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Breast Cancer Surgery and Reconstruction

What's Right For You

Patricia Anstett - Photographs by Kathleen Galligan

More than 100,000 American women undergo mastectomy and breast reconstruction every year because of breast cancer. Thousands more are having double mastectomies to prevent it. So much has been written about breast cancer, and so much overlooks the reality of reconstruction when a woman has a mastectomy and opts for this process. It is difficult, painful, and traumatizing at times. Most women do not emerge with a new set of breasts and nipples in a single operation. Breast reconstruction usually takes months and can take years to finish. Some women never do, living without nipples or with imperfect results. Others opt not to have reconstruction at all. Still others struggle with one of the biggest women’s health questions today: lumpectomy and radiation or mastectomy?

Breast Cancer Surgery and Reconstruction offers a glimpse into the big picture of the various stages and types of breast reconstruction using stories and photos of real women. It offers a true picture of what breast reconstruction entails, and offers hope to those facing it. This is a book to help women with a variety of issues surrounding their choices, with powerful insights from women who have been there.
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Rowman & Littlefield Publishers
Pages: 224Size: 6 1/2 x 9 1/4
978-1-4422-4262-3 • Hardback • June 2016 • $35.00 • (£23.95)
978-1-4422-4263-0 • eBook • June 2016 • $33.00 • (£22.95)
Patricia Anstett is an experienced medical writer who worked 40 years in newspaper journalism in Chicago, Washington D.C. and Detroit, her hometown. For the last 22 years of her professional newspaper career she was a medical writer for the Detroit Free Press, retiring in 2011. Her award-winning stories covered various aspects of breast cancer and breast implant surgery. The American Society of Plastic Surgeons honored her work in 1995 with an unsolicited national award. The same year, she also received the Vivian Castleberry Award, a national competition honoring top reporting on women’s issues, for her coverage of new breast biopsy options. The American Cancer Society and the Barbara Karmanos Cancer Institute each have given her awards for the accuracy and comprehensiveness of her breast cancer reporting. Anstett’s reporting has won national, state and local awards for breaking news, beat, and feature writing. She has been honored as Journalist of the Year, Detroit chapter, Society of Professional Journalists, and received the top Headliner award from the Detroit chapter of Women in Communications. Her freelance articles have appeared in the Reader’s Digest; the National Observer; the Chicago Tribune; Washingtonian magazine; and Paris MatchShe was part of a reporting team that published The Suicide Machineabout the first 47 patients to seek help from the late Dr. Jack Kevorkian.

Kathleen Galligan, photographer, is a two-time Emmy award-winning photographer and videographer who specializes in women’s health, social justice, mental health, poverty, and juvenile justice issues. A single mother with two sons, Galligan worked as a newspaper and plastic surgery center photographer before joining the Detroit Free Press in 2002. Her first online documentary project, "Christ Child," about a residential treatment center for severely abused and neglected boys, was awarded a national news and documentary Emmy in 2009. Her work also has captured a National Headliners Award in journalistic innovation as well as numerous national and state awards in photography.
  1. Modern Breast Surgery and Reconstruction
  2. Making the Decision
  3. Mastectomy: What to Expect
  4. A Veteran’s Story: Lumpectomy
  5. Reconstruction with tissue
  6. Medical destinations
  7. Silicone Implants
  8. Saline Implants
  9. Flat or one-breasted
  10. Uneven results
  11. Delayed reconstruction
  12. The Nipple: The Ultimate Challenge
  13. Revisionists
  14. Sex and Intimacy
  15. Lymphedema
  16. Body Image and Culture
  17. Money and Insurance
  18. Clothing and Breast Forms
  19. Doctor Selection Issues
  20. Previvors
  21. Family
  22. Pregnancy
  23. Wrapping It Up
This work by journalist Anstett and photographer and breast cancer survivor Galligan (she’s featured here in Chapter 4) highlights the options and advances made in breast cancer treatment for those facing the disease, with women sharing their experiences, in detail, in order to provide the most up-to-date information. Decision-making can focus on mastectomy over lumpectomy with radiation, contralateral prophylactic surgeries, reconstruction (a variety on the menu, including a Texas-based surgeon who performs robotically enhanced minimally invasive reconstruction), or none at all. Genetic testing is a driver of some procedures, and the efficacy of those choices is covered as well. Additional chapters address insurance, sexuality, and family responsibilities. The text overall is accessible, but ultimately the authors suggest women take the time to deliberate on the alternatives and resist pressure from the medical community to jump in without knowing all the therapies and their repercussions. VERDICT A straightforward addition to the breast cancer canon.
Library Journal

