Implant Question / Radiation Question - Concerns
 

So in the beginning I was thinking I would have implants, that's what my surgical oncologist spoke about. After I had a consultation with another plastic surgeon he told me that implants have to be replaced. For those who just have implants for aesthetics it's not a problem. For those with implants because of reconstruction, there is a lot of scar tissue. He said I would probably get 10-12 years out of the first maybe 7-10 out of the second and maybe or maybe not be able to get a third replacement. Well that's not good! I'm 41 years old.

I brought this up to my surgical oncologist and she said yes that is true. Well then implant doesn't seem like a good idea for me. The other plastic surgeon recommended DEIP Flap and seems to be my best option for long term. I don't have a lot of fat but enough to do the single breast.

Still, I wonder how many people move on with implants not knowing that one day (although far down the road) they might end up with no options left.

That really bothers me that she didn't meant ion that to me!!! Maybe she was waiting for the plastic surgeon to go over this with me. I have yet to meet with the plastic surgeon that she works with.

Also, did anyone have any permanent skin changes / color changes from radiation? Just curious how many people this effects.

Eva
ER/PR - , HER2 +
Stage 2B
2 tumors, 1-4cm, 1-2cm
2 lymph nodes positive
4 treatments of AC - Done
12 Treatments of Taxol (weekly) + Perjeta & Herceptin (every 3 weeks)
Then surgery
Then 9 months of Herceptin every 3 weeks

After AC - ultrasounds show clear nodes and small tumor gone and larger tumor shrinking
After two rounds of taxol, one round of perjeta & herceptin - larger tumor can not be felt at all

Re: Implant Question / Radiation Question - Concerns
 

Silicon implants today last about 10 years or so. Then you get new and improved implants. Who knows how much better or how much longer they would last? My plastic surgeon NEVER said that there would be a time when I couldn't have any implants. I am older than you are but I was not eligible for DIEP (fat issue) and I chose not to have any extensive surgery just for a pair of nice(er) boobs.

My friend's daughter (35) got a prophylactic BMX and she has silicon implants. She's got a long way to go, too.

My skin is a bit tighter after radiology and still a little "tan". It will fade all the way eventually

Best
Janis

Re: Implant Question / Radiation Question - Concerns
 

I was never told how long my saline implants would last or that I may never be able to replace them. I was stage 3 so not having a mastectomy was not an option according to my surgeon. I also was never told how bad the side effects would be after rads. I am 2 years out from rads and from my shoulder to below my ribs and my right (boob) is extremely hard, tight and uncomfortable. Can barely touch any of it to wash it. Recently I checked in with the plastic surgeon and she informed me it may get worse but never better than what it is now. If I knew then what I know now I would never have done the mastectomy. Think I would have taken my chances.
Anyway I hope all goes well for you and you have the least amount of side effects that you can.

Re: Implant Question / Radiation Question - Concerns
 

Yes, I knew they would not last forever, but not that I couldn't keep getting them replaced. And I trust technology will evolve. Regarding radiation, it's been a year and that side is still very tan. I also was told I can't have a fake nipple done because I had so much damage so now I'm very mismatched. Still need to do the tattooing. The radiation side also is tighter so my breasts don't match, but they look fine with clothes and a good bra. BTW, I was 48 when I was diagnosed, and single. Good luck and I'm interested in hearing more about how you progress through the reconstruction as I'm thinking about getting a 2nd opinion on the nipple thing.

Re: Implant Question / Radiation Question - Concerns
 

I know initially when I found out I had to have a mastectomy I did lots of research , ultimately decided to have the Diep. Spoke with a plastic surgeon who during are meeting did not bring up the Diep procedure but once I brought it up she informed me that this was not something she does hence referred me to a specialist who does do this procedure. Bottom line if I had not done my research I may have not ever been sent in the right direction I feel is needed for me.

Re: Implant Question / Radiation Question - Concerns
 

I opted to get implants. My exchange surgery to remove the expanders and replace with implants is scheduled in a couple of weeks. One of my breasts was radiated. The scar on the radiated breast is much more visable than the scar on the right side. Additionally, the skin on the radiated breast is much tighter that the right side. However, the skin color on both breast looks pretty much the same.

