Topic: double mastectomy with/without reconstruction

Forum: Living Without Reconstruction After a Mastectomy — Discuss prostheses, swimsuits, bras, and other options for women not having reconstruction or waiting for reconstruction.

Posted on: May 12, 2022 08:57PM

Posted on: May 12, 2022 08:57PM

lindsayz wrote:

Hello! I'm 62 years old and diagnosed with triple-negative invasive breast cancer StageIcN0M0. Currently, I'm under chemotherapy for 8 cycles/24 weeks and I'll have the last cycle of the chemo next week. After I finish the neoadjuvant therapy I will have a double mastectomy in late June since it is triple-negative breast cancer and I have a family history. My surgeon strongly suggested I have a mastectomy with reconstruction even though I originally planned to have a mastectomy without reconstruction when I saw my surgeon this week. Now it's a bit hard for me to make a decision (with or without reconstruction). I would like to hear your opinions and experience. Especially what was your experience/feel if you had a double mastectomy without reconstruction? Thanks.

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May 12, 2022 10:03PM txlorelei wrote:

I had been leaning towards going flat but decided for sure when the plastic surgeon recommended against using implants after radiation. I knew I did not want any sort of flap.

It’s now 6 months since my second surgery and I’m happy with my decision. I was an A cup before, so I took advantage of the opportunity to go up to B size prostheses. They’re fairly comfortable but I usually ditch the bra once I’m home for the evening. The local boutique provided me with 4 pocketed bras (covered by my insurance) but I found the “Joy Bra” from Amazon to be more comfortable.

Good luck on your surgery.


Dx 7/7/2020, ILC, Right, 5cm, Stage IIIC, Grade 2, 26/26 nodes, ER+/PR+, HER2- Hormonal Therapy 8/12/2020 Femara (letrozole) Surgery 1/4/2021 Lymph node removal (Right): Underarm/Axillary; Mastectomy (Right): Simple; Reconstruction (Right): Aesthetic Flat Closure Dx 8/25/2021, LCIS, Left, 1cm, ER+/PR+, HER2- Surgery 12/11/2021 Mastectomy (Left): Modified Radical; Reconstruction (Left): Aesthetic Flat Closure Radiation Therapy 1/3/2022 Whole breast: Lymph nodes, Chest wall, Right breast Targeted Therapy 3/3/2022 Verzenio Chemotherapy AC + T (Taxol)
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May 12, 2022 10:33PM serendipity09 wrote:

Lindsayz- Did your surgeon say why he/she recommends you have reconstruction? Not that I'm asking you post here, but I'm really surprised. My surgeons and the second opinions I had, never made a recommendation and respected that it was a personal a decision for me to make. However, my nurse navigator made me feel terrible during one of my last chemo treatments when I told her that I was choosing to have a double mastectomy and she responded with "well, we don't recommend removal of a healthy breast blah, blah, blah..." I was in tears. I felt violated. It's already hard enough to go through what we've gone through and have to make a decision on loosing a part of our body, for someone then to come and make you second guess yourself.

I say go with what YOU want.

I'm sorry you are having to go through this.

Chemotherapy 4/1/2020 AC + T (Taxol) Surgery 9/17/2020 Lymph node removal; Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Tissue Expander Chemotherapy 11/3/2020 Xeloda (capecitabine) Surgery 7/9/2021 Reconstruction (Left); Reconstruction (Right) Chemotherapy Xeloda (capecitabine) Chemotherapy Carboplatin (Paraplatin) Radiation Therapy Whole breast: Breast, Lymph nodes, Chest wall
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May 12, 2022 10:55PM wrenn wrote:

Welcome Lindsayz, My decision was easy. At 66 and with triple negative where chemo was recommended I didn't want more recovery time and didn't care if I had breasts.

Although I did get a prosthesis I only wore it for my daughter's wedding and since then have comfortably gone flat. The choice is different for everyone but I have no regrets about not having reconstruction.

