Breast reconstruction after mastectomy may be done at the time of mastectomy or at a future time. Multiple options for reconstruction are available and are considered to be part of the overall cancer treatment plan and not cosmetic surgery. It is therefore usually covered by most insurance plans.
What used to begin with the sometimes painful placement of a guide wire in a patient's breast to mark the location of a breast abnormality can now be done with a much more precise and less painful method. The process uses a thin needle to place one or two tiny radioactive seeds – about the size of a grain of rice – directly at the site of the abnormality. The procedure takes about 15 minutes from start to finish with minimal discomfort. The radiation in the seed is not dangerous. It gives off only enough radiation to act as a marker for the surgeon.
The radioactive seed allows the surgeon to accurately remove the abnormal tissue, the seed and ideally, if cancer is found, additional tissue in the margins around the cancer. Radiation or chemotherapy may still be required after surgery. The previous and still most common approach to marking an abnormality that can only be seen through mammography is to place a guide wire in the patient’s breast in the morning, and then have surgery later in the day. By using RSL, discomfort with the wire is eliminated. Additionally, the seeds can be implanted up to five days prior to surgery, offering more scheduling flexibility for patients and surgeons. On the day of surgery, the surgeon uses a detection device that pinpoints the radioactive seeds, identifying the exact location of the abnormality so it can be removed.