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Topic: Delayed reconstruction? Anyone?

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Nov 2, 2019 07:38PM

mnsotamom74 wrote:

I had a double skin sparing mastectomy one year ago. I decided at that time to be flat. My mom went through breast cancer 9 years ago and went flat, so I just assumed that is what I would also want. The last several months I’ve been really regretting my decision. I don’t like being flat and I don’t like wearing the prosthetics, they feel hot and sweaty and they move around. I’m seeing my surgeons partner on Monday to discuss options. I’m nervous as heck. I know I would like to do reconstruction, I’m just nervous about going through it. Have any of you done reconstruction after being flat for awhile? Are you happy with your results? Of course anyone who has had reconstruction can also reply. I’m just wondering are you all happy with the results or wish you wouldn’t have done it?

Thank you in advance for all replies:

Dx 10/25/2018, DCIS/IDC/IDC: Cribriform, Right, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (IHC) Surgery 11/4/2018 Lymph node removal: Sentinel; Mastectomy: Left, Right Chemotherapy 1/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/3/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Nov 3, 2019 10:19AM - edited Nov 3, 2019 10:19AM by Peregrinelady

I had a single mastectomy immediately after diagnosis and a Diep surgery (and mastectomy for the other breast) a year later. I have no regrets even with a couple of complications. I just didn't realize how important it was to feel “normal" and my mastectomy scar was very uncomfortable. Just make sure you find a surgeon who hasdone many of these surgeries and listens to you. Good luck!

Dx 4/24/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Hormonal Therapy 6/1/2015 Liquid tamoxifen (Soltamox) Surgery 4/17/2016 Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 7/30/2016 Arimidex (anastrozole)
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Nov 3, 2019 10:41AM mnsotamom74 wrote:

Thank you so much for the reply. I have been doing some research and I am a little concerned about some studies that show that delayed reconstruction has been shown in some case studies that it can awaken dormant cancer cells with the surgery and lead to a recurrence. I don’t know what to think. I’m definitely going to ask the surgery tomorrow about it. If it’s even a small chance? I will just learn to live flat. I’m anxious by nature and this would probably drive me nuts worrying

Dx 10/25/2018, DCIS/IDC/IDC: Cribriform, Right, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (IHC) Surgery 11/4/2018 Lymph node removal: Sentinel; Mastectomy: Left, Right Chemotherapy 1/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/3/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Nov 3, 2019 10:50AM Peregrinelady wrote:

I have seen those studies, too, but I am not sure how that happens unless your tumor was close to the chest wall. It is a huge surgery, so make sure you definitely are sure. What really helped me was reading all the DIEP threads to learn as much as possible before deciding.
Dx 4/24/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Hormonal Therapy 6/1/2015 Liquid tamoxifen (Soltamox) Surgery 4/17/2016 Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 7/30/2016 Arimidex (anastrozole)
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Nov 3, 2019 11:11AM DDF77 wrote:

I had a single mastectomy on August 20th. Waited two weeks for the oncotype to return and from that determined no chemo but 5 weeks radiation. There was a micro metastisis in the sentinel node. Now, 2/3rds of the way through radiation I'm facing hormone treatment after as well as reconstruction. HOWEVER, right before I was diagnosed I was scheduled to have a hip replacement surgery which was put on hold. I have severe stage four arthritic hip. So surgeon gave me a cortisone shot and sent me on my way. I went back to get a second shot last week and asked if he could do surgery after radiation. He said yes but that he'd prefer to do it before I start hormone therapy (obvious reasons) Does anyone know of any reason this plan would not be a good idea?

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Nov 3, 2019 02:54PM mnsotamom74 wrote:

DDFF7, I’m sorry, I don’t know the answer, hopefully someone will chime in.

Peregrinelady, no, my bc was not close to my chest wall. I am on anastrozole though and don’t know if you can have surgery on hormone therapy? I have been writing down a ton of questions for the surgeon

Dx 10/25/2018, DCIS/IDC/IDC: Cribriform, Right, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (IHC) Surgery 11/4/2018 Lymph node removal: Sentinel; Mastectomy: Left, Right Chemotherapy 1/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/3/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Nov 3, 2019 08:36PM Peregrinelady wrote:

I am not sure about AI’s, but I stopped my Tamoxifen for surgery then resumed afterwards. Definitely something to ask your Dr. about.
Dx 4/24/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Hormonal Therapy 6/1/2015 Liquid tamoxifen (Soltamox) Surgery 4/17/2016 Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 7/30/2016 Arimidex (anastrozole)
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Nov 5, 2019 03:52PM sunnyjay wrote:

I am in a similar boat.. I have a tissue expander from my single mastectomy 2 1/2 years ago. I was told at the time that it was better to wait until after chemo and radiation to get reconstruction done. I had to delay reconstruction longer because my husband got a kidney transplant 10 months ago and I am his caregiver. So far, he hasn't had complications and everything seems to be going well. So now it's my turn for surgery. I've had the expander for 2 years and haven't had any issues, but I know this is only temporary so I have to make a decision soon. I have an appointment with my plastic surgeon tomorrow to discuss my options. When I last spoke with her (2 years ago), she recommended getting an implant over flap surgery. It may be due to her inexperience with flap surgery because she didn't even mention that as an option until I asked about it. I am also preferring to do the implant because of the recovery time. I have my own business and can't afford to be out of commission for a couple of months. I recovered well after the mastectomy so I'm hoping recovery will go well for this also.

