HJBR May/Jun 2025

HEALTHCARE JOURNAL OF BATON ROUGE I  MAY / JUN 2025 53 Mindy Williams Bowie, MD, FACS Breast Surgical Oncologist Mary Bird Perkins Cancer Center in breast reconstruction linked to patient factors, including age, race, income, and insurance status. Reconstruction is categorized into im- plant-based reconstruction and autologous tissue reconstruction. In the U.S., 81% of re- constructive procedures after mastectomy for breast cancer are implant-based. This is when an implant is used to make a new breast after a mastectomy. The remaining 19% is autologous tissue reconstruction, which is when the patient uses her own body’s tissue to make a new breast, such as her abdominal tissue. Patients can have a combination of these two procedures as well. More recently, breast surgical oncologists and reconstructive surgeons have focused on oncoplastic procedures with lumpec- tomies, which allow for symmetry of the breasts after the cancer is removed. This involves surgical techniques to improve both cosmetic outcomes in breast shape af- ter lumpectomy, aiming for natural-looking breasts that are symmetric while ensuring effective cancer removal. Often, the affected breast is left slightly larger than the contralateral breast in an- ticipation for radiation, which can slightly shrink the affected breast. These techniques address potential deformities or asymmetry that can occur when the cancer is removed by reshaping the remaining breast tissue bilaterally. Hidden scar breast surgery is another advanced approach that aims to minimize visible scarring by placing incisions in inconspicuous areas, while still effectively removing cancerous tissue through lumpec- tomies or mastectomies. Women should be educated about breast cancer, including the importance of self- breast exams, yearly mammograms, and understanding if they are at increased risk for breast cancer, possibly benefitting from being followed in a high-risk clinic. If a woman is diagnosed with breast cancer, it is important that she is educated in her cancer treatment options, including surgery and reconstruction. Women are living longer with breast can- cer secondary to advancements in treatment. They should be offered an opportunity to still look and feel like a woman after their surgical treatment is complete, while mini- mizing scarring. Many studies have shown that most patients mentally do better when they have an aesthetically pleasing result after their cancer has been removed. This can lead to increased satisfaction and better quality of life. n MindyWilliams Bowie is a breast surgical oncologist at Mary Bird Perkins Cancer Center. She is board certified by the American Board of Surgery and is a fellow of the American College of Surgeons. Bowie earned a Bachelor of Science inmicrobiology and a Master of Science from Louisiana State University. She continued her education at Louisiana State Uni- versity Health Sciences Center, completingmedical school in 2004 and a general surgery residency in 2009. She then completed a breast surgical oncol- ogy fellowship at Moffitt Cancer Center in Tampa, Fla. Certified in Hidden Scar breast surgery, Bowie specializes in nipple-sparing mastectomies and on- coplastic breast surgery. She is actively involved in breast cancer research and prevention,with several publications in breast cancer journals. are choosing to have nipple areola-sparing mastectomies, which conserve all of the skin, nipple, and areola on the outside, removing the breast tissue on the inside, followed by reconstruction. The What A patient needs to be informed of her reconstructive options. As breast surgical oncologists, we should not only place em- phasis on the surgical removal of the cancer, but also on the long-term cosmetic aspect as well. Oncoplastic surgery is a specialized ap- proach to breast cancer surgery that aims to achieve both effective cancer removal and a cosmetically acceptable breast appearance. For women undergoing surgical treatment of breast cancer, breast reconstruction has important benefits, including improvement in body image and sexual functioning. Under the Women’s Health and Cancer Rights Act (WHCRA), insurance payer cov- erage for breast reconstruction has been mandated in the United States since 1998. Subsequent studies have reported rising rates of immediate breast reconstruction after mastectomy from 1998 to 2014, after which rates have stabilized. Possible ex- planations for this stabilization of breast reconstruction include population-level increases in age and accompanying health problems, or comorbidities. Other contrib- uting factors may include an increase in less invasive treatment, such as breast conser- vation. Studies have also found disparities