Radiation after 3 lumpectomies Will this distort my Breast?

JMH46

Hello Ladies,

I am new to this forum. Recently diagnosed with DCIS in my right breast. I have had 3 Lumpectomies and my margins are still not clean. I have two choices. Mastectomy or 4th lumpectomy with the hopes my margins come clean and radiation to follow. I know there are side affects to radiation and it differs among women. I am a smoker also. Although need to quit if I have a mastectomy anyway. I am hearing a lot about skin irritations and rashes and all but I have not heard about any disfigurement. I am a D cup with 3 surgeries I can not at this time tell any tissue has been removed the right still looks like the left! Will that changed after radiation? Does anyone know?

Denise-G

I just finished radiation 2.5 weeks ago - I had a mastectomy of left breast - no reconstruction.  Can only speak to that.  My skin held up well until the 5 boosts to the scar.  Then the entire area turned fire engine red and peeled about 2 weeks after Rads ended.  But it was not disfiguring.  It has almost gone back to how it looked before Rads.  Better than I thought.

JamieB86

Be sure to speak to your PS.  Mine was very forthcoming and said he knows he prejudiced against rads b/c he sees patients after it had gone wrong.  He told me what my options were, both if I decided to have rads and there was a problem, or go straight to MX.  I made the best choice for me.  I was very happy my BS encouraged me to talk to a PS before making any more surgery choices. I would not have know to do that otherwise. 

Remember too, you are probably still swollen from your lumpies.  Only you know what is most important to you. Keeping your breast no matter what or the cosmetic results.  Not that these things need to be exclusive, but rads can cause significant shrinkage. Just lots to think about. 

Best wishes.

JMH46

Thank You both so much for your input and suggestions. I will consult with a PS about this. I did hear reconstruction afterwards can be tricky? I hope you both are doing well and Best Wishes to you Both!

BLinthedesert

I am a small 34B cup.  I had 5 cm of tissue removed during my lumpectomy.  Right after surgery you couldn't even tell, but before I started radiation (5 weeks later) I was already losing my "swelling that makes things look normal".  Radiation has made my breast more firm (not in a good way), this usually happens over a period of 2-3 months and I was told it could become smaller, and firmer, in the next couple of months.  I would say it has shrunk about a 1/2 cup size.  That said, for me,  you can only tell when I am naked.  I use pads in my bra (not a big deal) and you can't tell.  I am also a runner, and when I wear a sports bra  you really need to stare back and forth to each side to see (I have done this ), and know what you are looking for.  One other thing to think about is that any shrinkage (due to fibrosis from radiation) is permanent .. so if you lose or gain weight the size of the fibrotic breast will pretty much stay the same while the other breast may get larger or smaller with weight gain/loss.  Even with these possibilities,  I am not at all sorry about my decision to have a lumpectomy, and it is not a cosmetically horrible outcome.

My surgeon had said it is more noticable for larger breasted women, but while it is common to shrink after radiation, how much depends on how much tissue they have to take out (and quite frankly, how good your surgeon is).   

Good luck!

JMH46

Blinthedesert,

It sounds like distortion would be something that would happen to me(more noticeable)as I am a 34 D. I also had 3 lumpectomies and would have to go for a fourth before Rads if my margins come out clean. If they do not come out clean I am looking at a MX anyway. I would want to be fixed I know that. But I have been told that I am only a candidate for an implant with a MX as I do not have enough fat tissue to fill my cup size. I am not sure a bout reconstruction after Rads only told can be difficult with the radiated skin. Do not have enough details on that! I am also a smoker and that is scaring me even though I need to quit if I have a MX it's the past that worries me. I also don't think I want those hormones pills or whatever as I am ER+ I am scared about that! So still have work to do before I make a final decision.

I thank you for your response. I hope, and wish, you to be, and do well with your recovery!

JMH46

proudtospin

I had 3 lumpies and then rads but since I now have some lymphodemia in my trunk and my boobie, the size is the same on both is my guess but the shape is definitely dif

yeah I also take those hormone pills

I never had really any burning as folks told me to watch during rads which is what I did and asked for creams when it got the tinyest pink

JMH46

I think I am leaning toward MX. Not sure I can handle the worry for the rest of my life? Sounds like I would need reconstruction any after rads so maybe I should do it and get it over with.

I hope everyone is doing well and I will keep in touch. I will let you all know what I end up doing!

proudtospin

it is a very personal choice, one to be made with your docs and your family

I am single and a mastectomy brings about a whole host of other problems with no better outcome (for me at least), so I will only do it if it is ordered by my surgeon and so far, she is not advising it.

I think where you live and what quality of docs are available to you is a consideration (as in I have met woman online who were in AL with few options where I am on the east coast with more docs and hospitals than you can imagine, and good ones too

JMH46

Yes it is a good area to be in! But none the less it is still very scary and a tough decision for anyone to have to make. It has been a recommendation to me by one doctor to do a mastectomy. I am separated so I really do not talk to much detail with him. But my 17 year old gives me her opinion that's for sure! LOL  I have a little time so hopefully make my decision soon. Can't wait until it is all over though I must say!

Infobabe

JMH46 

Have you made your decision?  I have read that reconstruction after rads it not just difficult, but may not be possible.   

You might research stem cell fat grafting.  There is some information on these pages and you can google it.  It was developed in Switzerland but a number of hospitals now do this in the US, such as LA and Miami.  In fact, it is even done in a city 65 miles from me in Grand Rapids.  I'll bet there is someplace near you doing it.

As I understand it, they take fat from your body with lipo, separate the stem cells and inject them into your breast.  There is no incision.  It takes the cells time to grow but in the end, you have your own living tissue.  This may be too far out there for you, but I believe it is the thing of the future.  Maybe near future. 

I am not urging you to do it because I have not had it done.  I just think it worth looking into since you are researching for the best way to move forward. 

JMH46

Thank You infobabe, Yes I have decided on BMX. I see a plastic surgeon tomorrow I hope it goes well. Then on to making an appointment for surgery.

After 3 lumpectomies and no clean edges and 3 BS's all saying the same thing(not that I was expecting a miracle)it's time to go  forward!

That is a very interesting procedure. I have not been able to find anyone in CT that does this to the extent of breast reconstruction. I must ask the PS tomorrow. I have read that it is out there! Not really hearing about the long term affects??? I did hear that Lipo isn't all it's cracked up to be? Meaning when they remove your body fat it appears somewhere else? (DR OZ) I also wonder about losing weight and gaining weight?? Maybe they will have it perfected in 10 yrs from now and us women who had to make decions now can bennefit from the improved technology in yrs to come when our implants need changed??? Something to look forward too! LOL I have to joke sometimes or I won't get through all this. Maybe I should take some cut outs of playboy and ask the PS if he can copy these?? Like going to the hair dresser!!! Or write to Hugh Hefner sp? and if he wants to pose the girl or women next door he should find real women real lives!!!