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newbreast.eu :: Uroš Ahčan
FOREWORD

Per Hedén

Being the most common form of cancer in the female body breast cancer concerns everybody. If we have not been affected by it ourselves we have family, relatives or friends that has. It is a disease that most women think of regularly and thus usually search information about. Today the internet is the obvious source of information for us but unfortunately in of the 21st century there is such an overflow of information that it is difficult to find the true and right one. Sadly much of what is found on internet is disinformation and faulty. Thus more objective information is needed. Dr Uros Ahcan has with this publication created a unique book for anybody who seeks objective and honest information about breast cancer and breast reconstructions.

In most modern societies of the 21st century it is a woman´s right to be offered a reconstruction of the breast after breast cancer. Only a half decade ago breast reconstructions was basically unheard of. With the introduction of silicon breast implants in 1962 a foundation for a new breast reconstructive era was made. Microsurgical techniques introduced in the late 1970´s resulted in the use of the patients own tissue (autologous) to rebuild the breast which became state of the art in the end of the 20th century. Today both implant based and autologous tissue reconstruction are widely used based on patients desires and biological conditions and we have also entered into a new era of fat transplantation as a compliment to both implants and autologous tissue transfer but also as a new stand alone procedure. Obviously this all makes it so much more difficult for patents to make informed consent about the reconstructive procedure she is going to go trough and this underlines the importance of this book. A book that can help patients better understand pros and cons of different procedures.

Close to 20 years ago I realized the importance of honest and objective objective information about plastic surgery to potential patients and this resulted in the publication of two books, one Swedish and one English (Plastic Surgery and You). I am glad and honoured to see that this has partly inspired Dr Ahcan to write this book. To write a book for the general public on a medical condition is not easy for a physician. Educated and used to reading nonfiction professional book he has to adopt and change the way he usually expresses himself. If not the text would be difficult to digest and boring for non-professional. Dr Ahcan has indeed succeeded in writing an absorbing and engaging text that can be enjoyed by anybody. The book is very objective and covers all different aspects of breast cancer and reconstructions. For women who are unfortunate to be affected by this disease this book will be giving them invaluable information that is difficult to find elsewhere and it will also in this way give them more security in facing their treatment.

I am impressed by this book, not only for its objective and fully covering text, but also for it´s very elegant layout. It has been truly delightful to read it but also to see its tasteful illustrations. The historical review underline how much things have changed in medical science and is a very interesting review of this evolution. It is definitely a book that I would recommend to anybody. Even if this book primarily is intended for the general public it is also of great interest for medical practitioners and especially for young plastic surgeons end even for the more experienced ones.

There are many misconceptions about plastic surgery and what we do in this speciality. I am grateful for this book because it will further help to create a true picture of a fantastic speciality that can do so much in helping to improve the quality of life for so many people.

Per Hedén
MD, Associate Professor in Plastic Surgery
Akademikliniken
Stockholm , Sweden

 

Maurice Y. Nahabedian

In the book, Breast Cancer and the Best Reconstructive Options, Uros Achan has beautifully reviewed and illustrated the essential elements that women diagnosed with breast cancer must be aware of. In the world of breast oncology and plastic and reconstructive surgery where the amount of information is continually increasing, it is important for women to have up-to-date information from an expert within the specialty. This resource provides just that and in a style that makes reading or perusing the book fun, enjoyable, and informative. Uros combines elements of antiquity with modern day science and includes beautiful and well-designed illustrations and photographs that keep the reader engaged throughout the book. There are patient testimonials that women with breast cancer and providers that treat breast cancer will relate to. The options for breast reconstruction ranging from prosthetic devices to autologous tissues to nipple reconstruction are clearly delineated and illustrated. Women will be better able to understand what to expect during the journey as she is taken through the steps of the initial diagnosis, the various consultations, management strategies, and all the way through recovery. I am confident that this book will answer many of the questions that frequently arise when making choices. This book should be a must read for all patients and health care providers that are involved in the care of women diagnosed with breast cancer.

