Imaging After Bi Mastectomy (with close margins)

bemmett

Hi all,

I'm 1.5 years since my bi lateral mastectomy and occasionally just worry. I had very close margins (.4mm and .5mm).  I was told it was all they could do and 'not to worry'.  Well, I worry.  I have had reconstruction (implants) and my doctors don't recommend any imaging per se.  I was told to get an MRI several years later to check the implants.  When that time comes however, I want them to look at everything. I've never had an MRI and that seems strange as it seems most women do.  Not sure why I didn't... 

Background - High grade, multi-focal DCIS covering almost the entire breast with a small amt of microinvasion. 34 yrs at diagnosis with 3 small kids (the basis for my worrying).  No rads or chemo and no tamox due to hormone negative. I see my surgeon each year for a quick look but no testing or anything.

Any thoughts or opinions? 

Beesie

I understand your reasons for concern but I think I have two pieces of good news for you.  First is that when you get the MRI, it will provide information not just on the status of the implants but also on whether there are any suspicious lesions. If you are really nervous about it, given how small your margins were you might be able to convince your surgeon to order any MRI for you sooner than 5 years. 

Second, and probably more important, is what my surgeon told me about implant reconstruction. Because the implant is put in behind the chest muscle, what it effectively does is push your muscle out to the front of your 'breast', right under your skin.  And your skin is stretched pretty tight.  What this means is that with no breast tissue that might hide a lesion, if a recurrence were to develop either against your chest wall or against your skin, it would become noticeable to you very quickly, at a point when it's still very tiny. Unlike a natural breast, you don't have to worry about what's inside, you just need to check the surface of your breast.

So my advice is to ensure that you do regular breast exams.  I do mine in the shower. When my hand and breast are soapy, my hand slides over my reconstructed breast very smoothy, so I'm pretty sure that I would notice even a tiny 1 or 2 mm nodule if it were to develop either against my skin or against the chest muscle, right under the skin. 

Hope that helps!