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03-06-2014, 02:33 PM
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#1
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Junior Member
Join Date: Mar 2014
Posts: 3
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Reconstruction after radiation?
Has anyone had breast reconstruction after having radiation? I was told implants would be difficult to do.
I'm facing a decision (soon) to have a bilateral prophylactic mastectomy with immediate implant reconstruction.
I am BRAC1 positive and am 9 years out from lumpectomy with chemo and rads, along with 10 months of Herceptin. Had to stop due to declining heart results.
Any help would be greatly appreciated.
Can I have immediate implants after radiation 9 years ago?
How is the scarring?
therocky
dx: 6/5/05, age 46 premenopausal
lumpectomy
er-, pr-, Her2+++
AC then Taxol
10 months Herceptin
Radiation
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03-06-2014, 03:05 PM
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#2
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Senior Member
Join Date: Oct 2012
Posts: 645
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Re: Reconstruction after radiation?
I had a bmx with tissue expanders, chemo, then radiation. Had exchange surgery 5 months after radiation (tissue expanders for silicone). I also had radiation on the other breast (see my signature) 14 years ago.
The most current radiated breast is a bit harder than the other one but I do massage all the time per my plastic surgeon's instruction.
Scarring is just the mastectomy scar - a little tight, but really, not bad at all.
They are worried about implants in the 9 year ago radiated breast? Mine older one is fine
Best
Janis
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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03-07-2014, 06:34 AM
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#3
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Senior Member
Join Date: Dec 2012
Location: Attica, IN
Posts: 371
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Re: Reconstruction after radiation?
I had radiation then I had to wait 6 months before I could do DIEP flap Surgery. My radiation doctor told me I would be a perfect candidate for it because I was so burned and my skin was so tight (she was a woman). I had the surgery done in Indy by Dr. Cacioppo which is the only type of Breast reconstruction surgery he does every day and has for 6 years now. It took a long time for him to do it because it is microscopic surgery, but I feel the results look pretty good considering all the damage done before hand.
The pros for me is it matches my other breast rather well! If I gain or lose weight it will gain with me. You don't get a full cosmetic tummy tuck but my Dr just pulled it tight without any need to cut into my core muscle in my stomach.
Now, I got next Friday to fill in the "Defiencey" areas, and he is going to put my new nipple with a skin graft from my weight that he left what the call "dog ears".
When I woke up the pain was OMG.....And I remember thinking I self inflicted this pain on myself what was I thinking!! I was thinking I went thru all this treatment, so this isn't nothing but a thing!! But WOW I thought it hurt like hell when I woke up!! It took me a while to recover from that, and I am not very patient.
I want to do the process, and on to the next and then be done!!
I had it done in August, and I am finally 6 months later starting to feel okay with it. Only for next week to face another unknown of the last surgery.
I hope this helps. 
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant
9/2012 Pre-adjunctive TCH chemo.
12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.
12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+
2/27/13 6 weeks of IMRT radiation finished
2/2013 Started on Tamoxifan 5 years.
8/2013 will take last Herceptin, 17 treatments total every 3 weeks.
BRCA1 & BRAC2 - Negative
August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.
3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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03-07-2014, 09:45 AM
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#4
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Senior Member
Join Date: May 2011
Location: El Paso ,Tx
Posts: 436
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Re: Reconstruction after radiation?
I had the latissimus flap done after radiation. Same as above hurt a lot at first had to do therapy on my shoulder due to capsular tightness. The results were good my radiated side has a little different shape but unless you are really staring at it you can't tell.
__________________
 dx: DCIS 6/8/10, HER 2+ 7/26/10; Stage I Age 41
Double mast w reconstruction
6 TCH w 1yr herceptin
Tamox.
25 radiation tx
Removal of expander on L due to infection. Tried to save it had 3 bouts of antibiotics and went to see plastic surgeon 2-3x wk to get drained. Saving it was my idea not his. But lost it anyway.
Reconstruction set for December 21st,2011
Finished chemo 12/2010
Finished Herceptin 8/26/11
Reconstruction 12/21/11
Expanders exchanged for silicon 3/19/12
Nipple reconstruction 5/18/12
Nipple tatooing- 7/9/12- All done yay!
11/22/12-Went back to get scar tissue stretched to even the outside of breast, didn't work due to it being radiated skin.
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03-07-2014, 11:17 AM
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#5
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Senior Member
Join Date: Apr 2013
Location: Lakewood, WA
Posts: 56
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Re: Reconstruction after radiation?
Linn,
I am 3 months out from radiation and am waiting to trade my expander (one side) for an implant or DIEP. I'd like to do DIEP but my goodness your story makes me thing twice. It sounds like the recovery from DIEP is months rather than weeks, but the final result is more permanent/natural.
Also interesting that you had the DIEP 6 months after rads rather than 12. I was thinking I'd have to wait for 12 months, but I've read that some places are saying 6 months is fine. I'm very tired of my expander and would rather get this show on the road as they say.
Shirley
__________________
- Age 54 at dx (April '13) Stage 2b, grade 3
- ER+ PR+ HER+, 9 cm tumor one breast and <0.5 cm in sentinal node
- BRCA1 and 2 negative
- Neoadjuvant TCH chemo started 5-15-13 (4 rounds, 3 weeks apart)
- Unilateral Mx w/expander 8-22-13 (right side)
- 5/5 nodes Neg
- clear margins but close. Tumor at removal down to 2.2 cm.
- Radiation 6 wks starting 10-17-13.
- Herceptin every 3 weeks until 4-23-14
- DIEP/Mastopexy 10-8-14, U of WA
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03-07-2014, 12:43 PM
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#6
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Senior Member
Join Date: Dec 2012
Location: Attica, IN
Posts: 371
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Re: Reconstruction after radiation?
Shirley,
I tried to talk him into doing it after 4 Months....He said NO!
It took a while, and I don't know about you but it all blur's together after awhile. I thought it wasn't going to hurt much after, so I was naive or maybe a sissy!
I rather be told straight up by experience and each one's pain tolerance is different...blah, blah, blah.
The surgery "Completion" next Friday. I asked the nurse and she said....When you wake up it will feel like someone hit you really hard in your AB's with a bat! I said...Yuck. Immediately, she said it isn't as bad as the first surgery! Sweet, that is refreshing!! haha
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant
9/2012 Pre-adjunctive TCH chemo.
12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.
12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+
2/27/13 6 weeks of IMRT radiation finished
2/2013 Started on Tamoxifan 5 years.
8/2013 will take last Herceptin, 17 treatments total every 3 weeks.
BRCA1 & BRAC2 - Negative
August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.
3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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