According to a survey by the National Cancer Institute (INCA), the estimated incidence of cancer in women in 2020 was around 66,000 new cases. Skin cancer, on the other hand, accounts for 27% of all malignant cases in Brazil.

On World Cancer Day (02/04/21), I answer the main questions I receive daily here at the clinic:

When is breast reconstruction indicated?

First, it’s necessary to analyze the proposed oncological treatment, as breast reconstruction with silicone implants cannot always be performed immediately, especially in cases where a lot of skin is removed or when complementary radiotherapy treatment precedes. Depending on the disease staging (determined by the lesion size, location, lymph node involvement, and presence of metastasis), mastectomy (breast removal) may be indicated, and it is at this moment that breast reconstruction can make a difference in restoring women's self-esteem and confidence, even contributing to strengthening the battle against the disease.

I consider it extremely important to emphasize that mammography is essential for early diagnosis. Therefore, do not fail to perform it, as this exam can reduce mortality by up to 30% when done periodically.

What is the result of a reconstructed breast?

Unlike cosmetic surgery, a reconstructed breast has distinct characteristics. The nipples often need to be reconstructed. The reconstructed breast will not have the same appearance as a healthy breast, as it may have scars and be harder. Therefore, I always advise patients to seek psychological support to understand this moment.

It is a woman's right to have breast reconstruction performed by the Unified Health System (SUS) and by health insurance plans in Brazil, as well as plastic surgery on the opposite breast for symmetrization and harmonization. Reconstruction, whether immediate or delayed, should be individualized, respecting both the patient's wishes and the clinical conditions and treatment they will undergo.

What skin signs indicate seeking a specialist and what are the types of skin cancer?

When you find the following changes in a suspicious lesion or mole, using the ABCDE method:

A – Asymmetry: when one part of the lesion is different from the other;

B – Border: irregularities in the outline;

C – Color: different colors in the same mole or lesion;

D – Diameter: when it is larger than 6 millimeters;

E – Evolution: notice if the lesion grows, changes shape, or color.

Wounds that do not heal after three weeks or that bleed easily should also be investigated.

There are several types of skin cancer; however, the three most common in Brazil are: basal cell carcinoma, squamous cell carcinoma, and melanoma, with the latter being the most severe, with a risk of developing metastasis and potentially leading to the patient's death.

Do dermatologists and plastic surgeons work as a team in skin cancer cases?

Normally, the dermatologist is the one who suspects the diagnosis through dermatoscopy, an examination performed with a magnifying lens. A biopsy and anatomopathological study are necessary to define the diagnosis. Depending on the location of the lesion, in the case of more delicate and exposed body areas, such as the face, the patient is referred to a plastic surgeon, who performs the removal and reconstruction if necessary.

After the disease is staged, that is, when its progression is identified, the involvement of other specialists, such as an oncologist, may be necessary to continue the treatment.

*Dr. Fernando Amato is a plastic surgeon, a full member of the Brazilian Society of Plastic Surgery, a member of the International Society of Aesthetic Plastic Surgery (ISAPS) and the American Society of Plastic Surgeons (ASPS).