Surgery for 2nd cancer after radiation/lymphedema

kateness

I had IDC and DCIS 16 years ago, treated with chemo, lumpectomy and radiation. That lump was nestled right up to the nipple and they took 10 lymph nodes, so the radiated side has a lot of nerve damage right into my armpit along with mild lymphedema. Now I have a second IDC cancer in the same breast, going through chemo and preparing to meet with the plastic surgeon to discuss my options. I have already consulted with the SO and decided that I'm going for the bilateral mastectomy -- I hate my breasts already, since the first cancer I had kids and I look like a before-and-after-breastfeeding diagram they are so uneven and unattractive. They bring me no pleasure and feel like ticking time bombs. So, the SO walked me through 3 options ranging from a single surgery to 3.

1) DIEP flap surgery

2) Standard mastectomy with tissue expanders, followed by either implant or flap surgery

3) Nipple-sparing mastectomy + breast reduction/lift on the non-radiated breast, followed by tissue expanders, followed by implants

Three surgeries sound like a little much to save non-matching nipples that already have nerve damage, so I'm thinking that the last one is out. But I'm wondering if any of you out there had a mastectomy on previously radiated skin -- which reconstruction did you choose and why? Are you happy with your choice now? Any tips or suggestions for me?

Thanks in advance!

shorfi

Hi Kate...I had a bilateral mastectomy and I was initially radiated back in 2004. I had a LAP flap because of that reason alone. I had immediate reconstruction and was completed filled at the time of the surgery. I was not concerned about saving my nipples because for ME, I just wanted these breasts off. The tissue expanders didn't bother me much, but I was glad to get rid of them. I felt like you...my breasts were trying to kill me so I wanted them removed. Prior to that I had decided to have them removed even before knowing that I had a second diagnosis of breast cancer. I was out of my mind with grief. And then my ER/PR status changed to TNBC.

If you have specific questions, please feel free to ask me. By the way...my breasts look beautiful.

BethL

HI Kate - going through something similar. Had partial radiation (mammosite) in 2005, now with second IDC in same breast too. I've been given the option to reradiate but my worry is for possible future reconstruction. Tossing this in my head for a few weeks now and need to make a decision soon. Probably going to opt for unilateral mastectomy (maybe bilateral), but still worried how I will heal because of previous radiation. I feel confident in my surgeon, feel blessed to have found her since my last one didn't win many points with me. Making my list of questions now for my appt. Wish I could help you, not on the other side yet but thinking of you!

Beth