the reduction+lumpectomy thread

lilyrose53

leeleeleepan - my PS told me to start massaging two days after surgery.  She just said not to go over the steri-strips.  I also started using mederma after my 4 week appointment with her.  My steri-strips were all gone by then.  The brushing looks scary at first, but it goes away.  My bruising was completely gone at ten weeks.  I guess every PS has their preferences.

lilyrose53

leeleeleepan - sorry, I just saw your post above.  I'm a little confused.  Are you saying they discovered a different type of cancer in your other breast?  I have heard several women say that their tumor didn't show up on a mammo. But they could feel the lump.  Mine was the opposite.  Neither the dr or I could feel the lump but it showed on my mammo.

Hope you get your path report back quickly.  Waiting sucks.

Wishing you well, hugs,  lilyrose

PinkCarn

My surgeon said to put nothing on incisions (they used the glue on mine). I followed Lillyrose's advice and use Aquaphor on the rest of the breast. I am two weeks post surgery. The breasts are still tight but less so than the first week. I can see progress. 

leeleeleepan

Thanks Lilyrose.  No, just one ductal lump (stage1:mostly in situ, with some infiltration) on right breast, discovered by PS manually and in mammogram two days later. Surgery (including bilateral reduct.)10 days ago. Doing quite well, despite some torutre-by-sports-bra. Pain minimal; mainly weird stiffness and abrasions because of peeling steri-strips in bra. Final pathology in now -- all news good.  No node involvement was confirmed.  This week, conversations about follow-up treatment. I  would like to postpone radiation until end of summer, but open to idea of it.  Very resistant to the idea of Tamoxifen......I imagine that these are the treatments that will be recommended to me......  

PinkCarn

I have now started radiation. They have me using aloe vera gel (100% aloe vera). Tech suggested putting it in the frig to make it feel good after rad. I had glue on top of my incisions. 4 weeks out and everything is feeling better. I will be glad when the glue is gone. I am still very fatigued from the anesthesia. Does anyone have any ideas other than time for that? I am taking Vit D which was suggested. 

Scoobycat

Hi everyone! I'm glad I found this thread too -- because I am trying to decide whether I should push for reduction surgery when I have my lumpectomy. I'm currently a 36G and would love to be a C+ or D. The first time I met with my BS back in May I asked about it and he seemed a bit reluctant (I think he's "old school") but said he'd think about it and also discuss with the RO to see if it was warranted in order to get my insurance to cover it. I meet with him again tomorrow (my surgery will hopefully be in mid-October. I will finish chemo mid-Sept) and I'm trying to decide if I should push for it. My concerns are:

1) Will it be really painful and is it an unnecessary surgical risk?

2) Is there a true medical benefit to reduce risk of recurrence?

3) If my current BS won't do it, should I seek a 2nd opinion and fine one who will?

At this point I don't know my lymph node situation - but am thinking that I will lose a few due to my tumor size, etc. Not sure what role that plays in the decision.

Anyone have any thoughts or suggestions? Thanks!

PoppyK

Hi Everyone!

I, too, just found this thread!

I chose to have an oncoplastic reduction and lift because I had back pain due to carrying around 38Gs on a 5'3" frame. I figured it would only become more difficult to carry them around as I got older.

It's been almost 4 weeks since the surgery and I am still swollen and sore. Torture by bra is in full swing!

ScoobyCat, I'll speak to your concerns from my experience.

The insurance covered mine. CA law requires insurance companies to cover surgery on both breasts, even if the cancer is only in one; either mastectomy or plastic surgery to make both sides match. (Bra shopping is difficult enough without having breasts that are two completely different sizes.)

Of course the surgery was longer, with a longer recovery. Both my SO and PS operated on me at the same time, one on each breast. When the SO was done removing the lymph node and areas of concern on the right, the PS starting putting that side back together. Not terribly painful in my case; I was on OC meds for pain within a few days of the surgery. My PS told me it wouldn't be as painful as my C-sections, mainly because he wouldn't be cutting through layers of muscle. He was right. I'm still pretty swollen and sleeping on my back!