Maurice Y. Nahabedian, MD
Professor and Vice Chairman
Department of Plastic Surgery
Georgetown University Hospital
Washington DC, USA
DrNahabedian@aol.com

 

Venkat V Ramakrishnan

I have known Professor Ahcan as a friend, professional colleague, international teacher, innovator and conscientious doctor, over the years, however, this book has shown me his impeccable skills and passion for writing. This book is an exhaustive compilation of information for not only the patients seeking breast reconstruction. But, it is an essential for all doctors, nurses, therapists, administrators involved in the field of breast reconstruction.

This book sets out the ‘project’ of breast reconstruction following mastectomy, as a positive rehabilitative measure for the woman, in the unfortunate situation. It helps the distinction between cosmetic breast surgery and the reconstructive breast surgery, which is often blurred in the minds of patients and healthcare providers at times. The visit into the history is enlightening as well as reassuring to the reader. The chapters on the procedures are beautifully laid out, and offer all the information required to the reader. The final chapters from patients, offers a very personal and direct connection with a real life situation and it will be a great support to women in this difficult times. Attention to detail, excellent illustrations, and easy reading text, are the hallmarks of this effort.

It will be a must have book for every breast centre, and I have no doubts numerous patients and clinicians will benefit from reading this over the years. I look forward to seeing this in print and available for my patients.

Venkat V Ramakrishnan
Consultant Plastic surgeon
United Kingdom

 

FOREWORD

Prof. Riccardo Mazzola, M.D.

With the many changes in breast surgery during the last two decades and the increasing need for interspecialty collaboration and cooperation, the seeds of “Breast cancer and the best Reconstructive Options” were sown.

In order to have the most expertise in as many areas as possible, Uros Ahcan has chosen a multi-authored approach to this subject. The atlas format is intended to provide a “how to” outline for many procedures. The text on the other hand is meant as resource regarding important oncologic, tissue biology, genetics, reconstructive or aesthetic principles or issues.

The contributions of and interplay between plastic surgeons and oncologists are presented for mutual benefit.

The female patient dominates the discussion. She is after all the patient at greater risk of or affected by breast cancer and to her the book is dedicated.

The key to excellent operative results achieved by Uros Ahcan and his team lies in understanding and communicating with the patient, carefully analyzing her physical and psychological situation identifying her expectations and finding the means to help patients to accept their dramatic mutilation. Some illustrative case studies are self explanatory for demonstrating the outcomes obtained nowadays by the plastic surgery group in Ljubljana.

This is a fine textbook about a key procedure, that is management of breast cancer. It has both the needed details and the necessary perspective and information for anyone with a strong interest in breast surgery. Its great strength is its emphasis on the importance of individualizing the appropriate procedure to answer the patient’s needs, not just anatomically but psychologically. The participants into this project – the author, the co-workers and the publisher – deserve praise for producing something that is different from most publications on this subject.

But having the text and keeping it on the shelf, does little good for anybody. For the surgeon desiring to add this special field of endeavor to his activities, it represents a unique opportunity for learning. It is a resource of information that has to be read and reread in conjunction with clinical practice. For the patient to benefit, this book has a higher mission. It must serve as a consultant, a sort of guideline, with the admirable advantage of being always available and ever accessible both before and after surgery.

The book is directed for plastic surgeons, general surgeons, general practitioner, gynecologists, and oncologists and for anyone else who is looking for a unified source of information for practical and principled surgical management of breast cancer. We hope that the well trained general surgeon as well as specialists wishing to possess a volume dedicated to this subject exclusively, will find this text useful for the purposes for which it was written. But also the less experienced surgeon is provided with requisite information to achieve better and more consistent results. Last but not least, the patient will discover the unexpected outcomes of reconstructive procedures.

