Bra Day 2017 at Penn Medicine
Most women facing breast cancer are aware of their option to undergo a mastectomy. The procedure is the standard of care for many women with the disease. However, the conversation does not end with the removal of the breast tissue and lymph nodes. Women still have options to continue their journey of healing. Unfortunately, too many women don’t know it.
Less than half of women who undergo mastectomies are even offered breast reconstruction surgery, and fewer than 20 percent actually undergo immediate reconstruction, according to the American Society of Plastic Surgeons. While immediate reconstruction may not be the right option for everyone – and some women decide to forego the procedure altogether – the ASPS points out that just 23 percent of women understand the wide range of options available to them.
In an effort to spread the word, the American Society of Plastic Surgeons and The Plastic Surgery Foundation launched a national initiative called Breast Reconstruction Awareness Day – BRA Day for short. Held annually on the third Wednesday of October – in the heart of Breast Cancer Awareness Month – the event is more than just an educational opportunity. It’s also a chance for women to help other women. That task was on the minds of both patients and survivors at Penn’s BRA Day event, held this year in the Smilow Center for Translational Research on October 18th.
“I come to this event every year, and I wouldn’t miss it,” said Ilyce Benton. The Newtown Square native had post-cancer reconstruction at Penn nine years ago, but says she takes advantage of the opportunity to talk to other women about her experience and to keep in touch with her doctors. “It’s important to keep the communication open.”
Dr. Joseph M. Serletti
This was the sixth year Penn has hosted a BRA Day event, and the turnout was the biggest yet. Guests not only got to ask their questions directly to Penn’s experts, they also got the chance to meet other women who have gone through their own journeys. Many women also showed up with new and gently used bras for donation that will go to women’s shelters across the country. Joseph M. Serletti, MD, FACS, the chief of Plastic Surgery, served as the event’s master of ceremonies, and he noted the message about the importance of reconstruction is spreading thanks to the courage of the women who have been through it and are willing to tell their stories.
“You’re the true heroes here because you help us get the word out,” Serletti told the crowd. “You also help us as doctors, because you contribute to our understanding of reconstruction and you help us tell the story that reconstruction really works.”
There are two main categories of breast reconstruction. The first involves implants. The second, called a tissue flap procedure, uses tissue from other parts of the patient’s body. Penn specializes in this method and performs more of these procedures than any other center in the country, an accomplishment recognized by the American Association of Plastic Surgeons earlier this year. There are several different methods that fall into each category, and the approaches can even be combined in some cases. In addition to the surgical procedures, patients can get nipple and areola tattoos for a more realistic aesthetic.
BRA Day participants said their reconstruction was about more than physical appearance. They said it also made them feel whole again, which carried huge benefits for their mental and emotional health. BRA Day’s official motto says it best: Closing the loop on breast cancer.
Dr. Paris D. Butler
Despite the efforts of doctors at Penn and across the country, the rates of reconstruction remain low, and that’s particularly true among minorities. The disparity is staggering, and while it’s often attributed to a woman’s insurance status or the number of plastic surgeons who work in the region where she lives, the problem appears to run even deeper than that. An upcoming study from Paris D. Butler, MD, MPH, an assistant professor of Plastic Surgery at Penn, shows that even when the number of plastic surgeons in the area are the same and the patient has private insurance as opposed to public, white women are 24 percent more likely to undergo reconstruction than black women, 26 percent more likely than Asians, Pacific Islanders, and Native Americans, and 19 percent more likely than Hispanics.
“The challenge of spreading the word about reconstruction isn’t limited to BRA Day,” Butler said as he addressed the crowd. “It’s a 365 day-a-year challenge, and BRA Day is only part of the answer.”
Butler pointed out that older women also tend to have lower rates of reconstruction. He says it’s crucial for experts to team up with advocates both locally and nationally to make sure women know their options. Back in the spring, Butler hosted an awareness symposium in West Philadelphia to bring the message directly to the community. He says he plans to do it again in April of 2018.
Many of the women who attended BRA Day said they also feel the importance of being their own advocates for reconstruction. Benton, who underwent two different types of reconstruction almost a decade ago, now takes part in Penn’s peer-to-peer program, which puts women facing possible reconstruction in touch with women who have gone through it so patients can decide if it’s right for them. She’s a vocal ambassador for the benefits of the procedure.
“I would lift up my shirt on the Walt Whitman Bridge if it helped women understand what it feels like to be whole again,” Benton said.