Ask your surgeon about medical benefit to reduce reoccurance. My BS informed me that there is less breast tissue for the cancer to form in, but that after my treatment plan was complete I would have the same cancer risk either way.

I would definitely seek a second opinion if I had ANY concerns. Plastic surgery gave me excellent results (so far).

BTW, plastic surgery works best before radiation therapy.

Wishing you the best!

Poppy

Scoobycat

Thanks, Poppy! This is helpful. I'm looking forward to talking to my BS tomorrow. Hope you feel better soon!

lilyrose53

Welcome Scoobycat! 

  I went from a DD to a C.  My BS told me insurance would cover my reduction surgery because it was as a result of breast cancer.  No way do you want to have your breasts two totally different sizes.  Bra shopping is difficult enough!  Lol. You need to find a good plastic surgeon that is familiar with the procedure, to do your reduction.  My PS specializes in reconstruction after BC.  My BS did the lumpectomy and lymph node removal.  He only took four, knowing that the more that are removed-the more likely there is a chance of lymphedema.  I was fortunate because mine were all negative.  I'm not sure about risk of recurrence.  I was told there was very little difference between a double mastectomy vs. lumpectomy with rads.  But that is if you are node negative.

I am very pleased with my surgery.  I am now 5 months out.  Just saw my BS today.  My breasts are still perky, but not hard.  The scars around my nipple area are almost unnoticeable.  The scars that run from my nipples straight down to the underside of my breasts are completely flat and almost invisible.  They are slightly pink.  The scars underneath my breasts are the only ones that I can really see.  But they don't bother me at all.  My BS said in a few months those too, will fade out.  I am scheduled to see my PS before I start rads next month.  I know she wanted to check on me before rads.  I hope this helps a little?

Hi PoppyK!

 I was also told surgery works best before rads.  I found some nice, cheap, soft bras at Kohl's.  They are from Bali.  I no longer need under wires, and am interested in comfort these days.  I am amazed at how good my breasts look and feel after 5 months.  Actually, except for the scars that are still visible underneath my breasts, you really can't tell I had a reduction.  So far, I am really glad I did this.

I must say that as pleased as I am with my results...each of us must do what we feel is best for ourselves.

Wishing you all well,   lilyrose

momoschki

I thought I would throw in my 2 cents here, although my situation is somewhat different-- I was not dx'ed with BC, but with ADH, which puts me at high risk.  I was specifically looking for risk reduction options and came upon literature (mostly from Scandinavia and Canada) that found women who had had reductions were found to have significantly decreased rates of BC.  I had an excisional biopsy and then, a couple off this later, had a reduction.  Many doctors have been slow to recognize this as a valid method of lowering risk, but my ps was on board.  If you google breast reduction+ breast cancer risk you'll find the citations.

Anyway, it's been over 3 years since the surgery and I am thrilled with the results.  I went from a 34D to a 34B.  At this point, you would have to look very hard and closely to even see the scars. Clothes fit better, and there are so many more options.  I used to be 2 sizes larger on top than on the bottom, but things are finally more proportional.  I am so glad I did this.

Scoobycat

Hi All,

Thanks for the helpful info! I just met with my BS and it was all good news. My tumor is definitely shrinking (he said he could no longer even feel it). I go back to see him at the end of September at which point we will schedule my surgery. In the meantime, he is referring me to a PS to discuss the reduction surgery. His response this time was totally 180 degrees different than the first time I brought it up to him. He agreed that it is a viable option and indicated that he didn't think there would be any issue having our insurance cover it. He said he is now doing this much more frequently. Needless to say -- I'm really happy about all of this.

Thanks again for the support!

PoppyK

ScoobyCat

I'm glad you had such a great appointment with your BS! I hope you have a wonderful experience with the PS too.

During my consult with the PS, I was asked what size I wanted to be when the surgery was over. I was shocked; hadn't even thought about it. Of course I wanted all of the cancer gone and relief for my back... but size??? Totally unprepared for that question! The PS informed me that some women want to keep as much of their original breasts as possible, while others want to become Bs.  This would help guide him during the surgery so I would be happy with the results. Just thought I would share that, to help you prepare.

