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Lumpectomy with oncoplasty (bilateral reduction mammaplasty)

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Comments

  • Nahelton12
    Nahelton12 Member Posts: 7
    edited September 2013

    Thanks. So much I don't know so appreciate your input!

  • DawnCT
    DawnCT Member Posts: 47
    edited September 2013

    Thanks Fephna -

    How are your rads going?  It looks like you had your third one today?

    I do have to have rads but no chemo.  This is a looong process!  

    There is one thing I forgot to mention is that the surgeon said that if the lumpectomy area is too much in the median area of the breast then he will have to remove and reattach the nipple.  Something about blood supply going through that area to the nipple.  That would stink but I still think it would be worth it.  He said he will not know that until he opens the breast up.  

    And, he said it is an outpatient surgery - I won't be in hospital overnight unless there is a problem or I'm really nauseous.  

    I appreciate your encouragement and that you are happier with your new breasts!

    Dawn

  • TeamKim
    TeamKim Member Posts: 301
    edited September 2013

    Hi Dawn -- so glad your ps explained so well and you feel confident with the decision you are making -- that is the important thing! Now you can get going with treatment and see the light at the end of the tunnel (and it's not a train!)



    Welcome nahelton12 -- I am medium-size, so mine is a different situation, kind of. In my case, the incision went all the way around the areola, straight down the bottom of my breast at 6:00 and then a curved incision in the crease along the bottom third of my breast (like the shape of an anchor). As the PS was marking me before surgery (he took a purple marker and drew what he was planning) he was talking with the BS about how to preserve the blood supply to the nipple since one of my BC areas (I had 2) was close to the nipple. What was interesting to me was that the wedge of tissue that was removed, containing both areas of BC was about at 3:00, but there is no incision there. SND was done through a smaller incision more in my underarm area, and then I had a small incision about 1 1/2 in below the breast where the drain came out. I was surprised to learn, when my BS removed the drain, that it wrapped all the way around my breast! Sometimes I think doctors do so many of these procedures that they forget all the information that we don't know, so ask your questions!



    Both of you, one thing that I just remembered was that the entire breast was pretty numb for the first couple of weeks after surgery, and it felt solid -- not exactly hard, but certainly not soft. When the little zinger pains began, it also began to soften up and the feeling returned. Now, two months after, the texture is back to normal -- just like the other breast, but not as droopy -- lol! All feeling has returned except along the 6:00 incision.

  • Fephna
    Fephna Member Posts: 45
    edited September 2013

    Hi Dawn today was actually #2 since the computer was down Wednesday. So another day added at the end. Hope there won't be too many other delays like that.



    My cancer was on the left at 3 o'clock position. My nipples weren't detached just moved higher. I do have more feeling in the left then the right. My ps said it could take up to 3 months for full feeling or might stay that way. That nipple is not inverted but parts around the areola still feels a little numb. But it's alive and healthy color. I believe if your ps has to remove it, it can be successfully be reattached.



    At first my bs said it was going to be outpatient. I explained my past issues with anesthesia, I get very sick. She felt since I live far it would be better to stay the night and not take the long drive home. I'm glad I did. I was sick until about 10pm and my surgery was at 8:30am. Lol but I knew that was gonna happen.



    I'm glad I have been able to help. We have the same goal...to be cancer free!! :)

  • DawnCT
    DawnCT Member Posts: 47
    edited October 2013

    Thanks Teamkim for the info!  Believe me, I will be re-reading all the info on this thread throughout the process.

    Fephna - You are well into your rads by now.  Yay for progress! I hope you're doing OK.  Yes, the nipple can be re-attached(called a graft) but it will have no feeling.  I am really hoping that I will not have to have the graft.  

    I have my surgery date set for October 29th.  I am nervous but am so glad to have you all by my side.  I am going to post my experience  too so hopefully it will help others in the future.

    Dawn

  • Fephna
    Fephna Member Posts: 45
    edited October 2013

    Hi Dawn, so glad you have a definite surgery date. Hopefully ps won't have to detach the nipple. But at least you know it can be grafted back on. My right areola is still numb on one side but I'm happy it's healthy looking.



