"how am i gonna make lemonade out of my lemon?"

LizzyGirl15

So...to give a little insight to my question. As you all know I have a bad lemon. 28, triple -, IDC, grade 3, stage 3, 6x10 cm tumor that showed it invaded my pectoral muscle and lymph nodes under the breast bone and armpit (mri). I am finishing my AC/T chemotherapy and I have been going out on my surgery consultations and getting mixed vibes/ideas on how to deal with the next steps. The first thing I am working on is finding the right team (personality is a must!) to handle the breast surgery, radiation, and plastic surgery. I feel pretty strongly that I want to "hire" all three from the same hospital because they do work with one another and having a supporting team is a must. From the Boston area and would love to hear about your experience! I have visited the Dana-Farber, The Mount Auburn and Lahey.

HOWEVER, the one team I met with said it was safe to have a skin-sparing bi-lateral masectomy with immediate reconstruction with expanders. I would then have radiation (this part is a must and I have to have the 7 to 8 week course of raditation) and some time after that I would have the expanders replaced with implants. PROS would be that I wouldn't be without a breast for a year, I have improved my chances of not getting the cancer in my left side, I would only have 2 small scars that would be covered with my new nipples, and I would think there would be more control over the final look because they are using 2 apples instead of untouched side and an orange. CONS are that there is only a 50% chance of success with the implants and my new apples would need to be replaced every 15 years.

But the other two teams I met with want me to have a single masectomy following with radiation. Then 6 months to a year later, I would have a "tissue" reconstruction. PROS are that there is a less chance of failure with the flap and less of a chance of reoccurrence of cancer in the same breast because they are taking more tissue and skin at that time (sort of because the cancer could come back in the other breast), I would have sensation in one side, and I was told that I might have better cosmetic results. CONS are that I would have large scar across my belly, the traditional scar across the lemon side, the lemon side would have eye-shaped peice of fresh tissue with radiated tissue around it, I will be walking around for 12 to 18 months without a breast, and the lemon would really be an orange compared to my other side.

I also have been given the option to have a tissue/implant reconstruction which has a better success rate than just implants alone. However, this will leave me with 2 6" to 10" scars across my back and the eye-shaped tissue on both sides. I keep referring this to an eye-shape because I will have a scar that is shaped like an eye with a reconstructed nipple in the middle.

Sigh...

I do still have to met with a few more doctors and I guess I have a lot of praying to do! Between logic, faith, and a sign...I hope to get an answer!

 Right now I would love to hear what you ladies have to say! I would love your support and hear what you have to say! I have been a total mess tonight and I really do not know what to do. Any and all advice would be soooo appreciated!

cmharris59

Are you quite sure about the eye shaped tissue scar? My PS is preparing to do my delayed recon on my left side.

I had a unilateral skin sparing with a tissue expander put in place. I have a small scar on my left breast mound. I also had to have radiation and I have had the TE in place since Dec 2007. He agrees that a better cosmetic result comes with a DIEP recon than with implants. I hate to think of the large scar across my belly, but I really don't know of any better options.

My PS promises that he is as picky abotu the results as I am. He believes that the large scar will fade to long thin line when he is finished. I am beginning to trust him more and more since I have had great results with the mx. I was numb for many many months, but now I have feeling all over that breast. It is not erotic feeling but it is not numb either.

He has not mentioned anything about an eye shaped tissue scar. I have not seen one in any of his before/after pix either.  I am going to see him for another consult next week and I will ask just to make sure. Make sure that you ask lots and lots of questions. It took me months before I was able to actually sit down calmly and discuss it with my PS but it really helped.

C