AS BREAST CANCER AWARENESS MONTH MARKS 40 YEARS OF PROGRESS, STATEN ISLAND UNIVERSITY HOSPITAL’S DR. MARILYN NG EXPLAINS HOW RECONSTRUCTIVE SURGEONS PLAY A VITAL ROLE IN WHOLE-BODY BREAST CANCER CARE, HELPING WOMEN RECLAIM NOT ONLY THEIR BODIES BUT THEIR CONFIDENCE AND SENSE OF SELF

BY AMANDA McCOY PHOTOS BY AMESSE PHOTOGRAPHY

This October marks the 40th anniversary of Breast Cancer Awareness Month, a sweeping global initiative that began as a weeklong campaign by the American Cancer Society in 1985 to bring widespread attention to the disease, promoting education and empowering women to take control of their health through regular screenings. Over the past four decades, groundbreaking advancements in research, treatments, and diagnostics have yielded significant strides in breast cancer care. Mortality rates continue to fall (dropping an incredible 44% since the cancer’s peak in the late 1980s), and today the five-year survival rate for stage 1 sits at 99%.

While these statistics are indubitably promising, breast cancer remains the second most common cancer diagnosis in U.S. women (behind only skin cancer), with about 315,000 new cases each year. For each of these women – daughters, mothers, sisters, nieces, spouses, and friends – treatment is only one part of their journey. Patients often face the physical and emotional tolls of surgery, and this is where breast reconstructive surgeons play a vital role, helping women regain confidence, balance, and a sense of wholeness after treatment.

“There are so many aspects of breast cancer that aren’t as openly talked about, like the toll it takes on your mental well-being, femininity, confidence, and identity,” said Marilyn Ng, MD, MSc, a board-certified plastic and reconstructive surgeon with Staten Island University Hospital who specializes in breast reconstruction. “My goal is to help each patient return to her previous quality of life as much as possible.”

At SIUH, Dr. Ng performs a broad range of plastic surgery, from aesthetics and body contouring to breast reconstruction and complex microsurgery. Raised in a small Midwestern town, her journey to plastic surgery was shaped by personal experience; while early childhood aspirations pointed toward a career in architecture, she changed directions after her grandmother passed away from pancreatic cancer. (“I saw the abrupt toll the disease had on her and our family, and this experience inspired me to pursue a career in medicine,” she recalled.) Upon earning her medical degree from New York Medical College and completing her General Surgery residency at SUNY Downstate and Kings County Hospital Center in Brooklyn, Dr. Ng continued her specialized training with a Plastic and Reconstructive Surgery fellowship at Summa Health Systems in Ohio, followed by an advanced fellowship in Reconstructive Microsurgery at Fox Chase Cancer Center in Philadelphia. She joined SIUH in 2017, kindled by the hospital’s rich sense of community.

“I knew that here I could make an impact,” said Dr. Ng, who also serves as a mentor for the next generation of plastic surgeons as an Assistant Professor in the Division of Plastic and Reconstructive Surgery at the Zucker School of Medicine. “SIUH is a world-class hospital with a tremendous amount of resources, talent, and support from the Northwell system, but it’s still very much community based. I was raised in a small town, and that resonated with me.”

While trained in the full breadth of plastics, aesthetics, and reconstructive surgery, Dr. Ng’s passion is breast-related reconstruction. “It’s so rewarding to be a part of a patient’s process, to help them through the lowest aspects of their breast cancer journey and restore her sense of self,” she said.

As Dr. Ng explained, breast reconstructive care is highly tailored to the individual. It generally falls into two categories, implant-based and autologous (tissue-based), and there are several factors that go into the decision-making model, including overall health, body type, personal preference, and cancer treatment plan. Because treatment therapies like radiation and chemotherapy can affect the timing of reconstruction, Dr. Ng encourages women to start the process early.

“We discuss all their options to optimize their results,” said Dr. Ng. “In some cases, we can directly insert silicone implants in the same procedure as the patient’s mastectomy. Other patients might benefit from tissue expanders, which are essentially balloons that we can fill gradually with saline, ensuring the patient’s blood supply isn’t impacted and giving their tissue time to heal. They also act as placeholders for patients undergoing radiation or chemotherapy until treatments are complete before moving to the next stage of reconstruction.”

The fellowship-trained surgeon also brings her expertise in microsurgery to SIUH. One of her specialties is a DIEP flap (short for “deep inferior epigastric perforator” flap), an intricate procedure that uses tissue from the patient’s own abdomen to restore the breast. After Dr. Ng transfers the tissue to the chest, she carefully reconnects the blood vessels with the assistance of a microscope. (“I tell patients it’s like connecting the pipes when installing a new sink in their home,” she added.) Because she uses the patient’s own tissue, the result looks and feels more natural. Through microsurgery, Dr. Ng can also address one of the most common but often undervalued side effects of a mastectomy – loss of sensation.

“Women often have numbness after a mastectomy,” said Dr. Ng. “Neurotization is a special technique that uses nerve grafts to connect the nerves of the chest wall to the reconstructed breast and nipple, helping to preserve to some degree the sensation of the nipple.”

Looking ahead, one of Dr. Ng’s goals is to create a community of resources and support for women with a higher risk of developing breast cancer. Along with her colleague, breast surgeon Dr. Karishma Kollipara, she is in the process of rolling out a comprehensive BRCA and hereditary cancer program for the women of Staten Island and outer regions.

“Many women have a high-risk family history of breast, ovarian, and other hereditary cancers,” said Dr. Ng. “We want them to know they have a place to go to have their questions answered. We can start exploring preventative or risk-reducing treatment options that are available to them, backed by an integrated care team of geneticists, medical oncologists, breast surgeons, and reconstructive plastic surgeons.”

Northwell Health Physician Partners Surgery

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