    Right before rads started I was so happy as they were really taking a nice shape and incisions were healing nicely. I was feeling really good. I also have been able to sleep on my sides but with 2 pillows. With out them its achy. I look forward to when that feeling will stop. Today was rads #7 my skin is getting pink, my breast feels a little swollen and hot like it did after surgery. I use the aquaphor several times a day. My last day of rads should be oct 29 if no more delays. So I will be sending you positive thoughts that day!! :)

  • TeamKim
    TeamKim Member Posts: 301
    edited October 2013

    Saw my PS yesterday and he said I was done with him, unless after all my treatments I decided to get a little mini lift on the non-BC side. I start chemo next week, will have rads starting in January, and he said two months after that to see him if I think I want a little restorative work. Right now the only difference between the two boobies is the BC boob nipple looks about a 1/2 inch higher. Volume and texture and feeling in both is the same. Scars are disappearing almost -- much more attractive than I had expected! PS says rads may lift the BC breast a bit more, but shouldn't be too much change. I am very pleased!

  • ketofan
    ketofan Member Posts: 3
    edited October 2013


    It was so comforting to find this discussion. I've not set up a signature, so I'll say that I was diagnosed on 7/26/13 with DCIS, ER+ PR+, HER2-, stage II, grade II. The surgery with lumpectomy and reduction was on 8/28 and went well. They a few days later, I developed an infection (not staph, thankfully) which has postponed the radiation. It looks as though I'll be able to start in about 3 weeks as the wound has finally begun to close. Here's my question: I've developed a necrosed fat lump in the cancer breast which continues to get bigger. Has anyone had experience with this? Will it have to be removed before radiation can be started? The PS didn't seem a big concerned about it and I haven't yet spoken with the radiologist. I'm not panicked, but the complications are getting a bit old.

  • Fephna
    Fephna Member Posts: 45
    edited October 2013


    Hi ketofan! I'm glad the surgery went well! I'm sorry as I didn't develop a necrosed lump, so I dont have an expwrience similar to ahare. I did have my T junction on my right side take forever to close and drained for almost 6 weeks till it finally closed with globs of Neosporin every day. I do know incisions can get bumpy and have to be massaged lightly to break it up. Is the lump near any incisions? Has the bs seen it yet? I know delays are frustrating. If your ps didn't seem concerned then it might not delay rads. Keep us posted!!

  • Fephna
    Fephna Member Posts: 45
    edited October 2013


    Hi TeamKim glad to hear ps appt went well. I see mine next week. Think that might be my last post op till after rads. All the incisions are healing well. Still getting the zingers every once in a while. Especially the left. Don't know if its the snb or the rads now that makes that side hurt more. By the time you start rads I can let you know how my reduction held up lol I will be sending positive thoughts as you start chemo next week :)

  • ketofan
    ketofan Member Posts: 3
    edited October 2013


    Thanks, Fephna. The ps wasn't a bit concerned. Research indicates that this is caused by lack of blood supply to the fat cells, such as what happens with surgery or radiation. These lumps can just be absorbed into the body. If they are too persistent, they can be surgically removed. Probably, this lump that I have will just go away. Maybe the radiation can shrink it as it would a tumor. It's located just above the nipple on the breast that had the tumor. I don't know if that has anything to do with it.

  • TeamKim
    TeamKim Member Posts: 301
    edited October 2013


    Hi Fephna -- Thanks for your good thoughts (can use all the karma I can get!). Hope your rads are SE free. Do let us know how the "rearrangement" holds up.


    By the way, my MO, who didn't realize I didn't have a traditional lumpectomy, started in telling me how rads would pull the girl toward my underarm and distort/scar/etc. Once I explained, he took that back, and said there would be some firming of the tissue with rads. He also said going forward that imaging (mammograms/MRIs) would also be easier and more comfortable since I had the oncoplasty.

  • DawnCT
    DawnCT Member Posts: 47
    edited October 2013


    Fephna and Teamkim - How are you doing with Rads?


