Mastectomy Question - Repost

[Patty F]

I have a question for all you ladies. I am scheduled for my 4th A/C on January 10th. After that I was told that I have to wait for 3 weeks before I have my mastectomy. How many of you have had both breast removed as a precaution? Will I be able to have the tissue expanders inserted at that time also? I know that I have to have 4 rounds of Taxol and then rads. Will they be able to place the tissue expanders in before the rads? I have so many questions and no answers here.
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[Mary Anne in TX]

Hey Patty! I asked my surgeon to do both sides and he told me that this kind of BC didn't usually go to the other side and he didn't want to do that. He was so charming about it, I gave in though I thought it would make life so much easier. I haven't had reconstruction yet so have no advice to offer, but keep moving this up til everyone is back on track after their Holiday break. You'll get some great answers from this bunch!

[PinkGirl]

Just bumping this up for you Patty.

[Chelee]

Patty, I'm not much help in that area especially since I was never even offered reconstruction. But until all the ladies return here from the holidays...you might want to check the breastcancer.org board out for that topic. It might be very helpful. They have different forums there and one of them is just for *reconstruction*. That forum is pretty busy so you might want to check it out. It will hold you over until everyone returns here. :)

http://community.breastcancer.org/

Chelee

[dlaxague]

Hi Patty,

Do you have a plastic surgeon on your team? That would be the person to ask your questions about reconstruction. Second opinions are always a good idea, and that rule applies for the plastic surgeon also (it will give you something to do while you wait for surgery).

I had both breasts removed, though there was only evidence of cancer in one. I had no reconstruction, so cannot address your questions about that.

I'd be glad to answer any more-specific questions that you have.

Debbie Laxague

[Sheila]

Patty
I waited to have reconstruction for 1 1/2 years...I wasn't sure I wanted to do it. These are questions to asl your surgeon/plastic surgeon and oncologist...I do know that sometimes radiated skin followed by reconstruction does not give as good of results as the skin does not want to stretch after radiation....I would think that they would put the tissue expander(s) in when they do the mastectomy...I would definately get this all settled beforehand with all the docs...including the radiation oncologist!

[Joannie]

Patty:
I had a mastectomy on the left breast when I found the lump. The plastic surgeon immediately inserted an expander and I had weekly fills. This was in May when I had the first mastectomy. After going through chemo, I decided to take the other breast off as a pre-caustion. I then had to have another expander placed in that breast and started the entire process over again. After both expanders were in place and filled, I had both removed at the same time and had saline implants inserted. It was a decision that was difficult to make but one that I'm glad I did. I have never looked back. The implants are quite comfortable. Good luck to you on making a decision. It's all about personal choice.

[suzan w]

I had a prophylactic bilateral because the type of cancer I had, invasive lobular, has a higher rate of recurrence to the other breast. I have had no reconstruction.

[KellyA]

Hi Patty,

I had a double mast. when I was dx'd even though the cancer was in only on one side. I did choose to have reconstruction at the time, and we were unsure if I would wake up with expanders in or if they would be able to get the implants in at the time of surgery. My doc did get the implants in- I was very happy, but couldn't stand up straight for a couple of weeks! :-) Anyways I did have radiation down the line and we all kept our fingers crossed as there is a very high failure rate with implants and radiation. My doc said they can harden, become very painful, or even MOVE to a new location. He had one patient whose moved to the center of her chest and she became the proud owner of three breasts. GREAT, I thought! But he said she took it in stride and even laughed about it and they were able to fix it. Luckily, I had no problems at all. Looking back, I am very happy I went with the decision I did, but hve to admit it was all luck, because I had no idea what I was doing, and relied on others advice. Good luck to you.

Love, Kelly

[Joanne S]

Patty, I had a double masectomy and immediate reconstruction. After full expansion over several weeks, I had radiation. I have had numerous problems with the radiated side, including extreme, severe pain for months.

Radiation damages skin and muscle tissue as well as squeezing/contracting the expander. The radiation caused my expander to move into my armpit and high up on my chest.
http://her2support.org/vbulletin/showthread.php?p=134059#poststop

My left expander was as hard as steel---I had severe capsular contracture --a common complication. http://www.implantforum.com/capsular-contracture/<!-- / message --><!-- sig -->

I had my expanders removed, capsulectomy, and gel implants five weeks ago. I feel very fortunate that my pain has diminished about 75%---Yeah---what a relief.

I honestly would not have gone this route if I had known then what I know now. Although I didn't have the best reconstruction experience (had infections too) and the radiated breast is smaller and not shaped as nicely as the other breast, I'm very happy now that I did it and that the worst is over and I have soft breasts.

Here's my story: http://her2support.org/vbulletin/showthread.php?t=30075
If I had it to do over again. although it would entail an additional surgery, I would wait until after radiation to get the tissue expanders implanted.

Make sure you explore all the different options for reconstruction, including tram flap, diep, etc. before making your final reconstruction decision. If you have any further questions, please don't hesitate to contact me.

Best to you!

[Cannon]

Hi Patty F,

I can only share my experience.

I had pre-surgery A/C also, and then had 3 or 4 weeks til surgery. I had cancer throughout the right breast, so there was no question at all that I would need a mastectomy on that. I immediately requested that they also remove the left, and my surgeon discouraged me. He said there was only a 1% chance of recurrence in the other breast, but that is not correct, I have read it is 1% per year for up to 20 years, so perhaps a 20% recurrence. In the end, I insisted that I wanted both removed, and had my ovaries removed for good measure (tested negative for BRCA1 and 2, but premenopausal and all aggressive features).

My surgeon also told me NOT to have any plastic done at time of surgery, as I would need radiation and the expanders could cause problems. I did insist on a referral to a plastic surgeon, who I saw before my surgery - I wanted him to know what I looked like "before." He would have been happy to do the expanders at the time of the surgery, but my surgeon seriously advised me against it.

I decided I would do the most aggressive treatment I could, so that I would be alive long enough for reconstruction to be a problem. After radiation, you must wait usually 1 year to do any reconstruction. I am not in any hurry, at this time I am not planning any reconsruction, but I've learned never to say "never."

Also as a result of my consult with the plastic surgeon, I learned I am not a candidate for any of the surgeries that use your own tissue (due to previous abdominal surgery and scarring), so I would have to have implants, and implants are supposed to be replaced EVERY 10 YEARS. I cannot imagine doing that once, never mind every 10 years.

I am divorced and had not started dating again when I was dx, so no one else is interested in my breasts at the moment. If I were lucky enough to find a great guy, I know he would love me for me and not be concerned about breasts.

Best,
Rebecca

[tousled1]

Hi Patty,

I opted for a bilateral mastectomy. I was told at that time that reconstruction could not be done immediately since we knew that I would be having radiation due to positive nodes. I had the radiation and as of today I still have not had reconstruction done. I'm happy with my decision. The most important thing is to gather as much information as you can and then make your decision.