Drs. Kristien Keymeulen surgical oncologist It takes a team to provide care to women with breast cancer. The patient herself is at the core of that team, surrounded by a radiologist, pathologist, oncologist, surgeon, radiotherapy specialist, clinical geneticist, plastic surgeon and breast cancer nurse. It is the patient who takes the final decisions at all times. As a surgeon, I run through the surgical options with the patient. This may involve a breast-conserving treatment, but in some cases, a mastectomy may be required. We discuss the advantages and disadvantages of each option, as well as the reconstruction options. We are the largest breast reconstruction centre in the Netherlands and we perform all existing techniques. We often work with patient’s own tissue, preferably from the patient’s abdomen. Our plastic surgeons here in Maastricht developed a technique to use fatty tissue from the thighs in cases where women do not have sufficient fatty tissue in their abdomen. The advantages of using the patient’s own tissue are that it feels more like part of the patient’s own body and that it results in a more natural breast shape than a prosthesis. We always look at what suits the patient and her body best, what she expects from a reconstruction and what we can achieve in terms of results. Once again, it is the patient who takes the final decisions on these issues. In a reconstruction using the patient’s own tissue, it is possible to preserve sensory nerves and reconnect them to nerves in the new breast tissue. By suturing these nerve endings together at a microscopic level, sensation can be restored in the new breast. We are currently carrying out research into what exactly people feel. Our patients are always given enough time to think things over, as well as the opportunity to ask additional questions. Our nursing staff and I support them in this process. If they need more support, we have psychologists at hand to help. I believe it is important to take a little time, because a cancer diagnosis is a life-changing event. If you take the time to talk to patients, you will find they have a life before breast cancer and a life after breast cancer. They place things in perspective and sometimes believe their life after cancer is better than before, however strange that may sound. On the job
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