Once you have made the decision it should get easier. It is not your surgeon's choice. It is yours. Good luck with the surgery.

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May 13, 2022 12:28AM katg wrote:

I am a BRCA2 women and small breasted, so my tumor gave me two choices. My friend did not have reconstruction. She is stage 4. I am stage 2. My City of Hope doctors said i was a candidate for reconstruction. Oddly, we did not cover more than two types. Likely cause i was staying my same size. No upper cup sizes for me. I got skin sparing. By gosh if i did not have my nipple area gone, both look the same. My right will go once my blood clot is gone. I really did not know which i wanted, but what am getting works and my doctor did a good job.

Honestly, I never had the thought i cannot lose my breast. I have cried after i got the one removed, knowing the other would go too. And the last person likely to touch my remaining one is my plastic surgeon. For me, if this will cut my chance for reoccurrence down, I will do it. Having reconstruction makes me feel good. With cancer treatments, that is good.

Chemotherapy 8/14/2021 AC + T (Taxol) Hormonal Therapy 1/1/2022 Femara (letrozole) Surgery 2/9/2022 Cryotherapy (Left); Lumpectomy (Left); Lymph node removal (Left): Sentinel, Underarm/Axillary; Mastectomy (Left): Modified Radical, Nipple Sparing, Partial, Radical, Simple, Skin Sparing; Prophylactic mastectomy (Left); Reconstruction (Left): Aesthetic Flat Closure, Fat grafting, Nipple reconstruction, Nipple tattoo, Removal (Left), Tissue Expander Dx IDC, Left, 5cm, Stage IIB, Grade 2, ER+/PR-, HER2+, ISH, IHC
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May 13, 2022 12:45PM blums8 wrote:

Hi all,

I am a 65 year old woman diagnosed with triple negative breast cancer in late December. I started treatment in February. I finished my first 12 weeks of Taxol, Carboplatin with Keytruda, and I have had 1 infusion of my second protocol; Keytruda, Adriamycin, and Cytoxin. I am leaning towards going flat and appreciate the input from all of you. I know that it might be difficult at first but I want the least amount of surgery that I can have. I will get prothesis and see how comfortable that is. I don't know yet if it will be single or double. I do not have any genetic markers. even though I am leaning in that direction, I still have some trepidation. I am small breasted so that might help.

Thanks,

Janice.........Blums8

Chemotherapy 2/1/2022 Other
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May 15, 2022 09:37PM beginagain22 wrote:

Lindsayz

I am 48 and had a DMX with a flat closure in March. I was going to have a lumpectomy but my genetic test came back with a mutation. So I had the DMX and have been very happy with the results. My Oncotype was low, so no chemo or rads. The Armidex has not been a picnic but I am very happy with my surgical result

Surgery 3/18/2022 Cryotherapy (Left); Cryotherapy (Right); Lumpectomy (Left); Lumpectomy (Right); Lymph node removal (Left): Sentinel, Underarm/Axillary; Lymph node removal (Right); Mastectomy (Left): Modified Radical, Nipple Sparing, Partial, Radical, Simple, Skin Sparing; Mastectomy (Right): Modified Radical, Nipple Sparing, Partial, Radical, Simple, Skin Sparing; Prophylactic mastectomy (Left); Prophylactic mastectomy (Right); Reconstruction (Left); Reconstruction (Right) Hormonal Therapy 5/1/2022 Arimidex (anastrozole) Dx IDC, Left, 2cm, Stage IIA, Grade 3, 2/10 nodes, ER+/PR+, HER2- Surgery 5/25/2022
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May 16, 2022 07:15AM castigame wrote:

I can only speak from my experience. The breast surgeon did say lumpectomy would not look decent at all as well as no immediate reconstruction. So it was DMX with no recon for me. Yes I still have boob envy every day even after 5 yrs. Had a simple mastectomy to remove a few skin blisters of sorts. (Pathology is clear) which could have turned to be suckers. It was opening up the same surgery line and remove 12.7×2.7×1.5 cm flap. Yes this BC thing still royally sucks but glad the recent mastectomy was simple.

