Topic: Uni mastectomy w/reconstruction fail, infection, radiation

Forum: Breast Reconstruction — Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: Feb 26, 2022 01:54PM - edited Feb 26, 2022 01:56PM by ale777

Posted on: Feb 26, 2022 01:54PM - edited Feb 26, 2022 01:56PM by ale777

ale777 wrote:

Hi

I was diagnosed with R side breast cancer (stage1, grade1) a few months ago and with team of drs decided to have a unilateral mastectomy on right with immediate reconstruction and R sentinel node. Left breast underwent lift and had benign result from MRI 'weird line' so they cut that part out. Had 2 surprising/unexpected pathology results. 1) Right sentinel node clinically negative but pathology found 4mm cancer. 2) Left breast pathology found 4mm (yes weird coincidence) cancer. Decision to do another surgery on left sentinel node, luckily negative. Because of right node discovery was told needed radiation of axilla. Expander process allowed to finish and went well. Felt good and ready for radiation. A few days before radiation was to start treatments (had gone through simulation etc), developed fever turned out somehow got infection(no one can pinpoint how) and had to have emergency surgery to remove expander. Back to square one reconstruction wise and delay radiation by a few weeks to heal. The Rad. oncologist told me he really wanted to radiate right mastectomy site. With that radiation, reconstruction with implant again ruled out because of damage that will happen during radiation and have to wait at least 6 months after radiation to restart process. I am basically having radiation from ribs up on both sides. Not looking forward to summer with one boob.

My questions are, has anyone else had infection, radiation than successful reconstruction? I'm in Atlanta but willing to look outside state for best most experienced surgeons that specialize in difficult reconstructions. Any suggestions? Any suggestions on treating skin during/after radiation to try to avoid fibrosis? I will most likely have to have some type of autoligious surgery(s). Any thoughts on easiest recovery? Finally, what do you do with symmetry of breasts now that expander out during the summer? (when its cold can hide better)

I appreciate any thoughts, suggestions, guidance etc. This started as a pretty straightforward process and has turned into a complications nightmare. Only saving grace is no Chemo. Thanks for listening!

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Feb 26, 2022 10:22PM ratherbesailing wrote:

So sorry you are going through all this. I didn’t have an infection. But I can tell you that, despite a skin sparing mastectomy, radiation had damaged my skin so much the plastic surgeon (DIEP operation) basically threw out my breast skin and used skin from the abdomen. The result is an elliptical shape that still shows a bit out of clothes due to the scar and the slight difference in skin color. But it really isn’t bad, and clothed bo one would ever know. I waited six months after radiation for the reconstruction.

There are many posts about protecting skin during radiation treatment, but I think it’s largely just a matter of an individual’s skin tolerance.

By all means, yes, try and find a PS now to give you some options and an idea of what to expect. And ask your surgeon for a prescription for a prosthetic to even you out until you can have reconstruction surgery. And ask them to write a separate rx for a swim prosthesis, which is more durable in water. There are some really lovely mastectomy swim suits out there, and I found I could put the prosthetics in my Speedo suits when I was doing laps.

Hang in there. Wishing you all the best.

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Feb 26, 2022 10:35PM parakeetsrule wrote:

Lots of people opt for single mastectomies with no reconstruction. There are many prosthetic options! I've been flat on one side for almost five years. I use mostly knitted knockers and trimmed shower poofs for bathing suits. But there are lots of other things out there.
Stage 2 at 37, Stage 4 at 41. Cancer is dumb. Cookies are good. Dx 3/21/2017, IDC, Left, Grade 2, ER+/PR-, HER2- Chemotherapy 5/15/2017 AC + T (Taxol) Hormonal Therapy 12/8/2021 Faslodex (fulvestrant) Targeted Therapy 12/13/2021 Piqray (alpelisib) Dx IDC, Other, Stage IV, ER+, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal (Left); Mastectomy (Left) Radiation Therapy Whole breast: Lymph nodes, Chest wall
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Feb 28, 2022 10:40AM lalbo wrote:

ALE777 - regarding plastic surgery. Check out The Center for Breast Reconstruction in New Orleans. They specialize in breast cancer reconstruction and they told me they work on radiated skin. Also, there is a plastic surgeon in Birmingham that I am going to see in March regarding revision. Dr. Michael Beckenstein, who has been mentioned on this board as being very good. I wish I had known about either of these PS options last year when I had my reconstruction. I had BMX, tissue expanders, radiation (right side only) and implant reconstruction. I am not pleased with the outcome of my reconstruction. I am considering having the implants removed and having DIEP. I've talked to NOLA and if I go with them it will have to be next year, they are out of insurance network and I have to come out of pocket quite a bit. I'd like to save up as much as possible.

In the meantime, I pad one side of my bra more than the other for some semblance of symmetry.

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Feb 28, 2022 11:39PM meow13 wrote:

I had simple mastectomy no skin sparing 2011, 4 months later did DIEP left side only 2012 still looks great 10 years later. Abdomen skin matches perfectly. Really happy but I never had radiation.

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Aug 13, 2022 04:35PM gh11 wrote:

Hello again, I see in this post it was unilateral mastectomy. Which plastic surgeon did you go to? I don't need radiation either and have a tissue expander in.

Surgery 6/1/2022 Mastectomy (Right): Nipple Sparing

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