Lumpectomy after Mastectomy

Sociologist

Hi All,

I had a mx in July 2007. There was a lump they were watching for over a year which changed and had a lumpectomy today for the mass on my chest wall (don't know the cm but it was at least the size of a nickle). I'll get the path results in 2 weeks. Anyone else have this happen, lumpectomy after mastectomy? I know bc (nasty thing that it is) can recur in the small amount of tissue that remains after the mx but was very surprised when I went last Thurs. for the CBE and they set me up for surgery today. Thanks for listening!

Margaret

hd1017

Hi, Margaret, 

I just found your post this morning, and am wondering how everything turned out for you, hoping the pathology came back benign. I had my bilateral 2 years ago, and found a new lump just last month. I am scheduled for my lumpectomy on July 19th and am fearful about the results. After having one breast cancer diagnosis, I am finding it difficult to stay positive this time around. Did you feel the same?

Hope you are on the path to recovery,

Helen 

Sociologist

Hi Helen,

Yes, it came back benign! I was scared out of my wits! They did find a softball sized seroma (probably from my implant being removed last summer) so I came home with a drain. I contracted MRSA (the drug resistant staph infection) and have been on antibiotics for a month and still have the drain. I go back Tuesday and hopefully the testicle hanging from my chest comes out! Please let me know how your test goes; I'll keep you in my prayers.

Margaret

hd1017

Margaret,

Well, good. It turned out as it should. Sorry to hear about the complications. My BS did say she was concerned about infection after the surgery. If you don't mind my asking, why was your implant removed? I goofed on my surgery date. Saying it was the 19th was wishful thinking on my part. It isn't until the 29th. Have to wait a bit longer. Thanks for sharing! Your news gives me hope.

Helen

Sociologist

Hi Helen,

I had constant pain from the implant. At first, I thought it was normal. After 6 months I hated the implant; it looked great but felt awful. I ended up having to get cortisone injections to get relief but that was short lived. I had to fight with the ps to remove it but it worked out well. The pain was gone immediately after the implant was out. I don't like my prosthetic (worn it once) but it's all good. My path result was fat necrosis (they removed a 2 cm lump from the chest wall). It is nerve wracking to say the least. Please keep me updated on your progress.

Margaret

hd1017

Hi, Margaret,

It's Friday. How did your Tuesday appt. go? Are you drain free? I just got the call from the hospital this morning to go over pre-op instructions. Same hospital where I had my bilat and recon done. The nurse asked me if I'd ever had surgery before. So funny!

What kind of reconstruction did you have done? Implant which was later removed?  No fat injections or anything, right? I'm just wondering how the fat necrosis forms when everything has been scraped away. Also, what kind of pain did you have with the implants? Was it a deep pain? I've been doing okay with mine, but wonder if the constant discomfort would go away without them. Anyway... sorry to ask so many questions. I actually held back. I have tons more! 

I hope your mind and body are feeling relief.

Helen 

Sociologist

Hi Helen

Yes I am FINALLY drain free! It feels wonderful to have that thing out. I got the same pre-op question and I said "Well that's a big YES!". 

My original surgery was a skin-sparing mastectomy with a tissue expander placed at that time. I went for the usual 100cc injections to get the expander to 760cc's to make sure there was enough skin for the implant. That process was horrific! I had constant muscle spasms in my chest because of the muscle being stretched. The exchange surgery was 6 months after the mastectomy. From the moment the implant was placed, I hated it. It looked great but felt awful and I had worse pain than I did with the tissue expander. The pain from the implant was more like a dull ache (like a toothache that never went away). It did get to the point I would have spasms that took my breath away.I teach college and it happened in class one day and my students had to get me up into a chair (I fell against the board and almost fainted) and roll me to my office and call my husband to come get me.

Two months after the exchange I couldn't take it and asked the ps to remove the implant. Of course he wouldn't ("It looks great" and "You need to get used to it" and "Give it a year" was what he said) but referred me to a pain management dr. who injected cortisone into the area (5 injections p/visit every 4 weeks). After 2 courses of that I just told the ps I wanted it out; he said no again and I found another surgeon to remove it. When they called for my medical records, my original ps said "I'll schedule the removal for Monday".  I haven't had any pain since the explant.

I never had fat injections or anything like that. From what I understand, the fat necrosis is scar tissue that builds up. They can't get all breast tissue out with a mastectomy; there's a very thin layer covering the chest wall (that was my case). 

