REQUESTS for breast reconstruction have significantly increased in Jamaica, with women as old as 80 years old seeking to replace their breasts after a mastectomy, says Dr Guyan Arscott, a senior plastic surgeon at the University Hospital of the West Indies.

He’s attributing the increase to various factors, including the involvement of plastic surgeons in the management of breast cancer and more awareness about the procedure among people with the dreaded condition.

“When I just started way back in 1988, the patients who came to me for reconstruction, most of them came of their own request. They were not sent by any doctor because it was just thought to be cosmetic surgery, but big changes are taking place,” Dr Arscott told the Jamaica Observer.

“Now, if I see 10 patients, about five to eight of them want reconstruction, so it’s a higher incidence. It is definitely increasing, there is no question about that,” he declared.

The seasoned plastic surgeon said that breast cancer patients in the younger age group — from early 30s to late 40s — are typically more keen on reconstruction because they want to feel as normal as possible after their treatment. However, he has noticed an uptick in more elderly breast cancer patients requesting the service.

“The other age group, 50 to 70 years old, that group nowadays consider themselves to be fairly young, and so we find that reconstructive requests have increased significantly in the older, more mature population,” said Dr Arscott, who added that he’s also seen a few patients in their 80s requesting the procedure.

“In the older age group, the chronological age is not necessarily an indication anymore that they will not want reconstruction — mash down that lie. They are healthy otherwise, and they want reconstruction,” he told the Sunday Observer.

Dr Arscott noted that, unlike other cancers, breast cancer has a strong psychosocial element, and he has seen where reconstruction significantly improves patients’ quality of life after treatment.

“We do have patients whose quality of life is significantly improved after they have been treated, after they have been reconstructed, and they are getting on with their activities…living and even going to carnival,” he said.

Prosthetic reconstruction is the most popular type of reconstructive surgery among breast cancer patients in Jamaica. However, an autologous reconstruction can also be done, said Dr Arscott.

An autologous reconstruction is done using tissue from elsewhere in the body to reconstruct the breast, while prosthetic implants are made of saline or silicone.

With breast cancer being the most prevalent cancer among Jamaican women, breast surgical oncologist and clinical director of breast oncology service at Kingston Public Hospital, Dr Jason Copeland said approximately 70 per cent of local breast cancer patients get prosthetic implants, while 30 per cent go the autologous route.

He noted that breast implants in cancer patients are safe and do not delay or hinder a patient’s ability to detect lumps or any other signs of recurrence of breast cancer.

“This is something we have looked at in terms of studies, and what we have found is that the presence of the implant does not delay the diagnosis of a breast cancer recurrence,” said Dr Copeland.

“For breast cancer patients who do reconstruction, there is no breast tissue there, and the implant sits either in the muscle or on top of the muscle, which is the subcutaneous tissue [the the deepest layer of your skin with the most fat cells]. Because the recurrences will occur either in the surgical incision wound or in the subcutaneous tissue, the presence of the implant does not prevent you from detecting these recurrences,” he explained to the Sunday Observer.

However, he noted that the presence of the implant can cause infection in the surgical wound.

“The risk is relatively small, but nonetheless we also advise patients that there is a risk of infection because of the presence of the implant,” said the breast oncologist.

Dr Copeland further noted that the presence of implants in patients who do breast augmentation to enhance the size of their breasts does not make it harder for them to detect lumps.

“How the implant is placed is that it actually goes beneath the breast or under the breast, so the breast tissue is actually on top of the implant so the same way in which you would have felt your breast normally is the same way you can feel the breast with the implant,” he said.

“I think some persons misunderstand the placement of the implants, and they think the implant is placed on top of the breast tissue, and therefore, there is an interface between your natural breast and the skin, but the implant actually goes below the breast and pushes the breast up and so there is no interface between your skin and the natural breast,” he further explained.

Dr Copeland encouraged women to become familiar with their breasts through self-examination and get routine screenings as early as 30 years old, noting that these methods can help to catch the disease earlier and reduce the chances of mortality.