In Latvia, at least 1,000 women are diagnosed with breast cancer each year; breast reconstruction covered by the state is available following a mastectomy

Regīna Olševska, “Praktiskais Latvietis,” AS “Latvijas Mediji”

Every year in Latvia, more than a thousand women are diagnosed with breast cancer. Although it is usually possible to perform breast-conserving surgery, several hundred women, unfortunately, must undergo surgical removal of the breast—a mastectomy. Starting this year, the government covers the cost of breast reconstruction with implants for patients, and this service is available even if the surgery was performed several years ago.

Performs surgeries at four hospitals

“Each year, 1,100–1,200 women in Latvia are diagnosed with breast cancer, and an average of 500 mastectomies are performed. Of course, not all women who have had a breast removed need reconstruction, as some of them are already of a respectable age and do not wish to undergo it, even though age has long since ceased to be a contraindication for such surgery. ”According to our estimates, 250 patients should undergo breast reconstruction each year,” says Kalvis Pastars, a microsurgeon at the Microsurgery Center of Riga East University Hospital, describing the situation in Latvia. He adds that breast reconstruction with an implant is the simplest and least expensive, but not the only method of reconstruction.

While many women have been deterred from undergoing breast reconstruction surgery due to the cost of implants, as of January 1, 2022, this is no longer a concern. The program “Mastectomy with Breast Reconstruction or Breast Reconstruction Due to Malignant Breast Tumors” provides for state-funded breast implant placement both concurrently with surgery for a malignant tumor as well as in cases where treatment has already been completed.

If surgery for a malignant tumor was performed a long time ago, you should contact your family doctor to get a referral to an oncologic surgeon or plastic surgeon, who, after assessing the situation, will organize a consultation to decide on reconstructive surgery. The patient should consult with her treating physician regarding breast reconstruction options.

How does it work?

Most women require surgery to treat a malignant breast tumor. Today, there is a strong emphasis on minimally invasive, breast-conserving surgeries, in which the tumor is excised down to the margin of healthy tissue; these procedures may be supplemented with chemotherapy, radiation therapy, or other methods.

If a breast-conserving surgery is not possible, a mastectomy must be performed—either a radical mastectomy, in which the breast tissue and some of the axillary lymph nodes are removed, or a simple mastectomy, in which only the breast tissue is removed. Today, breast reconstruction is considered an integral part of breast cancer treatment. One of the most commonly used methods is reconstruction with implants; another involves using the patient’s own tissue—specifically, a tissue flap—transferred from the abdomen, back, or other parts of the body. The doctor determines which method to use, but the decision—whether to undergo breast reconstruction or not—is up to the woman herself.

It is often possible to perform both procedures during a single operation—removing the tumor and reconstructing the breast. However, delayed or late reconstruction is also an option, in which the patient first undergoes oncological surgery followed by a course of radiation or chemotherapy, and a decision regarding reconstruction is made once that is complete. It may also be necessary to postpone implant placement if, during the mastectomy, it is not possible to use an implant of a size that matches the other breast. In such cases, a tissue expander is first inserted, which is gradually filled with fluid through a valve over the course of several months, gradually stretching the skin.

Breast reconstruction with implants, especially when performed at the same time as a mastectomy, is the simplest of the breast reconstruction methods. Delayed reconstruction is usually more complex—it depends on both the postoperative scar and the condition of the skin and muscles. If the tumor has affected only one breast, it is also possible to perform a correction on the other breast to ensure symmetry.

After reconstruction, the breast will not regain its former sensitivity and appearance, as scars will be visible.
Experts note that breast reconstruction allows patients to maintain their femininity and a sense of bodily integrity, reduces psychological and emotional problems, and improves their quality of life.
Breast reconstruction does not affect the prognosis of the disease, nor does it interfere with ongoing breast cancer treatment and rehabilitation.

NEWS

Breast Examination Methods

– A mammogram is a breast examination using low-intensity X-rays, which is used for preventive screenings.

– Ultrasonography uses high-frequency sound waves—ultrasound. This method is typically used when the breast tissue is very dense and changes in the breast cannot be seen on a mammogram.

– Magnetic resonance imaging is used when a woman has already been diagnosed with breast cancer and needs precise information about the extent of the tumor.

NEWS

Breast Cancer Treatment, Step by Step

– Screening – significantly increases the chances of detecting breast cancer early and treating it with minimally invasive methods.

– Using the green channel allows for rapid diagnosis, determination of the tumor stage, and initiation of treatment.

– A doctor’s decision regarding the treatment method for breast cancer: chemotherapy (including targeted therapy), hormone therapy, radiation therapy, and surgery.

– Breast-conserving surgery or breast reconstruction following a mastectomy; if breast-conserving surgery is not possible, lymph node surgery may be performed.

– Therapy that may be required in addition to surgical treatment, such as chemotherapy or radiation therapy.

– Follow-up care through regular visits to an oncologist, rehabilitation—including psycho-emotional rehabilitation, such as at a psychosocial rehabilitation camp designed to support cancer patients.