After treatment for breast cancer there may be differences in the size and shape of your breasts. Some difference is normal and to be expected and even women who have never had breast surgery will have differences between the two sides. However, if you find the differences distressing or it is difficult to get clothing to fit, your Breast Care Nurse and surgeon will be able to advise you if there are any options available to improve this.
Sometimes we can tell that breasts are going to be very different sizes at the time that we treat the affected breast; in that case we may offer symmetrisation surgery to the other side at the same time as we treat your breast cancer. Often, however we will advise getting through your treatment first. This is because the size of your treated breast may change during your treatments, particularly if you have radiotherapy. Also having additional surgery and scars may increase the risk of wound problems which could potentially delay the start of treatments like chemotherapy which need you to have fully healed wounds.
Sometimes differences between the breasts develop or become more obvious over time, as a breast that has been treated, particularly with radiotherapy, may not change as you get older in the same way as your other breast does. If you are concerned about differences between your breasts, even if your treatment was a long time ago, please contact your Breast Care Nurse for advice. If you are no longer under follow-up with us, please ask your GP to refer you to back to us.
Options to help may be simple such as being carefully fitted for a bra, or having a partial prosthesis to wear within your bra. Alternatively you may be advised that surgery could help you.
There are a range of operations available such as lipomodelling, breast reduction, breast augmentation (enlargement), and nipple reconstruction.
When a breast has been treated with radiotherapy we prefer to avoid operating on it unless we have to. This is because the effects of radiotherapy on the tissues last forever, even though you may not see a difference when you look at the breast. This means that wounds may not heal as well and the tissue may be firmer and react more strongly to foreign material such as breast implants. In general this means that we normally offer surgery such as breast reduction, breast lifts or enlargement to the untreated breast to improve symmetry for you. However, operations such as lipomodelling can be offered to the treated breast and may actually help to improve the tissue quality following radiotherapy.