I saw my PS today for a 4 week follow up. He seems quite pleased with the breasts he created! I'm still pretty sore and swollen. (I am limiting my activity and sometime taking OTC meds for discomfort.) The PS said while this is not unheard of, it is not common. I have NO numbness anywhere... a plus and minus when you are healing form surgery.

Poppy

cookiegal

I think the benefit comes from a very wide margin. My tumor bed was gone and no boost. Also BS says he was worried about rads complications.

I will say one thing. My ps made BC side bigger in anticipation of shrinking during rads.

Never happened. Breast swells ever since. I think it was pretty likely I was going to get LE from my family and medical history, so I wish I had vetoed that part.

cookiegal

I will say my pain took at least 2 to 3 months to resolve. 

PoppyK

Cookie,

Thanks for the information. It's nice to hear from someone on the other side of treatment. I meet with my RO tomorrow, so your info about that is very timely.

With my surgery, they removed enough tissue that they were able to remove an additional area of calcifications at my request. All of my margins were clear, one my only 1mm because of it's proximity to the nipple.

I will try to be patient with the healing and pain that comes with it.

Poppy

flaviarose

Hello all.  I just came home from breast reduction surgery on my "good" breast.  I was given the option to have a PS so a reduction on the "bad" breast could be done at the same time as the surgery.  It was always presented to me that I could reduce the other breast at some point in the future.   It was never presented as an option that I do them both at the same time.  So, I waited 16 months from the original surgery, but decided to go ahead for all of the afore mentioned reasons.   I was probably an "H" cup before hand, and now I'm a nice perky D.   No one wants elective surgery, but I opted for it hoping to improve my quality of life.   Hopefully I'll be able to get away with loose clothes and no bra from now on.  Anyway, one point I'd like to make is that it is possible to do the reduction at some point in the future.   I had a surgical complication the first surgery - a collapsed lung given to me by the anesthesiologist.   I had a fairly long recover, and started a full year of chemo right afterwards.  I had them remove my port today too.

PoppyK

Hi Flaviarose,

Wow, a collapsed lung, then chemo. That must have been so challenging. I hope your recovery from your this latest surgery is much, much easier.

The strangest thing for me about the reduction/lift is removing my bra and having my breasts stay in the same place the bra held them in. The best thing is a relief from the back pain.

I'm glad you brought up the option to have the surgery at a later date.

PinkCarn

I had breast reduction in both breasts. I choose it because it was more aggresive than a lumpectomy and less radical than a mastectomy. They were able to take 5 times more tissue than they would have with just a lumpectomy. The results on my 60 year old tatas was very good. It gave me a face lift for the girls. I am very pleased. I would recommend you find a breast surgeon and plastic surgeon who have done this less frequent surgery. Both worked on me at the same time. The surgery was 3 hours. I could not be more pleased. I had my surgery in May and then 33 rads. I still don't feel like my old self; but getting better each week. 

knmtwins

Scooby what did you choose?  I'm choosing a mastectomy on cancer breast and a propholactic mastectomy on 'good breast', both skin sparing, so immediate TEs, and reconstruction with implants.  I just want as much breast tissue gone as possible, so the HER2 as less to come back to.  Doesn't matter to me if my chances are the same or not.  I haven't enjoyed my chemo --- can ya tell.  Last one on Wed.  

cookiegal

pink carn I am impressed at the three hours!

April8

I'm HER2+ on one Breast and ER and PR on the other-had double lumpectomy and reduction 9/4-9mm margins. Wanted as much out as I could too before radiation. It's hard to know what to do but the BS told me that a BMX would not help survival so I figured I would try lumpectomies and hope for the best. 

cookiegal

April 8 hi!

I guess I should check this thread from time to time.

I think the procedure is a good compromise, you get really wide margins without the mast.

Someone else mentioned considering this so I am bumping.

PoppyK

I opted for a lumpectomy and reduction on the good side to make them match. I think it was a good choice for me. I maintained sensitivity, too. No additional surgeries.

justmaximom15

I'm scheduled for lumpectomy and reduction (both sides) in 10 days. I'm going to read through the posts here and combine that with info I read on the thread about what to pack for surgery so that I'm ready. The other thread seemed to have more to do with mastectomy and I'm not sure what all will apply to me. Had my pre-surgery consultant with the PS last week and I adore him and his nurse. They gave me a bound booklet with all the information we went over and I've already filled my scripts. He's saying it will be out-patient and no drains.