    My surgery is scheduled for Tues. I am nervous but have been keeping busy preparing the house etc. I am having a hard time knowing how much pain I am going to have.


    I have been told I will not be able to drive or reach for anything for 10 days. Do you think I will feel like doiing some things around the house after the first week? Things like paperwork? I bought my Christmas cards today in hopes that I will feel like doing those while I am laid up, I have a dentist appt on day 8. Will I be able to manage that? I am not having any nodes removed.


    Also, the nurse said they may put a urinary catheter in during surgery and I am prone to UTIs so that worries me a bit.


    My GP gave me a valium to take that morning so I know that will take the edge off!


    Thanks for your help!

  • TeamKim
    TeamKim Member Posts: 301
    edited October 2013


    Dawn -- I well remember how stressed I was before the surgery....I took Xanax and that took the edge off. The nurses and anesthesiologist were awesome in prep, and my BS and PS came in and while the PS was drawing on me with his purple marker they talked with me about their plans for the surgery. I was so reassured by the way they were in sync and by how they included me in the discussion! Same with post op -- PS and BS talked with DH, and I was well cared for by terrific nurses in post op.


    If my experience is any indicator, you will be a bit of a couch potato for a couple of days, but then paperwork and little tasks like Christmas cards will be a welcome distraction as you continue to heal. Once you get off the pain meds (48 hours for me) and use Tylenol instead, you are over the worst of it. Make sure to have something on hand for constipation (Colace worked for me). By one week after surgery I could drive, and range of motion on my left side came back gradually over about 6 weeks. To give you an idea, 3.5 weeks after my surgery I went with my DH to take my son to move in at college on the other side of the country -- other than being a little tired a couple of times, I was fine.


    Thanks for asking about rads.... I am not there yet. I had to have chemo first, and will have my 2nd of 4 tx on Thursday. Compared to how bad it could be, I have been lucky with mild SEs so far. Lost my hair this week, though, which is a bummer. I will finish chemo by Christmas, then start rads three weeks later.


    I'll be thinking of you on Tuesday, sending prayers and wishes for a restful Monday night, little pain and easy recovery!

  • DawnCT
    DawnCT Member Posts: 47
    edited October 2013


    TeamKim - Thank you so much for responding. It helps me a lot! I also don't feel so alone. No one who hasn't been through all this stuff can really understand!


    I have been reading a breast reduction message board and it seems like some people there have been taking the pain meds for two weeks or more. I'm glad to know that you were off them in two days! I had no problems with my first lumpectomy and really only needed tylenol. So, I hope that I will be as lucky as you during this surgery!


    It is a hectic time of year with the holidays coming but I am just accepting that I need to back of all of the major holiday preparations and take care of myself. There is always next year.


    I bought the Colace and started taking it last night. I will take a dose tonight as well and hope this helps to prevent a problem! The constipation seems to happen to just about everyone!


    I am sorry that you lost your hair but am sure you are still beautiful! I met a woman the other day who told me she had been through Chemo for breast cancer two years ago and she now has shoulder length thick hair. Yours will grow back too. It is just hard what you have to endure. I hope you continue to have minimal other side effects.


    Stay in touch!


    Dawn

  • Nancyinct
    Nancyinct Member Posts: 17
    edited October 2013

    Hi Dawn, I read your post and thought that I would chime in. I live in Connecticut as well. I had a (right) lumpectomy and reduction on the left on June 5th. The pain was perfectly managed and I only had to take the hard meds for a day or so after I got home. Tylenol managed it very well. I healed pretty quick and am doing quite well. When I got the pathology results after the first surgery, it showed that I had 3 areas of IDC in addition to the extensive DCIS and they didn't get glear margins either. So, 6 weeks later on July 23rd I had a mastectomy with immediate reconstruction. I was afraid of having a lot of pain and having another surgery so soon after the first one, but I did amazingly well, same as before, pain meds for a day after the surgery and then Tylenol. There was no lymph node involvement and I didn't have to have rads, chemo or hormone therapy. I am back to work and doing very very well.

    Nancy

  • DawnCT
    DawnCT Member Posts: 47
    edited October 2013


    Thank you Nancy! That is very reassuring! Maybe it won't be so bad then!


