the reduction+lumpectomy thread

AgathaNYC

Hi, Dagny. Good to hear the lumpectomy site felt better so quickly. How are they feeling about keeping your nipple? How is the SNB site doing? How are you doing with waiting for the pathology results? Hope that anxiety of waiting for reports is gentle for you and you are given an all-clear.

I'm still waiting to meet with a new surgeon (I think I mentioned on this thread that I wasn't feeling right with my BS and have put in a request to change - it's not an easy process at my breast center.) I'll have a clearer idea of my timeline after that. For now I just have 2 more DD Taxol infusions to go.

I also meet with the RO for the first time on the 12th. I'm anxious to start the conversation on what radiation therapy will be best for me.

DagnyT

Hi Autum and Agatha,

How are you ladies doing? autum I think you were scheduled for surgery on the 4th? Give us an update when you can.

When i got my path report back it was good news that my lymph nodes were ok and that they didn’t find anything unexpected. But they didn’t get clear margins, so I was going to need to get a second surgery whether I wanted it or not. So, any second guessing I had been doing about the reduction went out the window. If I was going under the knife again, then I was going to come out with something better for myself after it!

So this past Tuesday I went back in and they did a revised margin and the reduction on both sides. They ran into some complications with my nipple when they were doing the margin shave, and they wound up having to take it completely off and then try to reattach it with a skin graft. The surgeon mentioned there was about a 5% chance of that happening, but since he thought it was unlikely we didn’t talk a lot about it. So I have to wait until I see him next week to find out if the skin graft seems to be taking and what that all exactly means for both my recovery and my future radiation treatment. Not sure how I feel about all of that yet, I don’t really have enough information...

So here’s the nitty gritty on the reduction surgery so far. First off, it was a LOT more painful than my surgery from the prior week for the lumpectomy. Now, my LX was easy enough that I could have been ok just on Tylenol if the SNB site hadn’t gotten infected. So maybe I had it super easy for that surgery. For the first 24 hours after surgery, I was in bad pain which wasn’t really helped that much by my pain meds. When the nurse called to follow up the next day and I told her how bad the pain was, she said I should double up on the meds for two doses. That really helped! By the end of day 2, I felt like I had the pain under control. I hurt, but it was manageable. Today is day 3 and things are much better. I’m still taking my pain meds, but I skipped them during the night and was able to sleep. When I woke up I hurt a lot, so I took the next dose and am doing ok.

Despite the pain, the whole time I have been able to get myself in and out of bed, to and from the bathroom and up and down stairs to the kitchen all on my own. So while it has sucked, it has been ok to be without a helper. People have brought me food and treats and stopped in to say hello, and that has been enough.

I was warned by some others who have had reductions (not in connection with any cancer issues) that lifting up and using my arms would hurt and be hard. So I moved things to lower shelves and planned on having issues. But surprisingly I have not had any trouble. While my chest (particularly the incisions right under the breast crease) feels like it is on fire and in pain, my arms are working just fine and I’m able to reach for things without any issues.

Make sure to take your dr’s instructions about constipation and your pain meds seriously! I had a little issue after my LX, but this time it was much worse. I’ve been taking all the softeners prescribed and eating prunes, etc...and it’s helping, but it’s still not comfortable. So don’t ignore that part of your care!

I can’t see any of my incisions. The dressing isn’t the kind that will come off on its own in the shower like for the LX. I’m taped up tightly with what almost seems to be plastic wrap on top of gauze and bandages. I also have a surgical bra that is stuffed with pads....so it is hard to see what I am ultimately going to look like. I’ll report back on that once I get a peek!

Let me know how you guys are doing.

Linda2119

Hello,

I'm new to this forum. I am looking at a lumpectomy mid-March, with a reduction/lift in my other breast. BS says it will all be done at the same time. I scheduled an appointment with the PS, but couldn't get in until 2/13. So long to wait for an answer to my questions!

I am a DDD cup, and my cancer is all contained in one quadrant. The BS says she will take out that whole quadrant, and then the PS would match that volume in the other breast. I'm trying to figure out how big that will leave me. A quarter of my breast seems like a lot. I can't imagine, after living with these DDD's for all these years, going down to anything below a D cup. (Although I have always wanted some sort of a breast reduction/lift!)

Does anyone have any idea how big 75% of a DDD cup ends up being?

Thanks so much!

illimae

Linda, I was a DD and had a lumpectomy with reduction and lift in June. I too tried to predict what I’d be left with but you won’t know until after surgery and even though it will seem shocking at first, give it a couple months. I now have a D cup and I actually like it, I can now wear bras with thin straps, 2 or 3 clips and no underwire. Plus with an all in one surgery, you get to be done with that part, the drains are a total bummer though.

