William Beaumont Army Medical Center's Department of Plastic and Reconstructive Surgery, is slated to hold the third annual Breast Reconstruction Awareness (BRA) Day at the Freedom Crossing at Fort Bliss shopping center from 8 a.m. - 3 p.m., Oct. 17.
Introduced in 2011, the annual event, held on the third Wednesday of October, helps raise awareness and educate women on the options available to them following breast cancer treatments, such as mastectomy or lumpectomy.
"October is Breast Cancer Awareness Month, which many people have heard about: a way to increase awareness of one of the most common cancers amongst women," said Lt. Col. Owen Johnson III, Chief, Plastic and Reconstructive Surgery, WBAMC. "One part of going through the breast cancer process (for women) is coming to terms with the reality of the situation which may involve surgically losing their breast so part of that (recovery) process is trying to provide reconstruction (options) as a way to close the loop."
Healing and closure are emphasized in the BRA Day logo, which displays the familiar pink ribbon representing breast cancer awareness transformed as an infinity loop signifying closing the loop on breast cancer.
The reconstructive options, different for each patient, comprise three main modalities: implants, autologous reconstruction (meaning using tissue from other parts of the body to re-build the breast), and autologous tissue with implant. Patients can opt to have immediate, post-lumpectomy/mastectomy reconstruction or delayed reconstruction (performed months to years after completing cancer treatments).
"Plastic surgery, as a specialty, has become increasingly involved in the discussions and treatment of breast cancer patients over the last couple of decades as our reconstruction techniques have got better," said Johnson, a native of Woodbridge, Virginia. "We've gone from seeing patients, if they show up, well after their treatment is over, to being a part of the team which initially talks to the patient when they first get their diagnosis."
In January 2017, Martha Carmona, a 47-year-old veteran, was performing a breast self-examination, after a family member was diagnosed with breast cancer, and noticed a lump in her breast. After a referral to WBAMC general surgeons and a biopsy, Carmona was diagnosed with triple positive breast cancer, a distinct aggressive subtype of breast cancer.
"I was stage 2B and my treatment options were one year of chemotherapy after double mastectomy," said Carmona. "It is overwhelming especially because I got bombarded with medical appointments and medical terminology, what helped me was I was trying to cope with one treatment at a time."
"(The plastic and reconstructive surgery surgeons) started the reconstruction options last year, described in very detailed, very patiently explained to me what my options were prior to the (double mastectomy)," said Carmona. "(The staff) was wonderful explaining all my options from day one."
According to Johnson, the inclusion of reconstructive surgery in multidisciplinary treatment teams which traditionally included surgery, oncology and radiology, has helped initiate treatment options suitable to meet each patient's needs.
"In the past, breast reconstruction was really an afterthought, almost considered cosmetic and people didn't put it in the same category as treating a patient," said Johnson. "(Today) there's more of an awareness and understanding that reconstruction may help a patient feel whole again. That in itself makes them feel a lot better at the end of the process about dealing with their (cancer)."
For Carmona, who is still in the process of completing reconstruction, temporary tissue expanders placed after the double mastectomy have allowed for effective chemotherapy while weighing her options.
"I'm looking forward to the reconstruction so I could close this chapter of cancer in my life," said Carmona. "I already feel like myself, but I want to get it over with and move on."
In addition to discussing options with medical staff, Carmona also attended various support groups in the community and encourages other women to look into options for reconstruction.
"When I encounter another breast cancer patient I let them know there are options for reconstruction, including no reconstruction at all," said Carmona. "It's important to know which options exist to evaluate all options."
At WBAMC, the introduction of the Microsurgery Program in addition to other initiatives have broadened options for patients seeking reconstruction after cancer. New techniques available to eligible patients includes free-flap surgery, fat grafting and pre-pectoral breast reconstruction, which places implants over the pectoral muscle instead of more traditional methods, which may minimize certain complications.
This year's BRA Day will be the first-of-its-kind outside of WBAMC, to maximize exposure to the Fort Bliss community and Freedom Crossing at Fort Bliss patrons.
"We'd like to reach out to more of the community at large, to reach out to patients who may not be at the hospital all the time. If we tell them about it ahead of time and they think 'that will never happen to me,' and something should happen then maybe they are better prepared," said Johnson. "It is a common problem for women, which is why we have these awareness events and screenings for women over 40, because it's going to affect one in 10 women."