A diagnosis of breast cancer can be overwhelming. Not only do you have decisions to make for treatment, you also have choices when it comes to breast reconstruction. Until now, cancer surgery came first, and plans for reconstruction followed at a later date.
Meet Jason Marengo, M.D., the newest member of the Center for Specialty Care, a NorthBay affiliate, in Fairfield. Dr. Marengo is an oncoplastic surgeon—one of a handful of surgeons nationwide trained in both surgical oncology and plastic surgery.
He knows first-hand how breast cancer surgery can have long-term consequences—his grandmother is a breast cancer survivor.
“My grandmother had breast cancer at a time when procedures were much more invasive,” Dr. Marengo remembers. “I witnessed how she coped with the side affects of such radical surgery.”
While a surgical resident at UC San Diego, he had a mentor who was dually trained in plastic surgery and surgical breast oncology. The physician was performing breast reconstruction at the same time he removed breast cancer.
“When I saw the incredible psychological difference this made for women, I knew this was my field,” Dr. Marengo says.
After his general surgery training, Dr. Marengo completed a Surgical Breast Oncology Fellowship at UT-Southwestern Medical Center in Dallas. Following this fellowship, he completed a Plastic and Reconstructive Surgery program at the University of Utah.
“I feel that I am in a unique position to provide a truly comprehensive surgical plan to our patients,” Dr. Marengo says. “Breast reconstruction is often only discussed in the context of recreating a breast after mastectomy. I believe that reconstructive principles should be applied to every breast procedure, from the smallest breast biopsy to recreating a breast after mastectomy.
“These principles, classically used in breast lift, breast reduction, and breast augmentation, provide me with the tools to not only remove a breast cancer, but through careful placement of incisions and the use of breast-shaping techniques, restore and in some cases improve the breast’s appearance.”
These reconstructive principles also guide his approach to the cancer portion of the operation.
“The principle here is to remove the cancer with as little damage to existing breast structures as is oncologically safe,” he adds. “This is a marriage of surgical oncology and plastic reconstructive principles, often referred to as oncoplastic surgery, but in my case done by a single surgeon with dual oncology and reconstructive training.”
Women have a number of options to reconstruct their breasts after mastectomy. Each has the potential to provide an excellent outcome. Two questions can help a patient with her decision: What is the anticipated recovery time? And, is radiation required as part of the patient’s treatment course?
In terms of recovery time, breast implant-based reconstruction is usually the easiest to physically recover from, Dr. Marengo explains. When radiation is required following surgery, breast reconstruction using a patient’s own tissues is preferred.
“In addition, I can further contour the breast through fat transfer,” he adds. “In this procedure, fat is harvested using liposuction, and transferred to the breast to improve the contour and create a more natural-looking breast.”
For further information, please contact the Center for Specialty Care at (707) 646-4180.