In 2014, more than 230,000 women were diagnosed with breast cancer. More than 102,000 of them underwent reconstruction, more than 71,000 right away and nearly 31,000 later. Anstett, a veteran newspaper reporter, and Galligan, an Emmy-winning photographer and breast-cancer survivor, spent two years thoroughly investigating women’s choices: breast-sparing lumpectomies with radiation; removal of one breast with and without reconstruction; removal of two breasts with and without reconstruction; reconstruction with tissue, saline implants, and silicone implants; nipple-sparing operations; nipple tattoos; and preventive mastectomies. Fortunately, they ably spell out the pros and cons of each option, and they provide the full names of the survivors along with their photographs. Anstett and Galligan also include chapters on finances and insurance, sex and intimacy, and how to cope with feeling like 'damaged goods' after surgery. Shaded boxes provide invaluable additional information, including a Q&A with a genetics counselor and lists of resources, such as the American Society of Plastic Surgeons. This important, well-reported guide should empower women with breast cancer to figure out their own best treatment.

Anstett, a veteran medical writer and journalist, has compiled honest personal accounts of breast cancer, lumpectomies, preventive mastectomies, and reconstructive surgeries. The author describes the many difficult options and choices women face with breast cancer—from nipple-sparing, silicone versus saline implants, liposuction and tissue reconstruction, delayed reconstruction, revisions and lifts, nipple and areola tattoos, radiation effects, compression garments and breast forms, plastic surgeon and hospital selection, and insurance and non-medical financial help. The text also includes a chapter on Arab culture and the unique challenges of promoting mammograms, further diagnosis, and treatment. This collection of case histories and beautiful black-and-white photographs (by Galligan, an Emmy award-winning photographer and videographer) of real women survivors explores complications of lymphedema, pain, repeated surgeries, different sizes and uneven results, intimate relationships, pregnancies, genetic testing, and hereditary risk. . . .[T]echnical topics are often defined, and web addresses are frequently provided. The title includes a glossary, notes, a brief bibliography, and an index, which are all very useful. Summing Up: Recommended. All readers.

Patricia Anstett, a well-published medical writer, has written Breast Cancer Surgery and Reconstruction: What’s Right for You, a detailed account of one of the most important issues in the world of oncology. Along with the visual help of photographer Kathleen Galligan, Ms. Anstett has produced a valuable book in both the clinical cancer community as well as the patient-survivor sector.... Ms. Anstett made many wise choices in her book. She is a capable writer who knows her limitations in the craft of writing. As a result, she has produced an honest, valuable book that deals with clinical and emotional subjects that are daunting and confusing. Women who are facing these issues will be well served by this book.
The ASCO Post

[Breast Cancer Surgery and Reconstruction is] a book that provides all the information a woman will need when making life and body changes when faced with breast cancer. This is an extremely practical and user friendly read.The book is easy to follow. It is good as the reader is under any illusions as breast reconstruction is not for all women but with practical advice the woman can make informed decisions and choices with the aid of this book. The author reassures the woman by advising her to be patient and that she will feel feminine again. The photographs are of real women who have had breast cancer so the reader can associate herself in differing situations. The real life accounts and stories of real women make this a powerful book.... Although this is written in the US it applies equally to women in the UK. Well written, easy to read. The author is a medical writer so has experience and has been honoured for her work. Every time I went to a chapter, the subject I wanted to explore was there. There are notes with good references at the end and a glossary for women who may not have medical knowledge and could be confused with jargon.... All nursing and medical staff caring for women with breast cancer must read this book.
Nursing Times

In Breast Cancer Surgery and Reconstruction: What's Right for You Anstett personalizes facts and stats through case studies. The subjects are captured poignantly by photography Kathleen Galligan, who was diagnosed with breast cancer herself while working on the book. Since 1 out of 8 American women will be diagnosed with breast cancer, this book should be required reading. Anstett reinforces the notion that there is no wrong option. Every woman must decide the path that's best for her; the key is knowledge. This book soars beyond such common terms as mastectomy and lumpectomy to explore delayed robotic reconstruction and "previvors"–women at high risk who elect to have a radical double mastectomy and their ovaries removed. Amid the torrent of information, there are showers of inspiration as well.
Hour Detroit

The authors base this book on their two year journey of conducting in depth interviews and
observing women as they went through breast cancer diagnosis and decisions regarding
mastectomy and reconstructive surgery. The simple language and the narrative approach to
writing about these difficult subjects makes the content interesting and easy to understand. The
glossary will further assist the reader to understand the anatomical and surgical terminology
used throughout the text.... The topics covered here affect many women, and most would not know where to start in asking the right questions of their doctors and surgeons to make sure they make the right choice for their circumstance. This book will help those women to prepare. Recommended.
Consumer Connections

Breast reconstruction isn't for everyone, but the choice certainly should be. This comprehensive collection of patient experiences and perspectives serves as a unique and very valuable tool in making that very personal choice. A great resource!
Minas Chrysopoulo, MD, PRMA Center for Advanced Breast Reconstruction, San Antonio, Texas

Author Pat Anstett's YouTube Channel on Breast Cancer Surgery and Reconstruction Choices is at