Breast reconstruction advancements offer glimmer of hope for cancer survivors

While the journey through breast cancer is often fraught with emotional and physical challenges, the option of breast reconstruction offers a glimmer of hope and restoration. 

This is particularly evident in the stories of women like Nana Kilemi, Margaret Wanjiru, and Scholastica Ndung’u, each of whom has navigated their own unique paths through breast cancer and reconstruction.

Breast reconstruction generally falls into two categories: implant-based reconstruction and flap reconstruction. 

Implant-based reconstruction involves inserting a silicone or saline implant to recreate the shape of a breast while the Flap reconstruction uses tissue from another part of the body, such as the thighs, abdomen or back to reconstruct a new organ, the breast. Nana was courageous enough to undergo the later.

When she was diagnosed with stage three C breast cancer in 2022, she faced a whirlwind of emotions following her diagnosis. 

The news of her cancer was devastating, as she grappled with the prospect of a future without her right breast and the daunting costs associated with its treatment.

"I thought it was my end, I worried about my young family and the financial burden of treatment," Nana recounted, reflecting on her initial despair. 

Her right breast was removed, leaving her grappling with a sense of imbalance and loss. 

The surgery to remove her breast was conducted at Kenyatta University Teaching and Referral Hospital (KUTRRH), and she lived without her right breast for over a year. 

The physical and emotional impact was significant; “You put on your dress and you are like, Now what is this? Your body is not balancing,’” she admitted.

The psychological impact of seeing her altered body daily was profound, but it was also during this period that her surgeons suggested breast reconstruction.

"They told me that my breast could be reconstructed, and I was thrilled to learn that I would get a new body, with a flat tummy and nice boobs," she shares.

The reconstruction, performed at KUTRRH, was both physically and emotionally taxing but she does not regret the procedure and encourages other women in similar situations to consider reconstruction. 

“Even if the reconstruction was painful, I am happy I did it,” she said. 

At Ting’ang’a village in Kiambu county, we find Margaret Wanjiru, a 70-year-old breast cancer survivor sitting on a plastic chair enjoying the afternoon breeze. She offers a contrasting perspective. 

Diagnosed with the killer disease in March 1993, the mother of one underwent a mastectomy a month later and although she was aware of breast reconstruction options, she chose not to pursue them. 

The reasons were twofold; the anticipated pain of additional surgery and the financial burden of the procedure. 

“I cannot stand another theatre pain. The removal of my breast was enough. But again, that time I couldn’t afford the procedure. My financial constraints couldn’t allow me and you know it’s not a cheap procedure.” she explained. 

However, she encourages younger women who have lost breasts to consider reconstruction, believing it can enhance their quality of life and help overcome societal stigma.

Wanjiru’s experience with stigma was intense. Over 30 years ago, societal attitudes toward cancer were less accepting, and she faced harsh judgments from her community. 

Nevertheless, the cancer survivor champion remained resilient, finding strength in self-acceptance despite the negativity surrounding her. 

For many survivors, breast reconstruction is not just a medical procedure; it's a path to reclaiming their sense of self and overcoming the stigma associated with breast loss.

In contrast to Wanjiru's decision, Scholastica Ndung’u from Eastleigh, Nairobi, experienced a miraculous outcome. 

Diagnosed in 2022, cancer had consumed the lower part of her breast, necessitating its removal. "It was shocking and frightening," Scholastica recalls. "I felt incomplete without my breast."

Remarkably, in a surprising turn of events, the removed part of her breast grew back, seamlessly matching the other breast.

“It grew and matched the natural size of the other breast. It is not easy for a woman to live without what defines you,” she shared. 

Had the regrowth not occurred, she indicated that she would have pursued breast reconstruction, highlighting the significance of the procedure for many women.

At the KUTRRH, Dr. J.P. Ogalo, the head of plastic surgery at the level 6 facility, notes that the hospital performs around 15 breast reconstruction procedures annually. 

“It is an important procedure that restores confidence to a woman. For a standard procedure, it takes three to four hours” he acknowledged. 

Dr. Sarah Kemunto, a plastic surgeon at the same facility, acknowledges the challenges of breast reconstruction but emphasizes the honor of improving patients' quality of life. 

“It’s not an easy procedure, but it’s a privilege to be able to provide a better quality of life for our patients,” she stated.

As the number of breast cancer patients increases, KUTRRH is planning to establish a dedicated Breast Care Centre with an aim of providing comprehensive care for breast cancer patients while addressing stigma. 

Professor Olive Mugenda, the board chair of KUTRRH, explained the rationale behind the new center. “We are calling it a Breast Care Centre because we want to avoid the stigma associated with a ‘breast cancer’ label. We want to ensure that patients coming for checkups or support are not stigmatized,” she said. 

The new center will accommodate 108 patients, reflecting a significant step forward in specialized cancer care.

The cost of breast reconstruction remains a concern for many women. The procedure can be expensive, and financial constraints may deter some from pursuing it but it is worth noting that the procedure is covered by the National Hospital Insurance Fund (NHIF) at national referral hospitals like KUTRRH. 

Nana Kilemi’s reconstruction was fully covered by NHIF. This coverage aims to alleviate the financial burden and make reconstruction more accessible.