Consider a second opinion – You may want to ask for a second opinion from another breast surgeon or reconstructive (plastic) surgeon to confirm or clarify your specialist’s recommendations, or to reassure you that you have explored all of your options. Specialists are used to people doing this. Your general  practitioner (GP) or surgeon can refer you to another surgeon and send your initial results to that person. Ask how much the second opinion may cost, as some doctors charge more for this. 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, have a breast reconstruction or go flat 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 decline any of the reconstruction options offered to you.

BRECONDA is an online breast reconstruction decision aid. It 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 arrange to speak with a Cancer Connect volunteer who has had a breast reconstruction, gone flat or wears a prosthesis. Your breast care nurse or counsellor can also help you think through the pros and cons of each option.

What to consider about breast prostheses, breast reconstruction and going flat

• Find out what wearing a prosthesis, having a reconstruction or going flat involves so your expectations of the result are realistic.
• Talk with your treatment team about when to have the reconstruction. It may be possible to start the
  procedure when you have the mastectomy or later on.
• If you decide to delay the reconstruction or not have a reconstruction at all, you can choose to use a breast prosthesis or go flat.
• If you decide not to have a reconstruction, talk to your treatment team about how your chest will look after the surgery, where the scars will be and how to look after them.
• If you are referred to a reconstructive (plastic) surgeon, be clear about how you want to look after the reconstruction. Ask to see photos of their work and to talk to some of their previous patients.
• If you’re offered more than one type of reconstruction, compare the cost, the side effects and the length of recovery. If only one type of reconstruction is recommended, ask your doctor 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, talk about the options with them and ask them to come to appointments. You can also talk to friends, family or others who have had a similar experience.
• Ask how long you may have to wait for breast reconstruction surgery. This may vary depending on whether you have surgery in a public or private hospital.