the reduction+lumpectomy thread

cookiegal

Speedy recovery to you!

mimi1964

Thanks kadeeb and cookie gal! I hope you both have a very, Merry Christmas!  I know I got mine 

lane4

Just to update: I had outpatient surgery on Dec. 23rd for symmetry improvement. The PS reduced my healthy breast by liposuction (about 140 cc's), then cut out a crescent of skin above the areola to raise the nipple a bit. (I also had some abdominal liposuction while I was there - Merry Christmas to me.)  So now, I'm swollen, bruised, and sore, but otherwise fine. The breast is still larger than the other, though not as much as before, and I expect that to improve as the swelling goes down.  Hoping soon I'll have a pair that matches again!

cookiegal

Cool...that sounds like a relatively non-invasive way to do it! I was investigating lipo reduction before I got the ol BC.

mimi1964

Wonderful lane!! Congrats!!! Keep us posted on how you are healing and how the symmetry shapes up for you. 

I am still swollen a good bit on my healthy breast as well from the surgical procedure but the ps says that it will take time for it to go down.  Currently the itching from the healing is the worst part.

hadle

having double lumpectomy and reduction.  Had a reduction 3 years ago, but grew back.  My bs says she does not want me to have a reduction until after path report received, so I cannot have reduction same time as lumpectomy.  says she cannot make margins that much bigger because she is not sure where the ps will want to reduce me.  I am a DDD. has anybody had this experience?

cookiegal

handle no.....I wonder if she is not used to working that way.

I would go for second opinion.

It is a longer recovery than straight lumpectomy.....do they need to do chemo quick?

singlemom1

Please, I am looking for some help! I had a lumpectomy and breast reduction at the same time for an orginal diagnosis of DCIS on 4/5/11. The full pathology report came back with invasive cancer and an unclear margin. My BS and PS met and the PS stated he felt confident that he knew where the dirty margin is and can get to it. I am scheduled for surgery next week to take care of the margin and have my nodes checked.  I went to Dana Farber today for a 2nd opinon. They were very strong that this type of surgery should never of happened! The cancer should of been taken care of first because now all the breast tissue has been moved around and they don't know how anyone could be sure that they can get to where the dirty margin is and get it all. Dana Farber is recommending a masectomy and stated basically that this was a big screw up.  I am beside myself not knowing what to do.  Dana Farber also stated that there is the possibility that they could do the masectomy and find no cancer in the breast but they still recommend it as they stated there is just no real way to know at this point if they got all the cancer since the tissue has been moved unless they do the masectomy. My plan is to meet with my internest to talk about the two different opinions and if he has someone to recommend for a third. I will also be meeting with the PS to ask him why he is to confident he get find the dirty margin and if he has every had this before.  Has anyone had similar problems?? I an in CT and thought I had one of the best BS in this area - but now I don't know who to trust.

thank you!!!

singlemom1

any thoughts on my above post will be welcomed

Valnyc

Singlemom- I think a third opinion might be a good idea and give you some clarity as to how to proceed. I was also diagnosed with DCIS and had lumpectomy and bilateral lift and reduction. Before my surgery I was told that if margins were not clean, then a mastectomy would be necessary because the breast tissue would have been shifted and rearranged as the result of the lift and reduction. However, I was also told that the risk if the surgeon not getting clean margins was lower because the surgeon could take more tissue with a lift and reduction. This warning seems consistent with what Dana Farber is telling you should be your next step. I don't know that it necessarily means that your initial surgery was Il advised. I am so sorry that you are in this situation. Please keep us posted. Val

cookiegal

this is all super interesting. I never got that warning. I am so sorry that you have to deal with this.

singlemom1

valnyc - did you go to Sloane? Did they discuss doing seperate procedures - first the lumpectomy and then once the path report was cleared and there were clean margins then going ahead with the breast reduction My understanding is this is the way it should of been done. I am feeling so overwhelmed, as I did not want a masectomy. I am a single mother of a 5 year old girl and has not had a social life in many years. I had gained alot of weight after my daughter was born and was exhausted all the time taking care of her by myself. I was hoping that after this was done, I was going to work on getting back out there and developing a real life. With the masectomy, I am very worried about my self-esteem and "feeling like I have a dirty little secret" when I meet men. This may be very hard for me to work through and I don't want to give up my dream of having a relationship with a man again someday but there is so much against me. I have no family and some support from friends, but to develop a relationship I need time away from my daughter and I do not know how to do it. I am sorry for the rambling . I have maintained a positve attittude through it all and now I am am emotional wreck.

Valnyc

Singlemom- I was told that I could have the surgery in two steps but not that was the way it should be done. As I understood it, I took the risk of not getting clean margins so that I would not have to undergo two surgeries. I was at Columbia Presbyterian and I think my surgeon is generally considered to be conservative. I did have a MRI prior to my surgery. As much as possible, I think you need to focus on your next steps to preserve your health and make sure you are around to be with your daughter and not worry too much about future relationships. If it does turn out you need a mastectomy, I think there are a lot of woman on these boards who can help you with this process and the emotions that you will feel. In the short term, an anti anxiety medicine might be in order so you can continue to function under very trying conditions and consider your options. It's really unfair and awful and it is completely understandable that you are a wreck. If you would like the name of my surgeon or another surgeon at Sloan who was highly recommended to me, please pm me. Val

ToriGirl

Hi ladies!

