contralateral mastectomy over the last decade to eliminate this risk as much as possible. Those more likely to choose this avenue include younger women, caucasian women and those with a family history. Such women are more likely to choose breast reconstruction, typically implant reconstruction. There is no risk in detecting any recurrence of breast cancer for women choosing reconstruction and there is no risk to their long-term survival if they proceed with reconstruction. Reconstruction can be either at the time of mastectomy (immediate reconstruction) or delayed, to be performed at a suitable time after treatment (delayed reconstruction). The choice of the type of reconstruction is complex and it must be individualised but the broad choices are either tissue from the body (autologous flap reconstruction) or implant reconstruction often involving a tissue expander first, or a combination of both. There has been a ground swell of evidence, largely from population-based studies, but also interventional studies showing that lifestyle It is stating the obvious to say that being diagnosed with breast cancer is a life-changing event. The fear of recurrence is often the primary concern, however it must be noted that mortality from breast cancer has consistently declined over the last few decades in Australia, with current five-year survival sitting around 90%. Our success in treating breast cancer means that in Australia, in any one year, well over sixtythousand women will be breast cancer survivors. This means that many can put their breast cancer fears behind them and focus on lifestyle issues to improve their quality of life. It is not an uncommon objective for women, after being treated - and even after receiving the diagnosis - to want to reduce the possibility of ever having to go through the same ordeal twice and request removal of the other breast (prophylactic mastectomy). The risk of developing a contralateral tumour (tumour in the other breast) is approximately 0.5 - 1% per year, or around 10 - 15% over 20 years. There has been a noticeable trend in women selecting modifications can be very powerful methods to reduce the risk of the recurrence of breast cancer. Diet is certainly one important aspect in reducing calories, and has been shown to be very successful. The Women’s Interventional Nutrition Study (WINS) randomised over 2,400 patients who had previously had breast cancer to either a normal diet or a reduced-fat diet. Those on the reduced-fat intake had resulting weight loss which lowered breast cancer events (recurrence) by around 25%. This effect was seen to be more powerful in more aggressive types of breast cancer such as those that are not oestrogen dependant and are often harder to treat. Other studies have shown that exercise after breast cancer diagnosis can also have a protective effect in reducing risk. There is good evidence that three to four hours a week or half-an-hour a day of moderate to heavy exercise, which leaves you feeling sweaty and tired on completion, can reduce risk of recurrence by 30% or more. This benefit can be seen even without significant weight loss opinion. 36 Pindara Magazine 2016
Pindara Private Hospital Magazine - Issue Eight
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