    I am really glad you are doing so well.






    Dawn

  • Fephna
    Fephna Member Posts: 45
    edited October 2013


    Hi Dawn! I hope the surgery went well!! I remember the night before surgery I didn't sleep at all and night after surgery I didn't want to wake up lol


    I found driving after 3 weeks was still a little hard. Really turning around to back out of driveway or spot at supermarket is what hurt. Felt like i was pulling all the stitches. I also put a pillow under my left arm which helped.


    I used the pain killers for about 2-3 weeks. Then ps said I could start using Advil and I did that when I felt some pain. I didn't want to always rely on them but read when the body is relaxed and not tense from pain it heals faster. So I used them. I wanted to heal as fast as I could.


    I did no housework at all first few weeks. I couldn't bend. I would hold both boobs cause they felt like they were gonna fall off. Lol ps said that would never happen but that's the only way I could describe it. It was hard to reach over my head first couple of weeks and no lifting either.


    I slept on my back for over 6 weeks and I'm not a back sleeper. I would surround myself with all pillows to make it as comfortable as possible.


    I'm also a slow healer. Even tho ps said healing was on schedule to what she expected. But I think some heal much faster and some of these things are easier to do sooner after surgery.


    Today was last rads!! I'm so exhausted, but so relieved this step is over. I will write more about rads in the morning. I can't keep my eyes open. Lol Next step is oophorectomy nov 13, then meds. BC checklist is moving along now.


    Hi Nancy welcome :)


    TeamKim sorry about your hair. My cousin lost hers after a week after the first treatment. She looks just as beautiful!

  • TeamKim
    TeamKim Member Posts: 301
    edited November 2013


    Hi Dawn -- I have been thinking of you and hoping your surgery went well and recovery is going nicely. A couple of hints....


    1) they send you home in a surgical bra of some sort, and I was told to wear it night and day for one week, then to switch to a sports bra. I had a sports bra, but it was not as soft as the surgical bra and it cut across the SNB incision and that was not comfortable. About 5 days after surgery, I ended up going to Target, gathering up all the potential bras in my size and a little bigger, and trying them on -- it was a bit of a hassle with my drain dangling from the dressing room door on a hanger, but I managed. Ended up with two soft comfortable bras that I have worn for 6 months. Some women also buy one in one size larger to go on the outside so they can insert an ice pack in between the two bras. My ps/BC team said NOT to ice my girl, so I didn't do that.


    2) my shoulder on the surgery side was very stiff for a couple of months. BS said that was from holding my boob like a running back headed for the end zone. Try to relax that shoulder and put out arm down to your side, even slightly swing it when you walk. When sleeping and sitting, use a pillow to provide support, rather than holding the girl with your hand and arm. I got a sausage-shape travel pillow at Target which was great for this. -- filled with pellets which molded to whatever shape I needed. Also good for riding in the car -- when you go over a bump, you feel it for a few weeks.


    3) Keep incision area below your breast dry as possible once your dressings come off. This might not be a problem this time of year so much, but my surgery was in the heat of summer and I tend to perspire there. At the point where the incisions come together like an inverted T at the bottom of my breast, I ended up with a spot that took several weeks longer to heal. Once I was dealing with that I learned to put my blow dryer on cool setting and blow that area dry, then cover it with a folded piece of soft gauze, held on by my bra, to keep it dry. Any crusty bits on the incision can get a LIGHT smear of Neosporin to speed healing as well.


    Hope that helps!


    --kim

  • DawnCT
    DawnCT Member Posts: 47
    edited November 2013


    Hi Guys -


    I survived the surgery! It's now day 4 and I'm increasingly feeling better. The last pain pill I took was yesterday morning and have been doing Ok on extra strength Tylenol. I realize I may get days where I still need the prescription meds.


    I saw my surgeon on wed when he removed my drains and he said the nipples have good blood supply. Yay! He did not have to do the nipple graft and I'm so glad. He did say the BS removed an area right up to behind the nipple. I have to find out more about that. I expect to get the biopsy results back tomorrow. It would really be awful if I didn't get clear margins this time!


