Ask the DoctorThis week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answer your questions. Q: I was diagnosed with stage 3 breast cancer about 3 years ago. I underwent all the usual treatments since then; however my oncologist has moved to another state, leaving me without one! I have not been able to get the reconstruction process completed.The last time I spoke with my oncologist, I was informed that it couldn't be done. Do you think you can help? A: Thanks for your inquiry! Without knowing more details I can't answer your question with certainty, but only rarely do we encounter a patient who can't be reconstructed by any means. If you would like, we can have our nurse or PA call you to get more details. Dr. Richard M. Kline, Jr.   Q: My doctor recently told me that based on my family history--mom with a bilateral mastectomy, aunt (on mom's side) with bilateral mastectomy, and another aunt (on mom's side) with partial mastectomy--and combined with my PTEN mutation, thyroid issue, and other auto immune illnesses, that my chances of getting breast cancer in the next three years is 1 in 3. Should I seriously consider getting a preventive mastectomy?A: A preventive mastectomy is the most effective way women can reduce their risk for breast cancer. Close screenings with exams and x-rays or MRI, will only help with early detection and do not lower the chances of getting breast cancer. Women who are at high risk for breast cancer because of many different factors, family history or known genetic mutations do have preventive mastectomies to lower their chances. Before considering this big step you should review your risks with someone familiar with preventive mastectomies or a specialists in genetics. It sounds like you have a doctor helping you through this decision. When it comes to proceeding further you should look for a team with a surgeon specializing in the breast removal and one specializing in rebuilding the breast at the same time as the mastectomy. Preventive mastectomies can preserve the breast skin and nipple, and are very different from most other types of mastectomy. Also the reconstructive procedures are specific for preventive mastectomies and have the chance to be the most natural results. Our practice specializes in this type of breast reconstruction and we work with specialists who regularly perform nipple-sparing mastectomy. If you want more information we can contact you with a few more questions. Regarding my recommendation about when or if to do it I would say it is a very individualized decision to make, and the process is major surgery. You should know about all the risks and know what to expect regarding possible results. We would be glad to review the details with you if you like. If so just let us know and I will have our PA or RN give you a call to discuss the details. I hope this helps.Dr. James Craigie Center for Natural Breast Reconstruction

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