My PS does do DIEP surgery. He discussed the pro's/con's of this and of implants (including the need to have the implants periodically replaced about every 10 years). For me personally, I was unwilling to undergo a major surgery such as DIEP and just didn't want any more surgical scars. I saw pictures of DIEP before and after and it seemed like women ended up with nice breast but their abs were all scarred up. I'll be 56 soon so if my implant last 10 years, I'm thinking I'd only have to have them replaced twice.

Good luck with your decision.

Re: Implant Question / Radiation Question - Concerns
 

Eva,
My plastic surgeon wanted me to have a breast MRI at 3 years after my implants, which is coming up this December. I had TomoTube radiation on my cancer side. They radiated a large field since I had 12 positive lymph nodes and many areas of extracapsular spread to surrounding tissues. My radiated skin was fine for the implants (about a small B size) I don't think I had the option of any size (although I am not a big boob person) because of the radiated skin. I was normally about a B anyway, so the results are much like I was before. The surgery to replace my expanders and insert the implants was simple. I was home the night of the surgery. If 7 more years down the line I have to go through that again....it is not a difficult thing to go through. I also am counting on science to improve.

Re: Implant Question / Radiation Question - Concerns
 

I have a question about radiation. I am Her2 triple positive. I have gone through chemo with two conventional chemos and two target therapy drugs, one of them being Herceptin. Two weeks after finishing chemo I had a lumpectomy with 5 sentinel nodes removed. All margins came back clear. They now want me to have 5 weeks of daily radiation with a 6th week of boost radiation. Before Herceptin was discovered in 1998, chemo and radiation was not successful in treating Her2. My question is, why is radiation recommended for Her2 now? There is no data that shows that radiation kills Her2 cancer cells. My Dr. admitted as much and the only research is from the 70’s and 73% of the women in the study had hormone driven breast cancer and was not specific to Her2. My tumor was on the left side, the two target therapies I was given, one being Herceptin which I am continuing with every three weeks for a year, can potentially damage the heart, so can radiation on the left side. Along with all the other side effects of radiation, I am looking for any information that would encourage me to get the radiation. I am seriously afraid of getting radiation. I don’t want to get treatment that has serious side effects if it is not effective against Her2. It seems radiation is just the standard treatment for breast cancer in general so that is why they recommend it. But I want proof, I need proof. I am sick with worry. Radiation did not work for Her2 before Herceptin so why do they want to give radiation now? I need a reasonable answer.

Re: Implant Question / Radiation Question - Concerns
 

Mannettes - that's a great question, I think you should start a new thread on that. I didn't realize that radiation didn't kill her2 cells. I'm ER/PR negative so I don't see the point if that's the case.

I'm definatley going to ask my doc about that when I see her next week.

Please start a new thread I would love to hear what more experienced ladies here have to say.

Eva

Re: Implant Question / Radiation Question - Concerns
 

I also did not realize radiation does not kill her2neu cancer cells.
I will be seen my radiologist today and ask her about this as I to am Er/pr negative but her2+++ positive

Re: Implant Question / Radiation Question - Concerns
 

Hi, I am new to this website and I don't know how to start a new thread. I have searched but can't figure it out.

Re: Implant Question / Radiation Question - Concerns
 

Radiation is recommended and pretty much standard treatment for lumpectomies. It has nothing to do with the pathology of your tumor. It is to make sure any stray cells are zapped and the tumor bed gets that extra week of targeted radiation. My first breast cancer was treated with a lumpectomy and radiation. Herceptin was not given for early stage back then (2000).It was her2+ and never recurred. My second cancer was considered a new primary in the opposite breast.

Can you please share where you saw that radiation is not effective on her2+ breast cancer? I've never heard that.

Radiation is easy compared to chemo and chemo is way more destructive on your body than radiation. I would think that you would want to throw everything you can at the cancer now rather than have any regrets later.

Just my opinion, it's your body. Good luck with your treatment

Best
Janis

Re: Implant Question / Radiation Question - Concerns
 

The question is, does radiation kill her2 cancer cells. No one seems to have an answer to that question. You are right it is standard treatment for breast cancer but her2 is a different breast cancer just as hormone driven tumors are different. Before Herceptin, Her2 breast cancer treatment with regular chemo and radiation did not give a good survival rate for women with this cancer. It may have slowed it but it did not cure it and in fact her2 was a death sentence. That is why I have to know if radiation does kill her2 cells if it didn't work before why now.