VLH

One small bit of advice...don't buy more than a minimal number of bras during the first 4-5 months after surgery. I bought some D cup bras, but the cups now collapse in where I lack volume at the top of the breasts so I'll donate them.

Lyn

AgathaNYC

Thanks for the advice on bra buying :-)

My surgery schedule got a little confused because I switched breast surgeons and extended the time period of my neoadjuvant chemo.

Now I'm going to have my first consult with the plastic surgeon on 1/30, before I meet my new breast surgeon on 2/20. The doctors say they are fine with this seeing me in this order but it seems strange to me. Won't the PS need to know what the BS plans to do regarding removing breast/pectoral muscle tissue before he can consult on reduction/reconstruction?

Did anyone here see a plastic surgeon first?

illimae

I saw my PS and BS in conjunction with each other, the plan was in my medical file and they shared an OR, I don’t know how it works when the surgeries don’t take place together unfortunately.

danderRN

Hi, I am new to this forum. I opted for lumpectomy with bilateral breast reduction at the same time. I had an architectural distortion which makes it harder to get a clean margin. My cancer was in the 6 o’clock position. My BS and PS worked together. They got a 1 cm clean margin and the 2 sentinal nodes were also removed through the incision. My surgery was 12/20/17. I had a lot of nerve pain in both breasts. Started about 1 week after surgery and was very uncomfortable to around week 5. I had about 3 different bras which i changed every couple of hours and that helped. While I would not have had a reduction without the dx. I am very happy with my decision. My PS did a beautiful job. The girls look 20 years younger. I start hypofractionated radiation on 2/12 and femara 3 weeks after radiation is done. I have so many mixed emotions right now but I am grateful. Good luck to all.

AgathaNYC

danderRN - Thanks for sharing your experience. That's fantastic to hear you are happy with the results. I'm sorry to hear about your nerve pain. Has it eased up yet? Good luck as you start radiation.

Today I had my first meeting with my plastic surgeon. He doesn't see any reason on his end why I shouldn't be able to have a successful reduction. The tentative plan would be to do both sides at once, either at the time of my lumpectomy or about a week later after the pathology comes back on the margins.

I was worried about the fact that a layer of my pectoral muscle may need to be removed. He reassured me that if some muscle did need to be removed he could still do the reduction.

We discussed the possibility that radiation might shrink the one breast. He doesn't compensate for that possibility when he's doing the symmetrical reduction since shrinkage varies so much from patient to patient. If after radiation there is a size difference that bothers me I'd have to have it fixed later.

I looked through a lot of before and after photos with his nurse. I wish there had been more examples of lumpectomies with bi-lateral reduction. What I did see appealed to me much more than the implants. The breasts looked so much more natural and the scars weren't that bad.

I'm encouraged. I don't see the breast surgeon for 3 weeks - after I'm done with chemo and have my post-treatment mammogram/MRI. I guess I'll find out more then. Please keep your fingers crossed that I can go the lumpectomy + reduction route!

VLH

Good luck, Agatha!

Lyn

AgathaNYC

Thanks, VLH!

I'll keep you guys posted when I meet my new BS on 2/20.

ventureval

Hi Everyone,

I see a pt today for the first time. I just had my 6th chemo 2 more to go. I will be discussing the lumpectomy and the bilateral lift as my oncologist recommend. So crazy to think about this. I've always had big boobs. But always my left one has always been so much bigger than the right. Which got worse after breast feeding 3 kids. Now to think I can have boobs that are symmetrical. Well I just really kind of blew my mind the other day when my oncologist told me that I can have this procedure. I'm still trying to really come to grips with this. It sounds all pretty cool but I know more pain, but I guess worth it since I've got really big boobs and less radiation from what I've been reading? So it will be interesting to see what PT Dr wants me to do. My husband and I go today at 3:30 CT.

AgathaNYC

Hi, Ventureval - I hope your appointment went well today. Please keep us posted.

Tomorrow I go in for my first post-chemo scans (MRI and mammogram). I'm pretty nervous. My oncologist says she hasn't felt my tumor for weeks. I would love the imaging to back that up. I'm fairly certain it will have shrunk enough for a lumpectomy, but still concerned with muscle involvement.

I'd appreciate any good vibes you can send my way tomorrow!

AgathaNYC

hi, Popping back in to say my post-op imaging looked good. I'm very happy that the tumor definitely shrunk away from the muscle.

I'll be having my lumpectomy on Mon 3/5, and then the bi-lat reduction two weeks later on Mon 3/19.

Cathy0201

I know this is an old post but I see you too were Stage 2 IDC. Have you had any problems since ? I really rather this than a mastectomy, I am also triple negative.