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Re: Reconstruction
I am having double MX with immediate reconstruction next week. Did tons of research online and decided to go with latissimus flap with expander for the following reasons:
1.Good cosmetic result on the front ( with skin sparing mx, a circular incision is made around areola. Tissue from the back is harvested and tucked in the chest. A round piece is cut from the harvested tissue and stiched together. The nipple reconstruction and tatooing can usually cover the incision)
2. Latissimus flap tolerates radiation better than implant only
3. I only have enough abdominal tissue for one breast
My surgeon, plastic surgeon and oncologist didn't mention anything about delaying the reconstruction, i am very surprised to be honest since i am stage 3 grade 3. The recovery time will be longer though since there will be additional surgery on the back and ofcourse scars on the back as well. I didnt want to go with only the tissue expander because it does not tolerate radiation very well. i didn't want to take the 50% risk. With lattismus flap, the risk is 20% to 30%. Also, with only tissue expander, there will be a horizontal scar, maybe not as wide as a mastectomy scar but still very visible. It kinda of defeated the purpose of immediate reconstruction in some degree.
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1/11 age 36 DX
ER/PR-, Her2 +
TCH*6, Herceptin
BMX with immediate recontruction 5/2011 Lattismus Flap- Dx stage 3c 10/23 nodes
9/11 Radiation
3/12 Local recurrence to skin stage IV
Whole body scan CLEAR
4/12 Tykerb & Xeolda Skin mets slowly regressing
8/12 PET & Brain CT Clear
5/13 Skin mets progressing
6/13 PET scan chestwall recurrence in contralateral anxillary,internal mammary and ipsilateral subpectoral nodes
6/13 kadcyla
10/13 whole body scan -clear NED. previously resolved skin rash gone but 3 new lesions. Biopsy confirmed for skin recurrence
11/13 to 02/14 tykerb & herceptin
02/14 add abraxane/gemzar, 2 weeks on 1 week off at reduced dose
05/14 whole body PET clear/ brain CT clear but skin mets are getting worse, ready for new chemo
05/14 navelbine perjeta herceptin
07/14 skin mets progressing red rash worse
08/14 wide local excision with diep flap to close wound. Final path shows 2 positive margins showing inflammatory carcinoma Going back to surgery in 2 weeks
09/01/14 resection- clear margins
3 weeks after 2nd surgery, a new nodular rash found near drain incision with 2 small red spots behind the chest wall biopsy on 10/1. Positive for breast cancer
Radiation 11/2014 with xeloda then weekly cisplatin
11/14 brain MRI clean
12/14 finished 33 radiations burnt and very painful. Bedridden for 1 week
12/14 t current Herceptin and perjeta only
02/15 rash on upper back right side skin mets radiation planned
02/15 staring electron radiation *35
Stopped at 30 due to severe skin burn, resumed 10 days later
05/15 red patches appeared in between previously radiated area, skin mets. Ct and brain Mri clear. Simulation planned, radiation to start after trip to Alaska.
05/24 new spot identified in scar line on previously radiated reconstructed breast- electron on both side chest wall area and scar line
07/15 multiple skin and lung recurrence begin halaven
11/15 cough much better but very tired on halaven and starting to see some new red skin blotches-suspicious
11/15 heading to China for immune therapy
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