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Topic: breast reduction after radiation

Forum: Radiation Therapy - Before, During, and After —

What to expect from treatment and ways to cope with side effects.

Posted on: Jun 11, 2019 11:19PM

grandmaadams wrote:

Has anyone had breast reduction surgery AFTER the breast had been radiated? I told my surgeon I was going to have breast reduction surgery but then I was diagnosed and put everything on hold. He told me not to consider reduction surgery until one year after my radiation treatment had ended since the breast would continue to shrink. Today, 7 months after radiation, I asked for a referral to a plastic surgeon to start getting ready for the reduction. Today he tells me I can't surgically reduce the radiated breast because it won't heal properly! Has anyone else dealt with this issue?

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Jun 12, 2019 09:13AM sbelizabeth wrote:

Breast reconstruction procedures are done all the time for women who've had radiation treatments. They are typically flap procedures, since thin, inflexible, radiated skin has problems tolerating the expander process needed for implants. It's true, radiated tissue brings an increased risk of slower healing and infection, but a competent plastic surgeon takes this into account.

My team wanted me to wait at least six months after radiation to do my DIEP reconstruction, so the tissue damage could settle down. I had no healing issues.

I would INSIST on a referral to a plastic surgeon who has experience working with women who've had radiation. Long, long ago, way before BC raised its ugly head, I had reduction surgery. It changed my life--I could wear clothes that fit, and could find nice bras that made me feel pretty. You deserve the same.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Jun 12, 2019 12:31PM - edited Jun 12, 2019 12:33PM by Trying2staypositive

So im curious what they told you about any possible breast reduction and its affect on later imaging? I ask because I too have considered a reduction but have a family history of breast cancer and now I'm going through biopsies and more imaging for a few different things. (Hopefully all will be benign). I had previously made an appointment in November to talk to a surgeon about a possible reduction. He happens to be a surgical oncologist because I want his opinion on genetic testing but also as a surgeon as to what he feels the impact of a surgical breast reduction might have re: views on further screening tests in the future. Wondering what if anything your doctor said about this?

Dx 7/15/2019, ILC, Left, Grade 2, ER+/PR+, HER2- Surgery 9/10/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Jun 12, 2019 01:16PM Runrcrb wrote:


I agree with the above -see another plastic surgeon. Yes radiation can impact the skin and contribute to healing issues but doesn’t always. My DIEP flap was done after radiation and my recovery was easier than from the mastectomy. Talk to several plastic surgeons and find the one that is right for you.

Dx 6/27/2016, IDC, Right, 1cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Dx 6/27/2016, ILC/IDC, Right, 2cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Surgery 9/21/2016 Lymph node removal: Right; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 10/31/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/8/2017 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/22/2017 Arimidex (anastrozole), Aromasin (exemestane) Surgery 12/12/2017 Reconstruction (right): DIEP flap
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Jun 12, 2019 02:57PM grandmaadams wrote:

sbelizabeth Thank you so much for your information. I am definitely going to pursue this. Yesterday I got lots of encouragement and support from my long term female GYN that I should be able to have reduction surgery and she has referred me to a new surgeon/oncologist. Really looking forward to being able to buy clothes that fit.

trying2staypositive We didn't really have that discussion. I just know from my own searching that they would need to do new mammograms etc to establish a new baseline. It was my surgeon/oncologist who discouraged me from reduction surgery on the radiated breast so I never asked those questions. If I continue to proceed I will definitely want to ask the same questions. I have very dense breast tissue in the beast that wasn't treated and I am concerned that reduction surgery might interfere with a possible future diagnosis.

runrcrb Unfortunately my discussion was with my surgeon/oncologist, the one who performed the lumpectomy. Unfortunately for me just this past Monday, after asking questions because I was confused about my care … you need to have a full breast ultrasound … no you don't need a full breast ultrasound … I said I don't understand, what's changed. He raised his eyebrows and said if I was unhappy with the services he was providing, I needed to find a new doctor. Fortunately for me after discussions with my other doctors we have decided that changing to a new oncologist is exactly what I need to do. My long term female gynecologist (who did breast surgery up until 2014) has referred me for a whole breast ultrasound and to a new doctor. She also said, after examining my breasts, that she doesn't see why I can't have reduction surgery but she would let my new surgeon/oncologist follow through with that. HUGE sigh of relief.

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