Nipple Sparing Mastectomy with immediate reconstruction
Comments
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I found this article on the safety of NS. Could someone tell me if my links are working when I post them? I've been having problems with them working for some reason! Thanks!
http://www.sciencedaily.com/releases/2011/10/111027083037.htm
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Kate33 - I would hope that a PS would take a peek under there before going ahead and removing a nipple. For me, part of it was fresh and pink, but the side was definitely necrotic. It was just nasty looking for so long and took so long to heal that each time I had an appointment I was afraid my PS was going to say, "Let's cut our losses here and remove this nipple." But, we kept waiting and watching and scraping down to fresh tissue a little at a time. So, for me there was both healthy pink tissue under the black as well as necrotic tissue (where the dye was). One day it just split open and you could tell it didn't look good in there....
I think BSs and PSs involved with NSM know about black nipples; too bad they don't always pass that along to the patients before it happens. I was warned ahead of time by both my BS and PS that the nipples might get ugly looking as they recovered from the shock of the surgery.
Nope, your link doesn't work for me.....
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Kate I hope you get the all clear on your CT scan
Valerie-I was not given a choice and pushed very quickly to lumpectomy and rads. Found out later that I had an option and was pissed I was not given the option. I had had ADH 14 years earlier so I did have an opinion about what I wanted. Then got a lump in my other breast. Was another B9 breast disease which put me at high risk and I said take them off I am done. Funny BS still did not want to do MX, still do not know what her problem was but changed Dr's and got several opinions ended up with Dr. Peter Ledoux with PRMA in San Antonio and he has done a fabulous job. He is a PS and wanted to do my NSMX as well as my reconstruction. You don't find that often but he said he could control the outcome much better and wanted to do the best job possible for me. Said he wanted me to look fabulous and he has. Has your friend spoken to a MO yet. Seems that is who she really needs to be discussing possible chemo with. Also my PS would have done the IF had I gone to him in the very beginning but by the time I did I had already had incision on both breast so he used the excisting incisions and extended them instead of making new ones on my breast.
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Thanks everyone for your replies. The situation with my friend is that the doctor that wants to do the incision straight across trained the doctor that would do the IF - that's why she is thinking about going with older doctor. But I'm wondering if the younger doctor learned the NSM later and not from the older doctor. She is seeing a plastic surgeon. She will have to wait until after surgery to see the extent of bc and it will be up to oncologist to decide treatment. She is leaning toward lumpectomy - which is ok, but I preferred PBMX for ALH - so I guess each has to make their own decision.
Kate - did you get your results? Hope everything is ok!!
and no your links didn't work - but I looked it up - thanks!
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Does anybody know when NSM surgeries were started?
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Valerie- Not sure of the exact dates but I read once that they tried them for awhile but stopped because the rate of recurrence was too high. When they first started doing them they weren't as adept at it and were leaving a lot of breast tissue behind in order to save the nipples. Not sure when this was, or how long the gap was before they attempted it again, but I'm assuming with the newer techniques in microsurgery someone decided to use them for NS. So glad they did!
No results yet! Hoping to hear something by tomorrow. I'll keep you posted.
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Valerie: here is a current link from Georgetown University about NSBMX. I found this when researching recurrance risks with the procedure and found a whole lot more information.
www.georgetownunivesityhospital.org/documents/press/press_NippleSparingMastecomyStudy111411.pdf
(forum page would not allow me to paste this URL) happy reading, I found their study fascinating.
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Jill. Link didn't work for me. What did it say?
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Beckers I sent you the URL in PM, I can't figure out how to attached a pdf here. But if you google georgetown university nipple sparing reconstruction; it's the 3rd pdf document from the top. Entitled "Plastic & Reconstructive Surgery: Nipple Sparing Mastectomy...".
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Beckers-both of my nipples had thick black scabs over them. On the right side it peeled off and everything was fine. On the left side part of the tip was necrotic. I had to go back into surgery because my incisions had opened up and at that point he took off the tip of the left side nipple. It looks different of course but part of it is still there and looks ok. Most women have some sort of scab or color variation after the NSMX and are fine. It's a wait and see thing, but I wouldn't be too worried.
Valerie & Kate-I had incisions straight across and I wondered why they couldn't just do it on the IMF. I never asked. I guess I just assumed it couldn't be done. Now I'm wondering if it was because it was easier for the Dr's to do it straight across. I do feel for the dental hygienist who was not told about her options. That makes me so upset. Women need ALL the options set before them so they can truly make an informed choice.
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Kate - thinking about you and hoping all's OK!
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Tina- Thank you. I just called the doctor's office and got a recording saying they are closed until Tuesday. Are you kidding me?!? So I'm going to the imaging place and requesting my test results. Guess I'll find out on my own but my doctor is definitely going to hear about this. If you're going to take an extra long weekend how about putting some of your patients, who are waiting for test results, out of their misery? Grrrrrrr!
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Kate33 - Grrrrrrrrrrrr!!!!!!!!!!! Arghhhhhhhhhhh!!!!!!!!!!!!!!