PoppyK

Justmaxi, Welcome to the thread.

Do you know how much tissue they will remove? I see that you lumpy area is small, but I didn't know if they were taking extra tissue for the reduction.

Prepare to take it easy and listen to your body. If friends offer to bring meals, say yes! I also didn't have drains, which meant any blood or extra fluid took a while to be absorbed. I was very swollen.... they looked like implants. After a few months, the girls settled down and were soft, but higher than before. The incision from the node biopsy was the most annoying. I bought soft bras in different sizes for after surgery. I found front zip sports style bras at Kohl's and KMart. Because of the more extensive incisions, it was easier to put them on than back closure bras.

I brought a book, my phone and my husband. It was a long day, and due to feeling anxious, it was difficult for me to do much of anything while waiting for my OR time. I had a problem with the anesthesia and ended up being admitted, but went home the following night. This probably won't happen to you, but I thought I'd mention it so you can consider the possibility. I had my 3 kids at home, so it lead to some problems because we were okay with them home during the day, but didn't want them left alone at night.

Let me know if you have any questions!

Poppy

cookiegal

Big stretchy necklines. I had a black stretch robe,tunic, and pants and I felt a bit more pulled together in that. Have stuff on low shelves.

cookiegal

nice to see this thread active

Astarte

I had this surgery last Monday. I won't lie, it hurts like hell. Worse than a c section, IMHO and I do have a high pain threshold. I was up and about the day I had my son. This surgery had me on the DL and out of work for a week. Just went back to work today. I can't take much more of the bra they told me to wear or the drain. My ribs feel bruised. I have bad OA and don't sleep on my back, so this has been painful in many ways. My 20 month old nearly ripped my drain out and is overly rambunctious. I still need a hand with him, he's big for his age. I was thinking of having a brachioplasty after this.....I'm rethinking it now!

justmaximom15

Poppy, yes they are taking extra tissue for the reduction but I don't know exactly how much. I'm currently a DD and we talked size but he said it's hard to guarantee a finished size and we're looking at going to a D or maybe C cup instead. To me that sounds like quite a bit of tissue.

I have lots of stretchy necklines, ordered a few comfy button up blouses, a snap front "granny gown" which is incredibly comfortable and two light terry cloth zip front robes that are actually swimsuit coverups.... totally comfortable.

My Mom and sister are both coming up Sunday evening (they live 4 hrs away) to be there with me and my SO. He's only taking the one day off work though so by Tuesday I'll be in the care of Mom and Sis during the day at least. Not sure how long sis is staying because she has a pretty demanding job but Mom said she'll be here until I don't need her anymore or I tell her to leave LOL. I feel very thankful for that.

Astarte, thanks for being honest about the pain. I just don't know what to expect. Never had a c-section but did have natural childbirth for both sons without meds so at least at that time I had a high pain tolerance. Not sure how high it is now though. I've already scheduled to be off the entire week from work and told my boss that when I come back the next week it may be limited hours if I'm still in pain or exhausted.

PoppyK

Astarte, Wow! Sounds like you have your hands full! I hope you get stronger and in less pain every day.

I've had three C-sections..... and I would have to say they were just different from my lx and reduction/recon. Everyone who has had drains is soooo happy when they come out! Gentle hugs!

Justmaxi, Sounds like you have wonderful support! Without drains, you will be swollen. I had a HUGE hematoma in my good girl... I think it was 4x8. It took months for it to break down. I couldn't drive for weeks. I was weak and couldn't twist my body to check mirrors and look behind the car. After the first day, Tylenol managed the pain for me.

Give yourself time. I wanted to keep my breasts as still as possible.... I even held them when I walked to the bathroom. LOL I had a hard time sleeping on my back, too! I had a lot of tissue removed. I started with Gs and wanted D or full C. The PS gave me full D. My surgeons were careful not to cut nerves, so I don't have any numb areas.

Wishing you both the best!