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02-05-2008, 05:27 PM
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#21
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Senior Member
Join Date: Aug 2006
Location: Sheboygan, WI
Posts: 2,582
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Thank you Laurie for your explanation. Although I feel we did cover this topic it wasn't in the way you are talking so I will cover it again when we meet in 2 months.
Thank you,
Mary Jo
__________________
"Be still and know that I am God." Psalm 46:10
Dx. 6/24/05 age 45 Right Breast IDC ER/PR. Neg., - Her2+++ RB Mast. - 7/28/05 - 4 cm. tumor Margins clear - 1 microscopic cell 1 sent. node No Vasucular Invasion 4 DD A/C - 4 DD Taxol & Herceptin 1 full year of Herceptin received every 3 weeks 28 rads prophylactic Mast. 3/2/06
17 Years NED
<>< Romans 8:28
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02-05-2008, 11:24 PM
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#22
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Senior Member
Join Date: Mar 2007
Location: Hilo, Hawaii
Posts: 1,867
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For those of you who had the DIEP flap, how long did the surgery take? I am presuming most of you did not have the mastectomy at the same time and was it a bilateral DIEP?
Maryanne
__________________
*** MARYANNE *** aka HARRIECANARIE
1993: right side DCIS, lumpectomy, rads
1999: left side DCIS, lumpectomy, rads, tamoxifen
2006:
BRCA 2 positive
Stage I, invasive DCIS (6mm x 5mm)
Grade: intermediate
sentinal node biopsy: neg
HER2/neu amplified 4.7
ER+/PR+
TOPO II neg
Oncotype dx 20
Bilat mastectomy with DIEP flap reconstruction
oophorectomy
2007:
6 cycles TCH (taxotere, carboplatin, herceptin)
finished 1 yr herceptin 05/07
Arimidex, stopped after almost 1 yr
Femara
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02-06-2008, 08:52 PM
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#23
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Senior Member
Join Date: Oct 2005
Location: Lakeville, Minnesota
Posts: 199
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My surgery was 8 hours. I had a unilateral diep and a reduction on the other side. I had my surgery at Nola, where there are two drs who are a team, so it cuts down on the length of the surgery.
Laurie
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02-06-2008, 09:36 PM
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#24
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Senior Member
Join Date: Oct 2007
Posts: 1,851
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Mary Jo,
I'm glad your consultation went well!
You've really researched dieb flaps, which is great.
I was such a babe in the woods when I had mine done. My breast surgeon mentioned reconstruction, told me the difference between a tram flap and a diep flap and recommended a surgeon who did diep flaps (Dr. Alex Keller).
The doctor said he never did tram flaps anymore and that if during surgery he found for some reason that he couldn't do a diep flap, he didn't do any flap.
The day before the surgery he listened to the arteries in my abdomen and marked my abdomen and breast with a marker. My abdomen looked like a Super Bowl game plan when he was finished.
The surgery can take between 6 and 12 hours. My was six hours. The doctor said afterward that my surgery was easy.
I was very pleased with the results.
Joan
__________________
Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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02-06-2008, 11:29 PM
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#25
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Senior Member
Join Date: Mar 2007
Location: Hilo, Hawaii
Posts: 1,867
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My initial experience was a lot like Joan's. My surgical oncologist, who I absolutely loved and trusted, also explained the TRAM vs the DIEP. She recommended the DIEP for my lifestyle and recommeded who I should go to for the procedure. She set up the apt for me while I was in town (CA), and after the consult with that plastic surgeon, I knew that is what I wanted.
My surgery which was a bilat mastectomy and the DIEP flap reconstruction took 17 hrs! It took a lot longer because I had radiation in the past and that complicated the procedure somewhat. But it all turned out very successful in the end.
