Department of breast cancer surgery

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When can a patient have breast reconstruction?

• After mastectomy (removal) of the breast to treat breast cancer
• After preventive mastectomy (for example, if a patient is a BRCA mutation carrier)
• After sector resection (to reconstruct the shape of the breast)

When can the reconstruction be done?

• Immediate reconstruction (immediately after removal of the breast, at the same time as the cancer surgery)
• Delayed reconstruction (another surgery, after the cancer surgery; this option is also available to patients who underwent mastectomy in a different cancer center)
• On an ambulatory basis (such surgical procedures as reconstruction of the nipple and areola, a lift of the healthy breast, reshaping of the reconstructed breast)

What procedures are used to reconstruct the breast?

• breast reconstruction using patient’s own body tissues
• using subcutaneous tissue and skin (DIEP, SIEA, IGAP, SGAP, lipofilling);
• using muscle, subcutaneous tissue and skin (LD, TRAM, TUG);
• breast reconstruction using an implant (endoprosthesis)

What types of implants are used for breast reconstruction?

For endoprosthetic reconstruction, the Department uses implants and expanders manufactured by Mentor, Allergan and Polytech, as well as TiLOOP® Bra titanium-coated polypropylene mesh.

What equipment is used for breast reconstruction?

Scalpels with a more gentle effect on tissues, thin needles and strong sutures for creating muscle pockets, and absorbable suture material for sub-cuticular sutures.

In certain instances, magnifying equipment is used.

The Department also uses a stationary microscope to restore the blood supply to free flaps moved to the accepting area.

What should patients who are thinking about having reconstructive surgery after mastectomy/resection do?

1. Patients should request an appointment with a breast oncology specialist at the Center to discuss their breast reconstruction options.
2. After that, patients undergo follow-up examination (types and extent of exams will depend on when cancer treatment ends and when the patient had their last check-up).
3. Once the results of follow-up examination are ready, patients should have an appointment with either Professor V.F. Semiglazov, D.Sc., Corresponding Member of the Russian Academy of Sciences, or Dr P.V. Krivorotko, D.Sc., Head of the Department to select the best breast reconstruction option and agree on the date of the surgery.
4. Then, patients should provide the documents necessary to secure insurance coverage of the surgery (copies of the internal passport, insurance policy, individual insurance account number and the referral letter to the Center executed as per the F-57 form).

Who performs breast reconstruction?

Oncologists who are certifies plastic surgeons having considerable experience of performing this type of procedures. The Department performs about 350 breast reconstruction procedures every year.

How much does breast reconstruction cost?

Immediate and delayed breast reconstruction is covered by insurance provided by the Ministry of Health of Russia and the Federal Compulsory Medical Insurance Fund and is available to all Russian citizens regardless of their place of residence.

If some additional surgeries are performed to improve the aesthetic appearance of the breast during the same hospital stay at the inpatient clinic as the breast reconstruction surgery (creation of the breast pocket), they are also covered by insurance (i.e. free for patients). Such additional procedures may include a reconstruction of the nipple and areola and a lift of the healthy breast.

If these procedures are performed during another special hospital stay and on an ambulatory basis, they are paid for by patients.

If breast reconstruction is performed after preventive mastectomy, it is also paid for by patients.

The Department also performs reshaping of the breast after breast reconstruction which has been done in other cancer centers. This is an inpatient surgical procedure that is not covered by insurance.