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Kate-GRRR is right! I also request test results when I have anything done now. I want to see that copy. A lot of times you have blood work done and they Dr calls you and says "everything is f ine" but I want to see the numbers. I just had an ultrasound and I requested the results. I got them days before the Dr even called me. I was able to read and research it to have an understanding before they even called. Of course they called and said "everything is alright" and really didn't explain anything!
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sweetie2040 - I used to get the "Everything looks great" phone report on my mammograms from my previous doctor, which always made me angry because I saw my images and always asked for a copy of the report. How can "No abnormalities seen, but masses may be obscured by extremely dense breast tissue" possibly be interpreted to mean "Everything looks great"? So many docs merely read the impression ("No masses identified") at the end and skip the detailed report above. I agree, always best to get those reports to avoid falling through the cracks! Still patting myself on the back for begging for an MRI just to put my mind at ease, which ultimately found my cancers.
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Thank you who responded to by worries! BS and PS said My black nipple will slough off. Part of it is starting. There is some blood now on the gauze. They put me on Augmentin for the breast infection on that side and happy that they didn't admit me for IV's this weekend.
How long until you have the final nipples, as far as what they will ultimately look like? The right one looks beat up and the left is flat and an ugly tannish color with scabs.
I'm sure I need to be patient.0 -
Beckers - So glad you got encouraging news. It's really hard to say timewise as everybody heals at a different rate. Sounds like things are heading in the right direction. I would say to give it at least 4-6 weeks, but hopefully it will be faster than that (since you're not patient
). Of course, if things seem to be looking worse don't hesitate to contact the PS. Mine was great about sending pix via email. If you can take some good macro photos and the office is open to communicating that way that might help if you're nervous about things. Hang in there! 0 -
Lol! Thank you Tina.
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My doctor's office did call me this afternoon after all. They said there is an "area of concern" on the sternum that showed up on the CT scan as well. Since it correlates to where I'm having a lot of pain they want me to be seen by an oncologist for further evaluation. Kind of in shock and now have to find an onco as I only had a BS before. So sounds like more testing is in my future. Feeling a little shell shocked but trying not to get ahead of myself.
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Kate33 - I was secretly hoping that you hadn't gotten the results after all and that's why you didn't post sooner. So sorry this hasn't been resolved and, of course, right before a long holiday weekend
. I'm not well-versed in the treatment of DCIS, I didn't realize it wasn't necessary to see an oncologist. So, next is to find a good oncologist, then probaly a PET scan? Yes, please try to remember to breathe and take it one step at a time. Sending good thoughts your way! 0 -
Tina-I was told my mammogram results were great. I also had an ultrasound because of dense breast tissue and they said that was fine too, but I knew there was a lump there so I pushed them to take a second a look. Those results said to follow up in 6 weeks because of a possible infection. Once again I knew myself and knew it wasn't that. I didn't hesitate and took that report straight to a breast surgeon who ordered a biopsy. Even the Dr doing the biopsy said it's probably nothing and ordering ultrasounds give women unnecessary anxiety. All of them were wrong! Lesson learned-always be your own advocate. Who's knows your body better than you.
Beckers-glad to hear things are looking good. I second what Tina said. Give it some time. It does take quite a bit of time for everything to heal up. I'm guessing several weeks. Hang in there. This is a process and in the end everything will turn out fine.
Kate-I'm sorry to hear there is an area of concern on your report. One step at a time. It's good that they are being thorough. If anything I know what a great advocate you are for yourself. Please try not to worry and I know that's easier said than done, but we are always here for you. Keep us posted. We love you Kate!
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Thinking about you Kate, and hoping the area turns out to be nothing.
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Tina- I think I misspoke before as I wasn't thinking clearly. My BS is a surgical oncologist. She is 2 hours away, though, and I was getting a little ahead of myself thinking about chemo and needing a treatment place closer. I've decided to travel back down to her and find out what exactly is going on. If worst case scenario happens I'm sure she can refer me to someone closer to home. I'm optimistic though that this is going to turn out to be nothing. I just never expected to hear the "O" word!
Thanks everyone for the support! It means a lot. I'll keep you posted. Hope everyone has a wonderful and safe weekend!
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Kate thinking about you. So glad they are being cautious but truly hope it turns out to be nothing
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Thanks Sherry! I appreciate the good thoughts.
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Kate33 - If you have/had a good relationship with your BS, sounds like getting in touch with her is a logical next step. Good to have someone else in your corner to help you figure this out. Try to relax until then....always easier said than done, right? You know logically that worry is not going to affect the outcome one way or the other so might as well enjoy each day and take things as they come. Sending good "much ado about nothing" vibes your way!!!0
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Kate33-hoping its nothing!
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Kate, I am new to posting to this thread but I feel for you. I had a spot on pre-op chest xray, which was ok on CT scan, but the wait was one of the toughest by far.
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Tina, Soy and Beckers- Thank you all for the good thoughts!
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Kate - I've been out of town and just read up on your test results
So hoping it turns out to be ok - sending prayers your way!! Keep us posted!!Hugs, Valerie
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