Maryanne
__________________
*** MARYANNE *** aka HARRIECANARIE
1993: right side DCIS, lumpectomy, rads
1999: left side DCIS, lumpectomy, rads, tamoxifen
2006:
BRCA 2 positive
Stage I, invasive DCIS (6mm x 5mm)
Grade: intermediate
sentinal node biopsy: neg
HER2/neu amplified 4.7
ER+/PR+
TOPO II neg
Oncotype dx 20
Bilat mastectomy with DIEP flap reconstruction
oophorectomy
2007:
6 cycles TCH (taxotere, carboplatin, herceptin)
finished 1 yr herceptin 05/07
Arimidex, stopped after almost 1 yr
Femara
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02-07-2008, 03:59 PM
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#26
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Senior Member
Join Date: Apr 2007
Location: Maple Grove, MN
Posts: 67
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okay
what is the difference between a diep and a tram, I had the tram. Is the only difference removing muscle versus fat? I had my lower pouch removed to do the reconstruction and I love the fact that I got a tummy tuck in the process, so someone please help me understand what the difference is. Thanks
__________________
Diagnosis bc june,2006.
3months of taxol and herceptin, nupregin shots weekly. Now herceptin only, her2 positive. stage III. Left breast, mastectomy with reconstrutive surgery.
Herceptin until 10/06. Due to low echogram numbers had to stop Herceptin indefinetly.
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02-07-2008, 04:12 PM
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#27
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Senior Member
Join Date: Aug 2006
Location: Sheboygan, WI
Posts: 2,582
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That is what the difference is Theresa. The DIEP you only use skin and fat. The Tram uses skin, fat and muscle.
Mary Jo
__________________
"Be still and know that I am God." Psalm 46:10
Dx. 6/24/05 age 45 Right Breast IDC ER/PR. Neg., - Her2+++ RB Mast. - 7/28/05 - 4 cm. tumor Margins clear - 1 microscopic cell 1 sent. node No Vasucular Invasion 4 DD A/C - 4 DD Taxol & Herceptin 1 full year of Herceptin received every 3 weeks 28 rads prophylactic Mast. 3/2/06
17 Years NED
<>< Romans 8:28
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02-07-2008, 04:46 PM
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#28
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Senior Member
Join Date: Apr 2007
Location: Maple Grove, MN
Posts: 67
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Thanks MaryJo,
My surgeon didn't use skin, he just put the muscle under my skin where my breast was. He actually tunnel up thru my stomach.
__________________
Diagnosis bc june,2006.
3months of taxol and herceptin, nupregin shots weekly. Now herceptin only, her2 positive. stage III. Left breast, mastectomy with reconstrutive surgery.
Herceptin until 10/06. Due to low echogram numbers had to stop Herceptin indefinetly.
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02-07-2008, 11:14 PM
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#29
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Senior Member
Join Date: Mar 2007
Location: Hilo, Hawaii
Posts: 1,867
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The other difference between a TRAM and DIEP is that with the TRAM the vessels are tethered up to the breasts. There is no cutting and reconnecting of the vessels. And you are correct, the TRAM includes the use of the muscle which the DIEP does not and therefore the rehab is much faster with the DIEP. Getting back to the vessels... the DIEP is based on the deep inferior epigastic artery and vein. This artery and vein is cut and reattached to supply blood to the reconstruced area. It is a very highly technical procedure that not many physicians are qualified to preform.
My plastic surgeon did an amazing job. If you know of anyone in California interested in the DIEP, I would recommend a consult with him without hesitation.
Maryanne
__________________
*** MARYANNE *** aka HARRIECANARIE
1993: right side DCIS, lumpectomy, rads
1999: left side DCIS, lumpectomy, rads, tamoxifen
2006:
BRCA 2 positive
Stage I, invasive DCIS (6mm x 5mm)
Grade: intermediate
sentinal node biopsy: neg
HER2/neu amplified 4.7
ER+/PR+
TOPO II neg
Oncotype dx 20
Bilat mastectomy with DIEP flap reconstruction
oophorectomy
2007:
6 cycles TCH (taxotere, carboplatin, herceptin)
finished 1 yr herceptin 05/07
Arimidex, stopped after almost 1 yr
Femara
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