By Mollie Sugarman

A recent study in the prestigious Journal of the American Medical Association found that about one in four breast cancer patients who have lumpectomies will undergo a second surgery. Re-excision is performed when there is a suspicion that the initial surgery left behind cancerous tissues.

The anticipatory anxiety of facing second breast surgeries is not only heightened by the concern about additional discomfort and recovery time away from daily life schedules, but most significantly the unresolved diagnosis, treatment plan, and prognosis. Frequently, women experience a sense of urgency to explore all other options that may reduce future risks. To quickly gather accurate information with which to make informed choices is akin to being dropped into a war zone in a foreign country without any armor or awareness of the language.  The lack of uniformity of standards among the medical community often creates further stress for patients facing options.

Women who have one or more lumpectomies often struggle with the significant impact of the breast deformity on their sexual/feminine identities.  Within the past few years, the dramatic change in microsurgical options for breast reconstruction may also influence one’s choice.  At the heart of it all, there appears to be a need for greater consideration of the individual patient’s personality in developing a treatment plan for addressing breast cancer options. One patient, who recently underwent a bilateral mastectomy for risk-reduction purposes, perhaps best described her post-surgical mind-set: “I feel cleansed…I feel that I no longer need to look over my shoulder, no longer consumed by fear, and can now move on with my life.”

We have seen the dramatic effect of assisting patients through our Patient Empowerment Program (PEP).  The various tools offered to them and their significant others directly affect their recovery both physically and emotionally.  Many individuals do not have the support of friends and family members for their choices and it is critical that they have a nurturing environment in which to deal with their feelings. Learn more about PEP in the February 2012 issue of Plastic Surgery Practice.

Mollie Sugarman is the clinical director of the Patient Empowerment Program at Aesthetic Plastic Surgery, P.C., in Great Neck, NY.