    The worst part of this was an awful headache that started on Weds that I just could not shake. I finally called the doc on Thurs who told me to drink a cup of coffee as it might be caffeine withdrawal and voila, the headache was gone! I was so surprised abut this as I usually just have 2 cups of coffee a day. I mad sure I had a cup for breakfast this morning.


    The nurses and doctors at the hospital were great and the the scolpamine patch really helped with the nausea. I think it should be standard procedure in all hospitals.


    I am so far happy with the results as well and feel so much lighter. I just will be glad to get back to life again I guess radiation will start in a month or so.


    I am glad to be on the other side of the surgery and am grateful to this board for helping me to prepare.. All the tips about home preparation, what supplies to buy and what bra was the best has helped so much!


    Fephna - I am so happy for you that your rads are over!! How did your girl hold up? Rest up! I am glad you are on your way.


    Thanks again!


    Dawn

  • DawnCT
    DawnCT Member Posts: 47
    edited November 2013


    Teamkim -


    Thanks for your thoughtful post! I did not see it before I made my last post. I hope you are feeling OK.


    You gave me some great tips especially about keeping the incisions dry. I definitely want as few complications as possible.


    My surgeon had me buy surgical bras ahead of time to bring to his office. I got the Marena as suggested on BC.org by so many people and find it


    to be very comfortable. I am still stuffed with gauze and padding at least until I get the stitches removed on weds. It will be nice to get rid of all that and wear regular clothes again. I am already going stir crazy being in the house.


    I did get to see my results and think they look great. They are boxy but I know that will resolve in time.


    One question : - should I take pain meds to get the stitches removed? I thought the drain removal was a little painful but quick.






    Dawn





  • TeamKim
    TeamKim Member Posts: 301
    edited November 2013


    I thought the drain removal was uncomfortable too -- and I was amazed to see that it wrapped so far around my breast! I didn't have any external stitches -- all glue -- so for me it was just waiting for the glue to come off on its own, which took awhile. Probably wouldn't hurt to have some Tylenol in your system for the stitch removal, since there are bound to be a couple of stitches that tweak a bit.

  • DawnCT
    DawnCT Member Posts: 47
    edited November 2013


    Hi again,


    I had my stitches out today and it wasn't bad. I just took the tylenol like you suggested Kim. Thanks!


    I have seen the results of my surgery and am having to mentally adjust as my breasts are definitely smaller than I wanted. I saw the pathology report today and the breast surgeon was aggressive in what she took out so the plastic surgeon had to work with that. I actually had no DCIS found at all so the margins were clear at the first surgery! Oh well.


    Now my other concern is that the tissue they removed was described as "fatty" breast tissue. I am worried radiation is going to shrink my bad girl as apparently fatty breasts tend to do that more during radiation.


    I feel guilty even complaining as I know others have been through so much more.


    Thanks for listening


    Dawn

  • TeamKim
    TeamKim Member Posts: 301
    edited November 2013


    Hi Dawn -- never feel bad about venting -- that's why we are here! I am sorry you aren't completely happy with the outcome. I haven't had rads yet (that's coming in January after I finish chemo), but I have been told that rads will tighten up my girl. My PS said you don't really know how she will be until about 6 months after radiation. He said at that point if I want a little work done on the non-BC breast to even them up, it will still be considered reconstruction as far as insurance is concerned.


    Talk to your PS about your options if you aren't happy -- but be aware that things will change still. My surgery was in July, and I don't think my girl was completely healed and softened back up until late September. But I know there are more changes to come.... BC -- it just keeps on hitting us with new challenges.... Sigh

  • jessica13
    jessica13 Member Posts: 2
    edited November 2013

    Hi all-

    Four weeks ago I had a WLE with oncoplasty on my right breast to fill in tissue where the tumor was removed. Now my breast has got a lot of scar tissue underneath the tumor area and I've been advised to massage it out before rads begin so the lumpiness and dimpling don't harden in place. Did anyone else experience this? It's super painful to massage it but I don't want these dimples to last!! Advice or positive experiences welcome!

    thanks!

