Areola tissue left after mastectomy and DIEP reconstruction

Ina

In April 2009 I had a unilateral (left) mastectomy and immediate DIEP reconstruction for DCIS, grade 3 with comedonecrosis. The mastectomy had more DCIS in a different place, so it was multifocal. I've been finished with everything including the tattooing for almost a year.  It just occurred to me that I still have areolar tissue, and my original breast surgeon told me all that tissue should be removed because the DCIS was close to the nipple. 

I contacted the breast surgeon who did the mastectomy, and she said I didn't need to worry because she had shaved away all breast tissue. After a month of trying to get an answer so I could schedule revision surgery, today I spoke to the reconstructive surgeon,who treated me like I was an idiot for questioning things. He is one of the best, but I was crying when I hung up the phone. The first time he told me DCIS wasn't cancer I ignored him--when he repeated it today I told him neither I nor my surgeon here agree with that--DCIS is cancer. It just doesn't metastasize--mine was the worst kind. He also implied my surgeon here was an old fogey who knows nothing about cancer--it was all very hurtful.She is a young caring physician who just happens to have a conservative outlook on cancer--get it all! 

I have felt in the middle of opposing viewpoints on this for weeks. I wonder if anyone else has faced this situation, or has an opinion?

Mantra

Interesting timing . . . I'm about to go through a similar situation. I went for my 6 week post exchange appointment today. During our discussion, the PS made me aware that the BS who did my first mastectomy (cancer side) left more breast tissue on the skin than the second surgeon who did my prophylactic mastectomy.

I have my 6 month followup with my second BS in two weeks and I want her to order an MRI or ultrasound or whatever test is necessary to show just how much breast tissue the first surgeon left. I really don't know how she'll react to this request. But the level of assurance I had by have a mastectomy has been greatly thinned. Oddly enough, I know for a fact she removed my fascia so I'm not sure why she wouldn't be as diligent in removing the other tissue.  I remember the last thing she said to me was: I will remove as much breast tissue as I possibly can." So maybe surgeon #2 scraped it very thin? Have know idea but no matter how many toes I have to step on, I will find out the answer. I'm sick of fighting and sick of doing other people's jobs. I find it soooooo annoying!!

Ina

Good luck!  Hold out for what you want--it's your body. 

I know my breast surgeon here would say remove the areola skin, but since I had a skin sparing mastectomy, I think I'm going to have to trust and let it go. I may ask my med onc to order a mammogram for both sides, just to feel a lttle better. 

I know exactly what you mean about losing the level of assurance you had about having a mastectomy. 

Love your dog pics! 

Ina 

nmi

Ina, I am so sorry you are having to deal with this now.  You think you did everything right, find the best, then after it's over there's a potential problem!  It makes me mad the PS told you DCIS was even cancer, why did you have your breast removed then??  They should correct this for you. Just my thoughts. I'm in a bad mood. Maybe I should not post....