I met with my oncologist yesterday and mentioned that I plan to undergo reconstruction soon. He didn't say anything about having to stop tamoxifen prior to surgery. But I will make sure to ask about that.

Dx 3/23/2017, DCIS/IDC, Left, 4cm, Grade 1, 1/21 nodes, ER+/PR+, HER2- Surgery 5/17/2017 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Surgery 5/19/2017 Lymph node removal: Underarm/Axillary Chemotherapy 7/20/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Nov 6, 2019 11:35PM mnsotamom74 wrote:

wow, I didn’t know you could have a tissue expander in for that long. Keep us posted on how everything turns

Dx 10/25/2018, DCIS/IDC/IDC: Cribriform, Right, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (IHC) Surgery 11/4/2018 Lymph node removal: Sentinel; Mastectomy: Left, Right Chemotherapy 1/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/3/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Nov 6, 2019 11:45PM SimoneRC wrote:

I think one needs to stop Tamoxifen before surgery, but not AI’s. DVT and PE risk with Tamoxifen. For all of my pre op instructions it says to stop Tamoxifen if taking, but not AI. As always, please consult with your surgeon!!!


ATM Gene Mutation, Deletion. IDC w/Lobular Features and Focal Mucinous Features. Pre Pectoral Reconstruction. Hysterectomy Surgery 4/6/2018 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 5/5/2018 Arimidex (anastrozole) Surgery 7/3/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 4/29/2019 Prophylactic ovary removal Surgery 4/30/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 8/6/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Nov 7, 2019 12:04AM GreenEyes81 wrote:

I had a single mastectomy, went completely flat….one sided. Interesting experience to say the least. lol I have not heard of any thing about recon "triggering cancer cells"…interesting as well. I had DIEP on one side a little over a year after the first dx. I was dx with a recurrence in the middle…. Recurrence 7 months after mx with no recon…ya.

Do what will give you peace….worry about the statistics, the what if's….just do what gives you peace and don't look backwards.

Dx 7/21/2017, DCIS/IDC, Right, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 8/9/2017 Lymph node removal: Sentinel; Mastectomy: Right Dx 4/18/2018, DCIS/IDC, Right, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 5/2/2018 Radiation Therapy 5/27/2018 Whole-breast: Breast, Lymph nodes, Chest wall
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Nov 7, 2019 12:05AM GreenEyes81 wrote:

And yes, you have to stop tamoxifen for any surgery. Sounds like your doctor is on the right path. Even if you have a suregery a year out for something else, you would still stop tamoxifen for a while.

Dx 7/21/2017, DCIS/IDC, Right, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 8/9/2017 Lymph node removal: Sentinel; Mastectomy: Right Dx 4/18/2018, DCIS/IDC, Right, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 5/2/2018 Radiation Therapy 5/27/2018 Whole-breast: Breast, Lymph nodes, Chest wall
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Nov 14, 2019 10:29PM Mominator wrote:

Hello, I answered most of your questions on your other thread, questions for everyone who has done reconstruction

However, about surgery awakening dormant cells and causing a recurrence: You may wish to read this thread on TORADOL (ketorolac) linked to Recurrence Prevention. There is a theory that the inflammation from surgery (not just reconstruction, any surgery), can awaken dormant cells. The drug Toradol/Kerorolac lowers inflammation and thus may prevent recurrence. There was a video linked in this thread that is very enlightening. Toradol/Kerorolac is not very expensive.

https://community.breastcancer.org/forum/73/topics...

Best wishes.

Mominator, BRCA2+, STK-11 VUS. My Mom dx DCIS age 62, ILC stage IIIA age 79; Mom passed 2/28/18. My Grandmother died of ovarian cancer age 48. Friend to Lori M, passed 5/25/16. Surgery 11/10/2015 Prophylactic mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/18/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/29/2017 Reconstruction (left): Silicone implant
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Nov 15, 2019 04:45PM Soccermom4force wrote:

Hi there!

  I was dx in 2004 (Stage 2B) did bilateral mastectomies w/no recon as Mom was dying from metastatic disease and I didn’t need them to take care of business (at that time).

  3 years later I opted to reconstruct . Due to scarring/lack of tissue implants (alone)  were not an option.  I had stacked DIEP with small implants added for contour ,and that was roughly 11years ago. No regrets,no problems. 


best wishes no matter what you decide!