Just happened upon this thread and I"m so glad I did.  I am almost 6 months post rads and my radiated breast is at least a full cup size smaller than the other breast....( was DDD before all this stuff happened)....wondering if I will shrink more and how long I should wait before I even do a consult with a PS to see if they can be evened out.  Does anyone know if this usually covered by insurance or is it considered "cosmetic" only....

Anyone else out there considering this option? 

Any information is greatly appreciated!

Tori 

katgirl

Im 7years post stage one, had lumpectomy with rads and am

3rd week of recovery after a breast reduction and am worried that my result is not positive. My non-cancer side appears to be a. Firm C, the cancer side a D, not firm, very saggy. I was previously a 42, DD. At my 3 week check-up my PS said, well at least it looks better than it did. As of today, I not so sure that's true. Should I expect better results? Prior to this I had breasts that were too large, saggy and a huge dent in the cancer side but at least they matched. So depressed today.

ToriGirl

katgirl....sorry to hear that your results are what you want them to be right now...Is there a chance, you just need more time to heal?  

On a greater note...so happy to see that you are seven years out!  

God bless!

Tori 

cookiegal

hi newbies. I don't have answers to all the questions. As for the shrinking breast....ironically that is what is supposed to happen,so my PS made my cancer size larger, and ooops I got breast lymphedema and it never shrank!

Good luck all! 

mimi1964

Torigirl, one of the first keys is to find an excellent plastic surgeon who specializes in cancer patient reconstructions.  He then told me because I had had so much radiation I would have to wait at least a year for the irradiated breast to "settle" down.  Apparently the irradiated breast does continue to shrink after radiation therapy for up to a year (some people are lucky and that doesn't happen and others get lymphedema).  My PS ended up doing a lift and a reduction and the non-cancer side and a lift on the cancer side.  He saide he could not risk cutting into the tissue because there was a higher risk of infection with so much contracture of tissue. However, by only doing a lift he was only cutting the skin and not tissue.  The good thing that happened was that when he did cut into the tissue some my irradiated breast softened up and has continued to do so.  I guess I was one of the lucky ones and had a great Plastic Surgeon.  If you live in the Alabama area I'd be happy to give you his name

ToriGirl

Wow, thanks for the information Mimi1964!  I won't be a year out from rads until April 2012, so that gives me some time to do some more research here in Oklahoma for a PS that specializes.    Sounds like you are doing great, and that is awesome!

Take care and God Bless!

Tori 

mimi1964

You're welcome torigirl! Definitely look around and find someone who is great and the right fit for you, it really does make a difference.  I was lucky and my best friend referred me.  Unfortunately we were both dx at about the same time.  When you go for your first consult make sure and take someone with you so you can get all the information and ask all the questions.  Maybe even take a note pad with you.  It really helps in all situations to be prepared.  Also check to be sure that the plastic surgeon you are considering is on the list of covered physicians by your insurance company. 

Take Care and God Bless you also!

Renee

cookiegal

This is more funny than anything else but....they had hoola-hoops at a BC walk I went to yesterday. Boy I am I a lot better at hoola hooping than I was before this surgery.

mimi1964

cookiegal... LOL!

momoschki

Just came across this thread. I had a bilateral reduction in May of this year, after having a left lumpectomy for ADH. Went from a D to a B and couldn't be happier with the cosmetic results. I am due for my first post-surgical mammo in a couple of weeks though, and I am getting very anxious. I have read that scar tissue, when viewed on mammograms (and MRI's as well, I think), is often hard to distinguish from cancerous tissue. As I am relatively new to this, I would love to hear what other's experience has been with scar tissue and subsequent screenings. I just cannot imagine coping with endless biopsies every 6 months. Advice? Wisdom?

cookiegal

haven't had a problem...all clear x2...no additional views

Anonymous

I had a reduction/reexcision 7/09.  I have had at least 4 mammograms since that time, and all have been read without issue.  I have a lot of clips in my "bad" breast and they just make sure they have all of the clips accounted for....try not to worry. 

momoschki

Good to hear that for some of you, there have been no scar tissue issues.... Now I have my fingers crossed for my 11/10 mammo. Thanks for your feedback!

mimi1964

I've had 2 mammo's since I had completed my radiation without issue but I haven't had a mammo since I had my lift and reduction last Dec.  I am scheduled for mine Nov. 28th. I hope there are no problems.  Can't wait to hear your feedback momoschki... I'll be watching for your post. 

momoschki

Thanks, Mimi-- first mammo is a week from Thursday.  I will report back.  Meeting with the BS on the same day.

mimi1964

momoschki - I'll be waiting and praying all goes well with the mammo and the BS .  Sending you big hugs!!

momoschki

Thanks again for the good wishes.  Not surprisingly, as the first mammo follow-up date gets nearer, I am feeling more crazed.  I'm trying to take all this one step at a time and not overreact (so many women here have had SO much more to deal with that my situation looks very trivial by comparison), but it is still hard to envision going through this every 6 months--  forever?  For those veterans out there, if all tests come back clear for several years in a row, at some point do you revert to the annual screening protocol?  I am dealing with an ADH dx.

Another thing I find stressful (just to continue ranting!) is that the reduction-as-prophylactic-measure for high risk women is just not widely recognized, which makes others (both lay people and other doctors) look at me like I am delusional, which in turn, makes me doubt my own decision and worry more about what the future has in store for me. UGH.  I admit I have an extraordinary talent for torturing myself...