BRCA is the name of the gene that most commonly affects the hereditary risk of developing breast cancer. When these genes work normally, they suppress tumor development, however, when their DNA contains certain mutations, they can raise the likelihood that someone will get breast cancer and some other cancers.
Around one fourth of breast cancer cases in women younger than 30 years are tied to the genetic mutation of one of two BRCA genes, BRCA 1 and BRCA 2. (1) And in increasing numbers, women are seeking genetic counseling and testing for these mutations so they can mitigate the risks. One way to do this is to receive bilateral mastectomy surgery, in which the glandular tissue, areola, and nipple of both breasts are removed.
Dr. Michael Howard performs Deep Epigastric Inferior Perforator (DIEP) flap reconstruction for women who have undergone double mastectomy in Chicago, Lake Forest, and Glenview, IL. He has performed countless procedures which have helped his patients to regain confidence in their bodies. Whether you are choosing bilateral mastectomy because you have received positive genetic testing results for BRCA 1 or BRCA 2, or you are a breast cancer survivor, you can take control of your appearance with autologous breast reconstruction surgery. Call Michael Howard Plastic Surgery at (224) 271-4250 or fill out an online form to discuss DIEP flap reconstruction at one of our three Illinois locations.
- 1 Before & After Photos
- 2 About Breast Cancer
- 3 BRCA and Breast Cancer
- 4 Bilateral Mastectomy
- 5 Autologous Breast Reconstruction
- 6 Cost of DIEP Flap Breast Reconstruction in Chicago, IL
- 7 FAQ
- 8 References
Before & After Photos
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About Breast Cancer
Cancer is a disease that causes abnormal cell growth. It is a physical, emotional, and financial burden to an individual and their family, and a serious socio-economic problem for our broader society. In fact, according to the National Cancer Institute’s 2019 figures, the national economic burden of cancer care to patients was over $21 billion. (2)
Cancer in the United States
Public health institutions like the CDC and the National Cancer Institute release data regularly regarding breast cancer’s impact on the population.(3)(4)(5)
- There were an estimated 287,800 cases of breast cancer in the U.S. in 2022.
- Breast cancer makes up 15% of total cancer diagnoses every year.
- Breast cancer is the second most common cancer diagnosed in women.
- Women with BRCA 1 or BRCA 2 mutations reduce their risk of breast cancer by approximately 90% with bilateral prophylactic mastectomy.
- There are over 3.5 million breast cancer survivors in the United States.
BRCA and Breast Cancer
BRCA mutations cause cancer by altering the way cells grow and multiply. Normally, BRCA 1 and BRCA 2 are tumor suppressors. They protect the body from getting some kinds of cancer. Everyone, men and women, inherits two copies of each of the BRCA 1 and BRCA 2 genes. But certain changes in the way these genes develop can make it more likely that cells will grow and develop out of control, causing breast, ovarian, and other cancers. Despite this risk, not everyone who inherits these mutations will get cancer. (4)
BRCA1 & BRCA2 Statistics
BRCA 1 and BRCA 2 data are outlined below. (2)(6)
- Approximately 35% of hereditary breast cancer cases are caused by BRCA 1 mutation.
- Approximately 25% of hereditary breast cancer cases are caused by BRCA 2 mutation.
- One in every 300-800 people will have BRCA 1 or BRCA 2 mutations.
- Familial testing can help people find out if they have BRCA1 or BRCA 2 mutations.
- Once mutations are identified, people can increase monitoring and take preemptive steps to lower the risk of developing cancer.
Before getting genetic testing, physicians usually require you or a family member to receive genetic counseling. A genetic counselor will discuss your health details and your family’s cancer history, as well as discussing the next steps regarding testing. If there is a high enough risk you or a family member have the BRCA1 or BRCA 2 mutation, it is likely you will need genetic testing in the following circumstances.
- A strong family health history of breast and/or ovarian cancer
- Ashkenazi Jewish or Eastern European ancestry with a moderate family health history of breast and ovarian cancer
- A personal history of breast cancer
- A personal history of ovarian, fallopian tube, or primary peritoneal cancer
- BRCA1, BRCA2 mutation(s) have already been identified in your family (7)
You may undergo genetic testing if you are in a high risk group, and if your genetic counselor’s analysis indicates a high likelihood of BRCA 1 or BRCA 2 mutation. Testing involves the collection of blood or saliva and the analysis of the sample via multigene panel. It is important to receive genetic counseling after testing so you understand the implications of the results for yourself, and for your family.