Re: Implant Question / Radiation Question - Concerns
 

Radiation works by damaging the dna in actively reproducing cells so that they cannot reproduce. Cancer cells are actively reproducing. HER2 cells are even more active. Following this logic it seems to me that radiation would be even more effective on a HER2+ cancer cell than one that did not have this expression.

That being said I hated radiation more than chemo. I didn't want to do it but in the end the science to point to radiation. Now it's just a distant memory.

Shirley

Re: Implant Question / Radiation Question - Concerns
 

I spoke with my radiologist today regarding the effectiveness of radiation on her2 neu patients now vs previous studies, her response if I'm to understand it correctly is Since the introduction of herceptin for unknown reasons or reasons not co yet made clear that people treated with herceptin first then radiation the tx is now very effective. She said since the introduction of herceptin it now puts her2 neu cancer cells on the same playing feild she it comes to radiation but again they are unsure as to why

Re: Implant Question / Radiation Question - Concerns
 

I just came by to do a quick little check and this topic stood out for me and I hope to help. I coincidently had a check up with my PS and we discussed the exact same topic of switching out my implants. He said that it was the old standard to replace & replace however if I'm not experiencing any pain, hardness or problems there is no reason for him to change the silicon implants that I have. I am feeling GREAT! I have had them for almost 10 years and also had radiation, chemo & the works. I have my mammogram on the one existing breast and MRI when I'm due. As long as everything is ok I can stay away from the surgery.
Peace & hugs ~ Ruth

Re: Implant Question / Radiation Question - Concerns
 

"I have a question about radiation. I am Her2 triple positive. I have gone through chemo with two conventional chemos and two target therapy drugs, one of them being Herceptin. Two weeks after finishing chemo I had a lumpectomy with 5 sentinel nodes removed. All margins came back clear. They now want me to have 5 weeks of daily radiation with a 6th week of boost radiation. Before Herceptin was discovered in 1998, chemo and radiation was not successful in treating Her2. My question is, why is radiation recommended for Her2 now? There is no data that shows that radiation kills Her2 cancer cells. My Dr. admitted as much and the only research is from the 70’s and 73% of the women in the study had hormone driven breast cancer and was not specific to Her2. My tumor was on the left side, the two target therapies I was given, one being Herceptin which I am continuing with every three weeks for a year, can potentially damage the heart, so can radiation on the left side. Along with all the other side effects of radiation, I am looking for any information that would encourage me to get the radiation. I am seriously afraid of getting radiation. I don’t want to get treatment that has serious side effects if it is not effective against Her2. It seems radiation is just the standard treatment for breast cancer in general so that is why they recommend it. But I want proof, I need proof. I am sick with worry. Radiation did not work for Her2 before Herceptin so why do they want to give radiation now? I need a reasonable answer."

I'm not positive on this but my understanding is that herceptin damages the cell (plugs up the the growth receptors on the surface of the cell....Her2 cancer has WAY more growth receptors than usual) So, plugging up some of the growth receptors makes the cancer cells more like "regular cancer cells" rather than her2 cancer cells. I"m not sure I explained this well, but basically the herceptin makes the cells more like the her2 negative cells which means that radiation is able to be more effective.

That said, however, when I met with the radiation oncologist, I asked about long term effects of radiation on what will remain of my breast after lumpectomy and he mentioned most of what has already been mentioned....hardening of the skin, loss of feeling etc. I asked if the effects are immediate or if they show up over time. He said they usually DON'T show up until after at least THREE years post radiation and continue to develop for years sometimes. Wasn't exactly what I wanted to hear........

Re: Implant Question / Radiation Question - Concerns
 

P.s. as a neophyte here I'm not sure what NED means...... could someone enlighten me?

Re: Implant Question / Radiation Question - Concerns
 

NED means "no evidence of disease"

Re: Implant Question / Radiation Question - Concerns
 

Thanks thinkpositive! I was hoping that was what it meant....since it seemed to indicate a "GOOD THING!" :-)