Breast cancer survivor says she has no regrets after reconstruction procedure

A Waterloo, Ont. woman says she finally feels “complete” after getting surgery at one of the few healthcare centres in Canada offering diagonal upper gracilis free flap breast reconstruction.

Barb Burns, 64, was the first person to get the procedure at Cambridge Memorial Hospital in January.

She was diagnosed with breast cancer more than two decades ago. Burns then had a lumpectomy, which resulted in the removal of most of her breast. Years later, doctors found cancer again.

“I hadn’t had a breast pretty well for 24 years, and I had learned to live with it, cope with it,” she said.

That was until Burns contacted Dr. Kathryn Sawa, a plastic and reconstructive surgeon.

Burns did not have adequate abdominal tissue for a typical breast reconstruction, called a deep inferior epigastric artery perforator (DIEP) procedure. She was, however, a perfect fit for diagonal upper gracilis (DUG).

“It offers a choice to patients who may not be candidates for the more common DIEP free flap surgery, empowering them to avoid implants and utilize their own tissue," Dr. Sawa said in a media release.

Dr. Kathryn Sawa working in an operating room at Cambridge Memorial Hospital on May 17, 2024. (Colton Wiens/CTV Kitchener)

During DUG reconstruction, doctors take a part of the inner thigh and reconnecting blood vessels to create a living reconstructed breast.

Burns’ surgery at Cambridge Memorial Hospital took about eight hours and required five surgeons, multiple nursing staff, as well as pre and post-surgery physicians.

“We do micro-surgery reconstruction at least twice a month,” Dr. Sawa said. “As this is now a new option available for particular candidates, we may be doing it more frequently, but it just depends on the patient.”

She’s also the only person in the Region of Waterloo trained to do the DUG procedure.

“You have to be a micro-surgeon that has specialized training,” Dr. Sawa explained.

Suture thread that would be used during DUG free flap breast reconstruction surgery. (Colton Wiens/CTV Kitchener)

Other flap procedures, transverse upper gracilis (TUG) and vertical upper gracilis (VUG), also use the same upper inner thigh muscle. Dr. Sawa said she prefers the DUG method.

“It actually decreases the risk of getting lymphedema, so it positions the tissue and the scar in a different direction. A lower risk of complications, so that’s why I prefer that one.”

The hospital said both the DIEP and DUG surgeries have advantages over implants, like a reduced risk of complications, enhanced aesthetics and a seamless healing process. Doctors still have to keep an eye on typical post-operative risks, like wound healing and infections.

Cambridge Memorial Hospital is only one of a few offering the DUG procedure in North America.

Burns was thrilled a surgical option was available so close to home.

“I only have a half an hour drive to get here,” she explained. “There would have been quite a waiting list for me to get in in another area.”

She wants other patients to know a local option exists.

“If I had to do it again, I absolutely would,” she said. “Having a breast again, it just created balance and wholeness and completeness. I guess femininity was a part of it.”

Burns is also urging everyone to get a regular breast exam.