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Christina Applegate's Mastectomy: FAQ

Breast Cancer Survivor Christina Applegate Opts for Preventive Double Mastectomy and Breast Reconstructive Surgery

Does double mastectomy totally eliminate her risk?

Almost, but not quite; there's an estimated 5% chance of breast cancer after such a procedure, notes Neil Friedman, MD, FACS, medical director of the Hoffberger Breast Center at Mercy Medical Center in Baltimore.

He explains that there's no clear line where breast tissue ends.

"When you're in the operating room, it's not like you can look and say, 'All that yellow tissue is breast tissue and all that white tissue is fat.' So you try and take all the tissue out that you can, but you can leave isolated breast cells underneath the skin. Everybody does; there's not a surgeon in the world that can do that and remove all of the cells. That's why there is a small risk of having a breast cancer develop in one of those cells -- pretty uncommon, but it can happen," says Friedman.

Friedman says that immediate reconstruction -- starting the process at the time of the mastectomy -- "is something that should be offered to all patients."

"I offer it to all of my patients and if I think there's a reason why they shouldn't get it from a medical perspective, then I [explain why] I think it's advisable to delay the reconstruction. But they should at least have that conversation with their surgeons," says Friedman, adding that breast reconstruction is not an insurance issue, because it "must be paid for by federal law," regardless of the patient's age.

What about the emotional aspect of the decision?

"It is a difficult decision and an emotional decision, and it is not that simple to decide to lose your breast," says Avisar.

Alvarez says she took her time before choosing preventive double mastectomy. For her, breasts were "such a part of being a woman, so there [were] a lot of emotional factors" to consider.

"Little by little, I just went through the options," she says. One by one, she ruled out her other choices and felt that after mastectomy, she would "be able to live my life peacefully and life goes on."

Alvarez also said it helped that she works on a floor of Mercy Medical Center where women recover from mastectomy and breast reconstruction, so she knew what to expect. She also had seen women be upset by their appearance immediately after mastectomy.

"They just don't want to look at themselves ... it's an extremely difficult experience," says Alvarez. "I never really had a problem with that only because I knew what that was going to be like."

What's involved in breast reconstruction?

The first step is creating the breast or breasts, which can be done in two ways:

  • Option No. 1: Transplant your own fat [autologous tissue] from the belly or elsewhere in the body and implant it where the breasts were.
  • Option No. 2: Get saline or silicone implants.

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