Contact:Laura Pollio


Riverview physicians bring new option to breast cancer patients

Specialists at Riverview Medical Center have brought one of the most advanced breast reconstructive surgery procedure currently available to Monmouth County. For one breast cancer survivor from Long Island, a search throughout the tri-state area for the right doctors led her to Red Bank, NJ, where she found a team capable of conducting this exceptional procedure.

The DIEP (deep inferior epigastric perforator) flap is a microsurgical, state-of-the-art procedure which offers patients a new alternative for breast reconstruction. Excess tissue is removed from a woman's own abdomen and transplanted to create a new breast. Microsurgery is used to reconnect blood vessels to maintain the integrity of the transplanted tissue. Surgeons sculpt a new breast using the patient's own flesh, but without the trade-offs of other alternatives.

Long Island resident, Merle, was recently diagnosed with a recurrence of breast cancer. Having treated her first run-in with breast cancer by having a lumpectomy and chemotherapy ten years ago, she knew that she would require more extensive surgery this time. As someone who works for a breast cancer hotline, Merle was well aware of the various options, including the DIEP flap.

In Merle's case the medical decision was made for bilateral mastectomies (which is a procedure to remove the affected breast as well as the other breast.) Merle knew that she wanted the DIEP flap for reconstruction of her mastectomy defects and had to find the right experts. That is, a team of breast and plastic surgeons who can coordinate their techniques for a successful outcome.

Riverview plastic surgeon Negin N. Griffith, M.D. and breast surgeon Debra Camal, M.D. met with Merle and knew that they could help her. Dr. Camal would perform the life saving mastectomies and Dr. Griffith would follow with bilateral DIEP flap breast reconstruction. Since Merle would be having both breasts reconstructed, the physicians brought in a third team member, plastic surgeon John Taylor, M.D., to assist.

"It's exciting to bring this procedure into the mainstream of our community," says Dr. Griffith. "Very few community hospitals in the United States offer the DIEP flap as a reconstructive option to women undergoing mastectomy."

Other reconstructive techniques used by plastic sugeons include artificial implant based reconstruction and the TRAM (Transverse Rectus Abdominis Myocutaneous) flap. Both of these techniques are still widely used and appropriate in the right candidate. However, with artificial implant reconstruction, there is a risk of rejection of the implant by the body or failure of the implant. It also may complicate recovery in women who have undergone or will undergo radiation. The TRAM flap is a non-implant based reconstruction that also uses a woman's own tissue. In addition to excess skin and fat, the TRAM flap removes muscle from the abdominal wall and tunnels it up to the breast area. While still a good technique in breast reconstruction, the TRAM falp may lead to weakening of abdominal muscle strength and development of hernias. For those who are appropriate candidates, the DIEP flap technique offers an alternative. While the DIEP flap carries with it longer operative times and requires an ICU stay, it offers women with breast cancer a reconstructive option that avoids permanently disturbing the integrity of the abdominal musculature, while still using a woman's own tissue to create a breast.

After spending several days recovering at Riverview Medical Center, Merle returned home and is very pleased with her results. "Dr. Camal and Dr. Griffith far surpassed my expectations," says Merle. "The procedure went very well and I feel progress every day."

With the help of skilled anesthesiologist, Vijayalaxmi Varadarajan, M.D. and a team of expert nurses and operating room personnel, Doctors Griffith, Taylor and Camal are the first to introduce the DIEP flap procedure at Riverview Medical Center. Patients at any age can be a candidate for the procedure, depending on their medical history. The procedure can be performed at the time of a mastectomy or later.