Bilateral mastectomy involves the removal of tissue in both breasts, including the nipple and the areola. Actress Angelina Jolie has been publicly open about her precautionary double mastectomy, which took place in 2013.
Prophylactic Bilateral Mastectomy
A person who is identified by a medical professional as being at particularly high risk of developing cancer may opt for prophylactic bilateral mastectomy. Data indicates that this precautionary measure reduces a patient’s risk of developing breast cancer by 85-100%. (8)
Mastectomy After Cancer Diagnosis
In cases of unilateral (one breast) cancer diagnoses, their treatment plan may indicate either unilateral or bilateral mastectomy. In such cases, and in cases of preventive mastectomy, many women opt for breast reconstruction, either at the time of the mastectomy surgery (“immediate reconstruction”), or at a later date (“delayed reconstruction”).
Autologous Breast Reconstruction
Choosing breast reconstruction surgery is a personal decision. However, there are many advantages to the DIEP flap option. An autologous DIEP flap breast reconstruction procedure uses a patient’s own tissues to reconstruct the breasts following a mastectomy procedure. While some women will choose implants, the DIEP treatment pathway provides patients with a more natural way to heal. There are a number of variations of the procedure.
Benefits of DIEP Flap Reconstruction
- Uses living, natural tissue to reconstruct the breast
- No maintenance or revision surgery required
- No need for the use of tissue expanders
- Reconstructs areola to a natural position on the breast
- Creates chest proportions with a natural shape
Research data shows that the DIEP flap procedure is consistently viewed as the gold standard for achieving natural, lifelong breast reconstruction. (8)
DIEP Flap Procedures
- Stacked DIEP
- Superficial Inferior Epigastric Artery (SIEA) Perforator Flap
- Transverse Upper Gracilis (TUG) Flap
- Profunda Artery Perforator (PAP) Flap
- Thoracodorsal Artery Perforator (TAP Or TDAP) Flap
Cost of DIEP Flap Breast Reconstruction in Chicago, IL
The cost of DIEP flap reconstruction after mastectomy varies according to a patient’s treatment plan. The first atep in th eprocess is to book a personal consultation with Dr. Howard. Call (224) 271-4250 or submit a simple form on our website for more information.
If I have BRCA gene mutations, will I get breast cancer?
Even if a person has the BRCA 1 or BRCA 2 mutation, this does not mean they will get breast cancer. The most effective analyses of your health and your family’s medical history can be performed at a genetic counseling session.
Between 1 in 300 and 1 in 800 people will have BRCA 1 or BRCA 2 mutation.
What choices are there for breast reconstruction?
Breast reconstruction is a personal decision to be made between a patient and her physician. Many patients will get immediate reconstruction in the same procedure as their mastectomy, while others will wait before receiving reconstruction. A patient may choose implants, which usually require tissue expanders, or DIEP flap reconstruction which uses natural tissue from a patient’s own body to recreate the breast mound, areola, and nipple.
- Alkabban FM, Ferguson T. Breast Cancer. National Library of Medicine. Published 2018. https://www.ncbi.nlm.nih.gov/books/NBK482286/
- Casaubon JT, Grewal US, Regan JP. BRCA 1 and 2. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK470239/
- National Cancer Institute. Female Breast Cancer – Cancer Stat Facts. SEER. Published 2018. https://seer.cancer.gov/statfacts/html/breast.html
- The BRCA1 and BRCA2 Genes | CDC. www.cdc.gov. Published March 31, 2020. https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/genes_hboc.htm#:~:text=Normally%2C%20the%20BRCA1%20and%20BRCA2
- Rebbeck TR, Friebel T, Lynch HT, et al. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 2004;22(6):1055-1062. doi:https://doi.org/10.1200/JCO.2004.04.188
- Petrucelli N, Daly MB, Tuya Pal. BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer. Nih.gov. Published December 15, 2016. https://www.ncbi.nlm.nih.gov/books/NBK1247/
- Genetic Testing for Hereditary Breast and Ovarian Cancer | CDC. www.cdc.gov. Published January 26, 2021. https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/testing.htm#:~:text=Genetic%20testing%20for%20hereditary%20breast%20and%20ovarian%20cancer%20looks%20for
- Alaofi RK, Nassif MO, Al-Hajeili MR. Prophylactic mastectomy for the prevention of breast cancer: Review of the literature. Avicenna journal of medicine. 2018;8(3):67-77. doi:https://doi.org/10.4103/ajm.AJM_21_18