  • Fephna
    Fephna Member Posts: 45
    edited November 2013


    Hi Dawn I'm sorry you aren't happy with the results. Sounds very frustrating to know margins were clear the first time. But clear again now so that's a relief. I'm gonna share how I felt after my surgery. Maybe at some point you may feel different about you new look.


    My first few weeks out I was terribly uncomfortable. My pain lasted longer but I took the pain meds. My first post op with ps when everything was unwrapped the first time I just wanted to burst out crying. They were black and blue and scary looking. When I got home I still had like a hundred steri strips on both. They were much smaller then I expected and I was told they were very swollen. That made me very depressed to think they will still be smaller when swelling went down. I took pictures every week to document my progress. I look back now and it doesn't look like they got smaller. I do see now how nicely shaped they turned out to be. They are so much softer and it has taken since aug for me to get used to them. I think those who choose a plastic surgery want to change something. People like us didn't want to change but had to so I think it takes longer to get used to the new look. I was not happy when they were swollen, hard and not shaped well. Maybe give it some time and then see how you feel and definitely talk to the ps about it.


    Gentle hugs :)

  • Fephna
    Fephna Member Posts: 45
    edited November 2013


    Hi jessica13 I just recently started physical therapy at a woman's clinic. She has been massaging the scars and both breasts. She explained the scars should be soft and massaging the breast tissue helps to make sure the scars don't stick to other tissue. I felt she was much more aggressive with my new boobs then I have been. I guess I've been babying them. It was uncomfortable at first and I'm 3 months post surgery. Yours was only 4 weeks ago. When will you start rads?

  • jessica13
    jessica13 Member Posts: 2
    edited November 2013


    Hi Fephna,

    Thanks for replying. I start rads in 2.5 weeks which is why my surgeon was so emphatic that I do LOTS of massage now. I have a ton of scar tissue which is protuding from my chest like a muscle knot - it's nowhere near the scar itself but I guess the tissue that was moved around to fill in my tumor hole is contracting and getting really hard. Now I also have a ton of broken blood vessels from massaging it, and it's getting uglier by the day :(

    Jess

  • Fephna
    Fephna Member Posts: 45
    edited November 2013


    Hi Jess, I'm sorry that sounds discouraging. Can your surgeon get you in with a pt to help with the massage? And my other question have you seen the radiation oncologist yet? He/she might have some suggestions to help get the scar tissue softer and not break blood vessels. My RO said I could only use aquaphor during treatment. Maybe massage with that to get a jump start on moisturizing as well. It seems frustrating now but it will get better. Keep me posted! :)

  • DawnCT
    DawnCT Member Posts: 47
    edited November 2013


    I'm sorry did not respond sooner. I appreciate your input so much.


    Teamkim - thank you for replying and for listening to my venting. This is quite the process! My PS said the same thing - we won't really know the results until the 6 month point. I asked my PS what we would do if the bad girl shrinks and he said we would do lipo on the good girl. I am so hoping that I will not need that as I do not want to be smaller! What will be will be I guess. I am wishing for great final results for both of us!


    How are you doing with your Chemo? I hope it is not too bad and you will be done soon?


    Fephna - Thank you for responding and for sharing your feelings abut your reduction. It helps! I am getting used to them and feeling better. It will be nice to get back into a regular bra. I think you are right about dealing with the change is harder because if was not really our choice. I keep thinking of how much worse it could be and try to be grateful.


    I am into week three now an am more sore than week two. My skin on the bad girl feels sunburned. I have been taking Advil which helps but am trying not to be on it constantly. I don't want to take the pain meds as they make me groggy and of course I can't drive. I had this burning after the first lumectomy too so I guess this is just how I heal. I know it will be better in a couple of weeks. All in all, this surgery has not been too bad.


    I have an appt with my Oncologist next week to discuss radiation I do know that I do not have to have the boosts so that should help with the cosmetic outcome.


    I am posting this link to an article about breast reduction and radiation that made me feel better about having this procedure. Maybe it will help someone else.


    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884710/


    Dawn

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