Mimi Dx 1/11/2017, IDC: Papillary/IDC: Cribriform, Right, 3cm, Stage IIIA, Grade 2, 4/17 nodes, ER+/PR+, HER2- Dx 1/11/2017, IDC, Left, <1cm, Stage IA, 0/2 nodes Surgery 2/15/2017 Lymph node removal; Lymph node removal (Left): Sentinel, Underarm/Axillary; Mastectomy; Mastectomy (Left); Mastectomy (Right) Chemotherapy 3/21/2017 Radiation Therapy 7/31/2017 Whole breast: Breast, Lymph nodes, Chest wall Surgery 10/30/2017
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May 16, 2022 10:56AM - edited May 16, 2022 10:58AM by miriandra

I was offered a lumpectomy, but my surgeon told me that because of the shape and placement of my tumor, she wasn't sure if they'd get the whole thing the first time. So I decided to go with the mastectomy. Literally two weeks before my surgery, they had that huge recall on textured implants and expanders. (https://www.cancer.org/latest-news/breast-implant-recall-what-you-need-to-know.html) That confirmed for me that I made the right decision. Many of us can be very comfortable going flat.

This is not to dismiss the women who went with implants for psychological or social reasons. Those are totally valid. But we don't necessarily need breasts to be women.

Dx 5/31/2019, DCIS/IDC, Left, 1cm, Stage IA, 0/1 nodes, ER+ Surgery 8/14/2019 Lymph node removal; Mastectomy; Mastectomy (Left)
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May 16, 2022 10:47PM katg wrote:

It really is a personal decision. I would ask for pictures. Honestly. I had thought as i wrote before that with s BRCA2 mutation, that i would not be a candidate. The skin saving is really simple. Remove the insides and place an implant. After surgery. I was supposed to have radiation, so my one side removed had an expander put in. I actually hade my fallopian tubes and ovaries out, then the breast surgeon did her thing and then plastics. All in about 6.5 hours. No side effects from their work. I still have the expander as i got a blood clot. That takes from 3-6 months to treat. My expander is with me.

I love how all of us make a different choice, with most happy. For sure once they are gone, those two are gone. For me, being small made it easier. I would say i am an A. City of Hope is a cancer center. If implants are good for me, i know they have the skill and care tp get it right. My body must do the recovery.

miriandra and the others are right. My friend went flat and felt the same.

Chemotherapy 8/14/2021 AC + T (Taxol) Hormonal Therapy 1/1/2022 Femara (letrozole) Surgery 2/9/2022 Cryotherapy (Left); Lumpectomy (Left); Lymph node removal (Left): Sentinel, Underarm/Axillary; Mastectomy (Left): Modified Radical, Nipple Sparing, Partial, Radical, Simple, Skin Sparing; Prophylactic mastectomy (Left); Reconstruction (Left): Aesthetic Flat Closure, Fat grafting, Nipple reconstruction, Nipple tattoo, Removal (Left), Tissue Expander Dx IDC, Left, 5cm, Stage IIB, Grade 2, ER+/PR-, HER2+, ISH, IHC
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11 hours ago janiehs wrote:

I too went flat after a BMX. Although all genetic testing has been negative, most of the women in my family have breast cancer or have died from it. So doing the BMX was a no brainer for me. And like others here have mentioned, i just decided I didn’t want any further surgery or recovery time. Probably helps that I was 66 at the time of diagnosis and have been married forever and my husband was ok with my decision. Plus I was never a huge fan of my boobs anyway - they were fine when I was young but the older I got and the saggier they got, the less I liked them. I wear a prothesis occasionally but mostly I just go around flat. At my age, no one is looking. I think the best thing to do if you can manage it is to make your decision, trust your gut,and then just don’t look back.

Surgery 2/11/2020 Mastectomy; Mastectomy (Left); Mastectomy (Right)

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