Double mastectomy changed to unilateral mast.-no reconstruction

AllYouNeedIsLove

I am finished chemo (yay!!) And I have been scheduled for my surgery this Monday, March 23rd, for nipple sparing double mastectomy with expanders put in. I have to get 6 1/2 weeks of radiation once I am healed due to 2 internal mammary lymph nodes that the dr's think could/could not be positive with cancer. My surgeon just called me yesterday because my case was reviewed again, and the radiation oncologist said that due to my small frame, the expanders would create a radiation field that could potentially cause major heart problems down the road. Because of this, they all think the best choice is to do mastectomy on the cancer side (left) with no reconstruction. That way I can have radiation sooner than later and not worry about heart issues. I then will undergo another surgery in fall or next year to do mastectomy on the other side (my healthy breast) and do reconstruction at that time. I will worry about the reconstitution part when that time comes, but my biggest concern is what to expect with this new surgery being thrown at me. I have done so much research and was mentally and emotionally prepared for my original surgery... I don't even know where to begin to gather information with the new surgery. Anyone else have this same type of surgery? I would love to get tips, advice, anything about healing and what to expect afterwards. Thank you for taking the time to read this! XO

SpecialK

Traditional expander to implant reconstruction after radiation gives you about a 50/50 chance of success, as radiated skin does not stretch very well.  Many plastic surgeons opt for an autologous (flap) recon after rads, rather than implants.  You should have another PS consult in light of this new recommendation just so you understand fully what options you have after receiving rads, and also understand the timeline - many docs want a period of time after rads for skin healing, some 6 months to a year.  Having a simple mastectomy with no recon is actually an easier surgery to recover from - but potentially a more difficult adjustment due to being flat on one side for a period of time.

AllYouNeedIsLove

Thank you! I am 4 days post surgery and feel pretty good! I am even more nervous for 2nd surgery now but will worry about it when the time comes. Thank you for your input!

Scwilly

I wish you a speedy and pain free recovery. I had a UMX in April 2014, with plans to have reconstruction later this year. I was always going to have radiation as I was dx with IBC. I decided on a UMX vs a MX because I wanted to minimize the surgery and so I could heal as quick as possible and start radiation without any delay. I had always thought I might have the other side removed at reconstruction time, which I expected to be at the end of 2015.

As it happens, I had a spot of DCIS discovered at the beginning of Feb and will be having my right UMX and reconstruction (DIEP) done in April. My PS said she usually likes to leave it a year after rads, but was happy to go ahead after 8 months as my skin had healed well.

I'm glad I made the decision to stick with a UMX, and protheses are great. Best wishes for your recovery and remaining treatments. Sarah