Ask as many questions as you want!

Margaret

hd1017

Hi, Margaret,

Sounds like we had similar surgeries. I had an expander placed, but had plenty of skin for the implants, which ended up being too small in the end. I still have rippling, but that is the least of my worries. You had a much different experience. It's a good thing you teach college students. Don't think my third graders would be able to lift me if I keeled over! 

When you had your lumpectomy did they removes any nodes to biopsy as well. Is that why you had a drain? My BS is excising the lump for testing, but no nodes this time. I am wondering if I'll need a drain in that case. I have my post-op one week after surgery, but am hoping they call sooner with the path results. I hate all this waiting. I want to get back to summer relaxation!

Helen 

Sociologist

Hi Helen,

The only reason I came home with a drain is because they found a softball sized seroma where the implant used to be. I could always hear schloshing around like I did with the expander so I thought it was normal!  They didn't need to remove any nodes this time because they were going for the lump near the chest wall. 

Teaching third grade is difficult but one of my favorite grades to substitute years ago. They were past the whining stage and not to the smart-alec stage. I couldn't do it now though! The college students are still in the whining stage and the smar-alec stage!

I'll be thinking about you tomorrow. Post when you can and let me know how the surgery goes. Best of luck! I'm keeping my fingers crossed for benign results!

Margaret

hd1017

Hi Margaret,

Unfortunately, as it turns out, I was not as lucky as you this time. The lump was IDC without clear margins, and I now face another surgery, radiation and possibly chemo. I have so many questions, and so few answers. I have no idea how to calm my self. Thanks for checking back with me through my wait. It seems I am now on the wrong discussion board, and need to move over to a recurrence thread. 

All the best,

Helen 

Sociologist

Hi Helen,

I am so very sorry for your results.  I wish you nothing but the best on this step of your journey. Please let me know if you need anything.

Margaret

hd1017

Margaret,

Thank you for continuing to check here. Actually your advice would be appreciated!

I have to have a breast MRI, another surgery to get clear margins and a sentinel node biopsy. The surgery is on the 24th. I'll get the results on the 30th, which was supposed to be my first day back at work. If my nodes are involved I'll need chemo followed by radiation. If they're not, I'll need radiation followed by medication, unless I'm not Her2+ this go around. They still don't have the results. I have no idea how to plan for this.

I really don't want to start the school year out then have to go out on medical leave three weeks later. It's such a crazy, busy time of year, and requires so much of my energy. My heart and mind are elsewhere right now. I told my principal what little I know, and though she was warm and caring she did not offer any solution. What would you do?

Hugs,

Helen 

Sociologist

Hi Helen,

You would qualify for FMLA (family medical leave) for 12 weeks. It secures your job but doesn't pay you (which sucks!). You may want to take any leave you have, but then again, maybe save it for after the chemo and rads may start. If you're teaching little ones, it may be good to start the year but it can be confusing for them as well. I'm not sure which would be best! Fortunately I didn't have that issue as the mast took care of most of this. I did get tremendous help from the college as I only had to go in 2 days a week for a year and worked online with my student the other 2 days. Look into FMLA though, it can be a lifesaver for job security in these difficult economic times. Job security is everything. If you belong to a teacher's union, also talk to your union rep for advice. If you are tenured, that should help as well (community colleges in Louisiana don't have tenure which sucks!). Let me know how things go and if I can do anything. I probably made it more confusing! 

Hugs, 

Margaret

hd1017

Margaret,

No you didn't make it more confusing. I am tenured. Been with my county 11 years now. I went out on short term last time but I wasn't a classroom teacher then, so leaving, and starting back was easier because my schedule was more flexible. Maybe my oncologist can advise me and give me a better idea of what to expect. It's all speculation at this point. I see him on Monday. 

How are you? Are you healing as expected? You must be so relieved! Can you believe how resilient we are?

xo Helen 

Sociologist

Hi Helen,

I'm feeling MUCH better. The MRSA staff infection is gone and so are the side effects of the antibiotics. Being sick for a month though has pushed all of my work back and I go back to school on the 15th. I'm just trying to write quizzes and get at least my first tests ready for my classes (I'm anal and way over prepared!).

I think after your appt. Monday you'll have a better idea of what to expect. Hopefully things will turn out better that what you expect! E-mail me and let me know how the visit goes.

Hugs

Margaret