Is this silly?
My 77 yo mom asked the surgeon today, "is it silly to consider reconstruction at my age?". We went for the appointment after mom got the results back from her metastatic workup. Multi focal idc in her right breast...it looks like a lot of large, overlapping tumors the surgeon said. We went for a consult since no sign of distant disease showed up on scans. But my issue is the surgeon did a great job explaining a total mastectomy, but never once mentioned or asked about reconstruction. When I mentioned it he was like a deer in the headlights.
He has now referred mom to a plastic surgeon to find out more, but the whole experience left mom questioning whether she was being " silly". She is not sure if she even wants reconstruction... But she'd like to at least know her options. I totally support whatever she wants to do but I'm shocked the assumption was just that she wouldn't want it.
Am I missing something? Does a particular age mean too old for reconstruction? I've been reading her some of the discussions here (she really struggles with technology and tablet reading). She has appreciated the insights. Its all so new, so fast.
Any thoughts?
Thanks!
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I don't think you're ever too old but it's tough surgery either way you go and usually the older you are the more gentle they want to be with treatment.
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@bellevue1110 , While this is anecdotal, women in their 70s and 80s do get reconstruction. People, whatever their age, often feel more comfortable in a body like the one they are used to. My daughter is a surgical/postsurgical PA at a well known cancer center. According to her almost all in this age group who choose reconstruction have implants since that procedure does not not involve a second healing site on the body as autologous reconstructions do. An implant would involve a second surgery and additional healing but those are topics your mom can discuss with the plastic surgeon.
There are many choices to be made but it's a good idea to get all the information first. Sometimes doctors make assumptions based on a person's age when decisions should be based on medical criteria and patient preference.
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If it was my mom at age 77, knowing how painful reconstruction is, I would agree with the doctor. I told my BS that if I was 60, I would have skipped the breast reconstruction but since I was still young with young daughters, I decided for reconstruction. What a difficult set of surgeries to have reconstruction! I had DMX, ovaries removed without any problem at all but implants are difficult. It has been 3.5 years and I still get aches and pains and they still feel like containers inserted inside my chest. I go yearly for follow up to check for raptures and other problems. When the time comes for replacement, I told PS that I won't replace them, I will go flat. I won't go through another painful set of surgeries for cosmetic reasons. I would rather have a facelift instead :). Just me.
How fit is your mom? Would she be ok to have discomfort and other risks once reconstruction is over?
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I really appreciate the comments and insights...mom says "thank you!". She said it just ticked her off the surgeon assumed. Ticked me off too, for what that's worth! My mom has C-D size breasts and is concerned about discomfort and not feeling lopsided. I can't speak for her, but that's what I heard her express. I have zero insight, even anecdotal, so I was at a loss. Mom is in ok health (BC aside). She does have type II diabetes and hypothyroidism. She loves to garden and gets out weekly for lunch and shopping with friends. I am hearing you about increased risks and pain.
The plastic surgeon mom is referred to is at Cleveland Clinic and highly rated. I'm hopeful she will be able to talk to mom about options, risks and recommendations. Mom said she'll feel better making a decision based on on information, not frustration. I know she'll make a good decision...my only goal is SHE gets to decide!
Again, thanks for the replies. Much appreciated.
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Reconstruction at any age, assuming that it’s medically feasible, is always the patients choice. That being said, older women are less likely to choose recon over younger women, though many do. As has been pointed out, implant recon would likely be suggested as various flap recons involve another surgical site besides the breast and the surgeries can be very long. I would like to correct one comment made about implant recon. In cases that meet certain criteria, a one step implant surgery may be possible. This skips the tissue expander stage and subsequent surgery to exchange for final implants. While not totally familiar with all the criteria for one step implants, the mastectomy should be skin sparing, i.e. since skin is left intact there is no need for expanders to stretch the skin. A plastic surgeon should be able to evaluate if this is possible. I will be honest and say that it is the less common route to take with implants and it seems that not all ps are comfortable doing this (some even poo poo the idea). I had it done 12 years ago without a single issue but my ps was kind of a rarity in that he was experienced in the procedure. BTW, he only did various kinds of reconstructive surgery, nothing purely cosmetic. All the best to your mom.
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Thanks exbrnxgrl. That's helpful to know. We've made an appointment for mom to see the breast specialist at Cleveland Clinic. The doctor has the best reviews I've ever read on a doctor, and more importantly, she was highly recommended by another doctor my mom trusts and has seen long term. The CC doctor will do the mastectomy whatever mom decides on reconstruction and mom (and me!) feel confident she will get good consul on what recommended. Despite knowing surgery was the next step it's really sinking in for my mom this week. I think awareness of some of the potential issues with lymphedema and neuropathy worry her more than the removal of the breast. I'm glad she will be in the hands of someone specialized. My mom is pretty amazing. She's stayed right on with her usual routine. She and my dad know how to support but not smother. I'm grateful for everyone's willingness to share experiences I can share with her.
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