Marcia


" I expect to pass through life but once. If therefore,there be any kindness I can show, or any good thing I can do to any fellow human being, let me do it now, as I shall not pass this way again." Dx 12/2/2004, LCIS/DCIS/IDC, Right, 2cm, Stage IIB, Grade 3, 1/21 nodes, ER+/PR+, HER2+ (FISH)
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Nov 15, 2019 08:39PM mnsotamom74 wrote:

thank you ladies for your replies. My oncologist said he is not even slightly concerned about it. I told him that if he even felt the chance was teeny tiny I want to know and he got very strict with me and said I need to stop doing google research and talk to him or my breast surgeon. I am guilty of googling way too much since my breast cancer diagnosis a year ago, I’ve literally scared myself so badly from reading worst case scenarios online and convincing myself that it’s definitely going to happen to me. Sometimes I don’t know how he puts up with me Scared

Dx 10/25/2018, DCIS/IDC/IDC: Cribriform, Right, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (IHC) Surgery 11/4/2018 Lymph node removal: Sentinel; Mastectomy: Left, Right Chemotherapy 1/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/3/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Dec 29, 2019 11:39PM Whatjusthappened wrote:

Hi ladies, just looking for some advice here. I had a bmx 10 months ago and still trying to decide whether or not I want to reconstruct. I met with a plastic surgeon and was told that my only real option was a DIEP since the radiated side would not be able to take an implant. Early on I was determined to stay flat, but just cannot stand how I look now. I have a growing collection of bras and prosthetics and just can't find an option I'm comfortable with.

Adding to my poor self-image is the fact that since my diagnosis I've probably put on 20 pounds. I tend toward gaining weight easily and only keep it off with a lot of exercise, and that went out the window this year, for multiple reasons. If I were going to go with the DIEP, would it better to lose the extra weight first? I am worried about losing the weight, having the surgery, and then gaining it back again while I'm recovering. Even with weight loss I think I'd have plenty of tissue- I've never been able to lose the tummy no matter how much weight I lose.

If I do the surgery it will probably be in the summer. My family is against me having more surgery but would support me. So I guess in addition to whether or not to lose weight first I'm wondering how long of a recovery to expect.

Any advice greatly appreciated- I've been agonizing over this decision for a long time!


BRCA2 positive; multifocal LCIS/ILC found after sugery Dx 2/1/2019, LCIS/ILC, Right, 4cm, Stage IB, Grade 2, 1/3 nodes, ER+/PR+, HER2- (FISH) Surgery 2/21/2019 Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 4/22/2019 External: Lymph nodes, Chest wall Surgery 6/17/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Dec 30, 2019 09:50PM mnsotamom74 wrote:

oh whatjusthappened, I totally understand how you feel. I thought I would be ok with being flat or wearing my prosthetics. I had my double mastectomy Nov 2018. I had chemo but didn’t need radiation. I have gained weight since chemo and being on arimidex, I look like I’m constantly 5 months pregnant. I had 2 other surgeries not related to my breast cancer during 2019, but 3 weeks of hospital stays and long recovery. I didn’t think I could handle another surgery, but I decided to go for it. I had expanders placed December 16. I’m incredibly pleased with the surgeons work and very excited to get them filled again. I know you said you would need diep, I think I would have definitely gone for that if this would not have been an option. It’s very personal and each woman has to decide for herself. I’m glad I moved forward and decided to have reconstruction. I know there is a private face book group for women who have done diep and they share their knowledge and answer questions for women preparing or gathering information to make their decision. Very best of luck to you in whatever you decide

Dx 10/25/2018, DCIS/IDC/IDC: Cribriform, Right, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (IHC) Surgery 11/4/2018 Lymph node removal: Sentinel; Mastectomy: Left, Right Chemotherapy 1/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/3/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Dec 31, 2019 12:05AM Whatjusthappened wrote:

mmnsotamom74, thank you so much for your response. It truly means the world just to know someone else gets it. I totally understand what you mean about looking pregnant. The"Buddha belly", as it's referred to often on this site, is just not a good look on me. I've seen plenty of women (pictures, anyway) who look awesome flat, but I'm not one of them. Just gotta work up the nerve to go thru the surgery. I find it much scarier than a bmx.

I'm glad that you are happy with your decision and results. I wish you all the best.

BRCA2 positive; multifocal LCIS/ILC found after sugery Dx 2/1/2019, LCIS/ILC, Right, 4cm, Stage IB, Grade 2, 1/3 nodes, ER+/PR+, HER2- (FISH) Surgery 2/21/2019 Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 4/22/2019 External: Lymph nodes, Chest wall Surgery 6/17/2019 Prophylactic ovary removal Hormonal Therapy Arimidex (anastrozole)
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Jan 4, 2020 03:19PM Mobri wrote:

I had my reconstruction about five years after I finished treatment. My doc was really concerned about potential complications from reconstruction surgery delaying the start of my chemo treatment. And so for that reason, I'm not sorry I waited.

I wound up having a diep flap surgery. Overall, mostly happy with the results. The nipple reconstruction didn't take so I'm not thrilled about that but also don't want yet another surgery.

I didn't wait to lose wait before having the surgery...and I don't think 20 pounds really makes that much difference one way or the other. FWIW. And, you may want to ask the surgeon, but those extra 20 pounds might be better for diep.

Best of luck to you whatever you decide.

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Jan 4, 2020 05:38PM Moderators wrote:

Mobri, thank you for sharing your experiences. We welcome you warmly to our community. Whatjusthappened, it is a difficult decision. Certainly also get as many professional opinions as possible, to help guide your decision-making.

We're here for you All. Medicating

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