American Medical Association Family Medical Guide - American Medical Association [581]
The usual hospital stay for breast reconstruction is 2 to 5 days. You will probably feel pain and be very tired for the first 2 weeks after surgery. Your doctor will prescribe medication to relieve your discomfort. Stitches are usually removed in about a week to 10 days, and it may take up to 6 weeks to fully recover from the surgery. You probably will not have normal sensation in the reconstructed breast, although some feeling may return over time. By the second year after your surgery, your scars will fade substantially, but they will never disappear completely.
Breast reconstruction using abdominal tissue
For breast reconstruction after a mastectomy, the surgeon cuts out an area from the mastectomy site (left). He or she then cuts out a flap of tissue (including skin, muscle, fat, and attached blood vessels) from the abdomen (center) to use to create the new breast. With the blood vessels still intact, the tissue flap is tunneled up under the skin to the area of the mastectomy, guided out through the incision at the mastectomy site, and stitched in place on the chest (right). The abdominal (rectus) muscle and fat under the skin of the flap produce a natural-looking breast mound. A nipple may be reconstructed in later surgery.
A drug called trastuzumab (Herceptin) is used to treat breast cancer that has spread in women whose tumors produce an excessive amount of the protein associated with the HER2 gene. By blocking HER2, trastuzumab slows or stops the growth of the cancer cells. Trastuzumab is given by injection, either alone or in addition to chemotherapy.
The side effects of biological therapy depend on the substances used and can vary from person to person. Rashes or swelling at the site of the injection and flulike symptoms are common side effects. Trastuzumab can damage the heart, potentially leading to heart failure (see page 570), and can affect the lungs, causing breathing problems that require immediate medical attention. You will be monitored carefully during your treatment.
Experimental treatments
Even when a cancer has spread extensively from the breast, experimental treatments may be helpful for some women. One experimental biological treatment uses antibodies (immune proteins) that block the growth factor receptors on breast cancer cells, which prevents the cells from growing and multiplying. Many of these treatments are available through clinical trials. Ask your doctor about participating in a clinical trial.
Disorders of the Ovaries, Uterus, and Cervix
The two ovaries and the uterus make up the primary female reproductive organs. The ovaries sit on either side of the uterus, just above the pubic bone, and move freely within a small area. Each ovary contains thousands of eggs, which a woman is born with. During your fertile years, one egg (or sometimes more) ripens each month and is released into a fallopian tube. As the egg travels slowly down the tube toward the uterus, it can be fertilized by a sperm. The uterus lies in the pelvis, behind the bladder. The walls of the uterus consist of powerful muscles that contract to push out a baby during delivery. At the lower end of the uterus is a narrow, thick-walled structure called the cervix, which leads into the vagina.
The female reproductive system
Ovarian Cysts
An ovarian cyst is a sac full of fluid that forms on or in an ovary. Most ovarian cysts are harmless and go away on their own within a couple of months. Others can interfere with the ovary’s production of sex hormones or become cancerous; for this reason, all cysts should be evaluated by a doctor. Ovarian cysts are common in women of childbearing age and are usually caused by the changing hormone levels that naturally occur during the menstrual cycle. Ovarian cysts can range from the size of a pea to the size of a grapefruit. A woman may develop one cyst at a time or many. Multiple cysts that form repeatedly month after month characterize a disorder called polycystic