Topic: Immediate Reconstruction

Trudie ~

I had a mastectomy followed by an immediate expander.  Unfortunately, one positive margin brought me to 7 weeks (35 rounds of radiation) I had an MRI prior and both my PS  and surgeon knew in advance that a mastectomy is recommended as I had multi-centric ( more than one quadrant )

Anyway, my case was "rare" but they recommend immediate reconstruction as it saves a step and the PS can determine where the cut will be so you have a better outcome as far as physical results.

We will see..keeping my fingers crossed that this "beef jerky" of mine can be stretched enough due to rads.

Good luck with your decisions...go with your gut instincts!

Much LUV

Hey Trudie,

 I was dx with DCIS in multiple sites in March o8 and since its taking so long to see 2 different surgeons, a plastic surgeon, a geneologist, oncologist, breast care councelor, and Im getting a third, independant opinion, thats without a possible MRI and a possible second biopsy, I dont see me having any surgury until June or July. My doctors seem less concerned about the lapsed time only that I make the right decision. So I guess my advice would be if they seem ok to let you move slowly then gather as much onfo as you can so that you feel confident about what ever decision you end up making.

I am probably facing a bilat masectomy and will have immediate recon if all goes well. It seems like a good idea to eliminate one of the surgeries.

Good luck with your journey and Im right there with you.

Andrea 

Hi Trudie,

The time frame you are experiencing does not seem out of the norm or too slow to treatment.  DCIS is slow to progress and non-invasive.  You have many treatment options to choose from and time to research them. Your MRI results will help you make that decision too.  This site is a good one to begin your research at.

When I rec'd my diagnosis I was told I had time to decide on treatment and to find a PS and did not need to rush. I am a DCIS right breast bilat survivor almost finished with immediate implant reconstruction a year later. I chose prophylactic mastectomy on non-cancer breast for peace of mind. 

My sister in law was also diagnosed w/DCIS at the same time as me but had to wait 6 months to do bilat/recon due to other health issues needing resolution.  She finished her recon ahead of me and is now no evidence of disease as I am.

It is also my understanding that if they had found any DCIS in my lymph nodes they would have removed all my nodes and perhaps done chemo as follow up.  I believe it may possible to begin some types of reconstruction while undergoing chemo. 

Over the course of this past year I have felt like I have been trying to run in chest high water, meaning that everything seemed to take TOO long! However when I look back at my first recon photos and am amazed I am looking this far transformed in just one year. 

Keep in touch, all the best to you,

Mook 

Yes. I had a DCIS dx 12/31/03 and surgery in February 2004. I had right mast/immediate TRAM recon. Since the mast path came back as invasive, I then had an April 2004 lymph node removal to check for spread. Nothing found, but onc suggested 4 AC as a safeguard. The only thing I would do differently would be to have a SNB first and also, I'd go for bi-lateral, as I agree that it's best to get it out of the way. My ps at the time talked me out of bi-lateral, but everything seems ok now.

Hi Trudie,

I was dx'd with DCIS in right breast in Feb 2006.  Dr. did lumpectomy (actually turned out to be partial mast. since she took from 9 to noon) and sentinal node biopsy. Nodes were clear but 3 of the 4 margins were not.  Choices were to have further excision, hope for clear margins, then rads.  However she said I probably would not be happy with the look of the breast after rads, especially since I am a very small B, actually closer to an A.  Other choice was to have mast. w/implant reconstruction.  That option was out due to RA.  Next choice was to do mast. & TRAM flap reconstruction. BUT, I have 4 herniated discs and cannot be without my stomach muscle, which is how they do the TRAM flap.  Last choice was to do the mast. and wear the prothesis, which is the one I ended up thinking I was going to do.

But I think the Lord had other plans because I found a website that explained the DIEP reconstruction method.  I sent them an inquiry on a Friday afternoon, they called be back Fri. PM, I talked with them more extensively on Mon. when they answered all my ???? and scheduled an appointment to go to SC in April for the surgery.  At that time in 2006, there were only 8-10 docs in the country that did the perforator flap reconstructions; a method that does not take the muscle to do the reconstruction.  Exactly what I need!  Dr. Robert Allen, out of New Orleans and Charleston, was my surgeon and he has trained many, many of the surgeons that are doing these surgeries.  In fact we now have a PS here in MI trained by Dr. Allen.  I will be seeing her at 11:00 am today, since DCIS has returned in the left breast.

I do not regret having the mast. and immediate DIEP reconstruction.  My only regret is that I did not do both at the same time.  I was given the option, but at that time I just couldn't see taking off a healthy breast.  Turns out it wasn't probably all that healthy.  With the amount of DCIS that is now showing up, the doc feels that there were cells already growing.  But you cant go back, only forward.

I wish you the best in your decision. You can listen to others, read lots and lots but in the end, the final decision is yours alone.  I havent' been on this site only a couple of days, but I can tell you that I have been so blessed by what I have read and the true caring and compassion that is expressed.  We do know what each other is feeling because we do walk in each other's shoes.

Best wishes to you and prayers go with you as you make your decisions.

Sunkist in MI

Hi there Sunkist and Keryl, My situation got more complicated.  My MRI showed "something" in my left breast too which has been biopsied and shows as Atypical Lobular Hyperplasia, so it's not cancerous but isn't normal and COULD turn cancerous.  My Surgeon recommends a bilateral Mastectomy with Immediate Implant Reconstruction -  I don't have enough tummy to do both with a DIEP flap!!  She says the decision is entirely mine, if I want to just remove the right breast and go for DIEP flap she'll do that but in her opinion I'd get a better result cosmetically doing both now with implants.  I'm swaying towards that now.  My husband says let's just go for it and then all the element of risk is removed.  But I still feel sad at losing both my breasts.

Hi Trudie--I too was dx with dcis last year and opted for a bilateral mast. with immediate reconstruction (latissimus dorsi procedure) last September.  I am 4 weeks out from my expander exchange--and my breasts feel like my own.  I too had lots of ups and downs about what to do and spoke to 4 breast surg. and PS as well as countless women.  

I just returned from a 4 day cruise and spent most of my time in a bathing suit--and got lots of lookers (in a good way!)

Good luck---and do what you are most comfortable with.

Erin