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After having been operated on for breast cancer and having chosen to preventively remove the other mammary gland, Alice Detollenaere, companion of the ex-star of the basins Camille Lacourt, shares a photo on her Instagram feed. A photo where she poses in lingerie, as if to put the test that she has definitely lived behind her. What is breast reconstruction? What are the different options for this surgery? The answers of Pr Laurent Lantieri, plastic and aesthetic surgeon at the European Georges-Pompidou Hospital in Paris.
It was almost a year ago. After having undergone the ordeal of cancer, Alice Detollenaere announced to have surgery preventively to have her other mammary gland removed. She shares today the result of this double mastectomy, by publishing a photo where she poses in lingerie, on her Instagram feed.
What is breast reconstruction?
Breast reconstruction is an operation that reconstructs the breast, after removal of it or the mammary gland only.
“In the case of Alice Detollenaere, it is a mastectomy immediately followed by reconstruction, the patient only undergoes one surgery” first of all indicates Pr Laurent Lantieri. “It’s possible because as we remove a healthy gland, we keep the cutaneous sheath of the breast and we place a prosthesis directly” adds the surgeon. A prosthesis that can be kept for a long time “Like any product, there is a risk of wear and tear over the years. On the other hand, it is a misconception to believe that they have to be changed after X years”.
More aggressive cancers in case of genetic predisposition
By carrying out this act of prevention, women go from a risk of developing breast cancer of around 70% to 2 or 3%.
“It is currently the only method of preventing breast cancer that exists. We can carry out close monitoring, but it is not prevention, when the cancer will be detected it will already be present” further details Laurent Lantieri.
For these women, it is a double penalty: in addition to being at genetic risk, because carrying a BRCA1 or 2 gene which exposes them very strongly to the risk of cancer, they also have a great chance of a more aggressive form of cancer. “I have some patients who regret not having made preventive withdrawal and who had very aggressive cancers, with total removal of the breast”.
A more delicate reconstruction once the cancer is diagnosed
For women undergoing mastectomy for breast cancer, things are a little different. “When patients have breast cancer, it’s different: the silicone prosthesis is less often possible, because sometimes the breast sheath is missing because the skin had to be removed too, because of the disease or the patient will be entitled to radiotherapy sessions. In these cases, it is better to opt for reconstruction by flaps” adds the surgeon.
The operation then requires preparing the patient in another place, for a removal of fat and skin: the stomach or the thigh, depending on the technique used. “We can also take muscle from the back, the latissimus dorsi, but this is a technique that I avoid because it can cause back pain for the patient afterwards”.
“It’s not a catalog”
After having described these different types of reconstructions, Laurent Lantieri insists on a crucial point. “Patients need to understand that this is not a catalogue: they cannot choose how they will be reconstructed. It depends on the type of cancer, its location, the continuation of their treatment… There is no will have no choice”.
“I’m glad she had the courage to come out and say it”
In addition, for those who take the step of removing their healthy mammary gland, surgical removal of the ovaries is also proposed. “We do it for women over 40, because of the risk of cancer too”. Finally, Professor Lantieri wishes to salute the courage of Alice Detollenaere. “I’m happy that she had the courage to come forward and say it. It’s the best way to free herself from this sword of Damocles and to resume her life as a woman and I congratulate her for that”.