Prof. Riccardo Mazzola, M.D.
Presidente della Società Italiana di Chirurgia Plastica
Ricostruttiva ed Estetica (SICPRE)
Specialista in Chirurgia Plastica Ricostruttiva ed Estetica
Dipartimento di Scienze Chirurgiche Specialistiche
Università degli Studi
Ospedale Policlinico
Milano, Italia

 

EXCERPT FROM THE REVIEW

Breast cancer and best reconstructive options

Restore your body and life - choose a state of the art approach for modern women

Every physician - one that transforms his life into a mission - is very well aware of what he should be encouraging and preaching to the people he meets through his work. What is greater than meeting a person that has been diagnosed with BREAST CANCER, redeeming her from the dreaded social stigma that the disease brings, and offering her hope of not only the restoration of her health, but of her body and mind as well? The incidence of this dreadful disease among modern women is on the rise as a result of the change in our lifestyle and our longer life expectancy. Breast cancer will affect one in every eight women of the western world. The diagnosis is dealt with by several medical professionals, including the general physician (who is usually the one to suspect it in the first place), the surgical oncologist, the internist, the radiologist and the psychotherapist - all of them helpers on the patient’s journey. But the treatment does not end there - reconstruction can bring it to the level of restoring the woman’s physical integrity. As incredible as this may sound, a woman’s physical health is only brought back along with a reconstructed breast!

Prof. Dr. Uroš Ahčan experienced all of this through years of hard work as a plastic and reconstructive surgeon. His enormous potential, the depth of his knowledge and his committed professionalism helped him surpass the status quo and introduce new experience and new knowledge into the world. As he travelled through the world, Dr. Ahčan slowly realized that despite the blooming progress of information technology and the abundance of facts in the public sphere today, breast cancer patient are nothing short of confused when browsing through such “treasuries” of data. Slowly but surely, Dr. Ahčan made the decision to help and offer breast cancer patients some hope in the shape of a book. He wanted to put forth a comprehensive view of the modern options for interdisciplinary treatment of breast carcinoma patients. And the result? An amazing book - one that no one in the world can offer! A gentle voice of hope for the patients and their relatives, offering faith and optimism and at the same time reminding them that the story of cancer is concluded with a happy ending more and more frequently.

The shared interdisciplinary contribution of professional writers - oncologists, radiotherapists, internist oncologists and psycho-oncologists - adds to the book’s persuasive impulse. The author’s own reconstructive work on patients not only fills the reader with optimism and complete trust in the expert abilities of his team of co-workers, but also invokes a profound admiration of the exceptional skill with which he exceeds all expectations. Layered above the aesthetic appearance of a reconstructed breast is a deeply respective stance toward breast cancer patients and an understanding of their grief coupled with a highly ethical approach to their distressed personality and the affected, intimate parts of the patients’ bodies.

The book was conceived to cover many fields we would not expect to find in a regular book on medicine. But they are much needed, as the lives of many patients will testify. A woman with a deformed body desires not only to emerge healed, but also to be completely renewed physically and mentally. With an erudite approach, the author and his team discuss the ideals of female beauty through time and the depictions of the breast as the most splendid part of the female body. The expected logic and scientific way of writing in the medical passages about cancer treatment itself is vividly contrasted with the other chapters, which come across as fresh, original and invigoratingly human. One could also look to the book as a didactical model because it includes short summaries and highlighted passages that bring the message closer to the reader, and the several lists of interesting facts ensure that whoever is reading stays engaged in the subject until the very last page.

The visual material deserves special praise; it is a rare occasion to see the breast - especially a diseased one - in such a vivid depiction and from so many points of view! A series of incredible photos makes for a splendid, demonstrative companion to the gradual change a reconstructed breast goes through. I congratulate the author for the courage and I applaud the patients that have helped him by sharing their experience in the book and allowing their body to be photographed. The photos themselves speak - more than a thousand words could - of suffering, disease, courage, and finally a cathartic victory, when the affected body part is replaced by healthy tissue and the women emerge blissfully transformed on the outside as well as on the inside. They are the best models of a restored health condition and a rehabilitated relationship to one’s own body. I applaud them again, for realizing that the only way to demystify this dreadful affliction is by exposing it how it really is and what it really looks like. I also congratulate the photographer, Aljoša Rebolj, for effectively using the medium of photography to surpass the physicality of the nude body and to successfully render the beautiful posture of a woman who is no longer a handicapped Amazonian, but a proud human being again. The curtains are down, there is no room for magic - the artistic eye of the surgeon and the sharpness of the scalpel are the ones that take the stage. And with all their dedication, they transform pieces of diseased tissue into new breasts, not infrequently leaving them better than they ever were.

prof. dr. Zvonka Zupanič Slavec

© Uroš Ahčan | 2014