DCIS Stage O - I have breast implants

Luvrun

I have DCIS, Stage 0, Estrogen + in the right breast. I have implants from 7 years ago in both breasts. I don't know if  #1 of the following is possible, but this is what I am considering:

1. Removal of implants along with lumpectomy, expander, radiation, tomaxifin; reconstruction to follow

2. Bilateral mastectomy, expander; reconstruction to follow; no tomaxifin 

I have spoken to 3 women/friends who have had similar and different experiences, but not with implants prior. 2/3 wish they did bilateral mastectomy with reconstruction for symmetry, least/none recurrence of breast cancer, no radiation. The 3rd chose bilateral and is content with her decision.

Has anyone out there been in the same situation as me? If so, please reach out and let me know your choice and how you feel after doing it. It would help immensely in my decision process...grateful!

VegGal

Hi Luvrun,

Sorry you're going through this. I didn't have prior implants but I was diagnosed with DCIS in January. I had a BMX, expanders and exchange to implants. No hormonal therapy or any other treatment. I am very content with my choice.

Are your implants under the muscle now? If so, I'll bet you would be finished very fast with the reconstruction process if you choose that option. I was done in 12 weeks start to finish.

Good luck with your decisions.

Carla

mom2allboys

Hi Luvrun,

I was diagnosed with DCIS stage 0 in June but subsequently learned I have the BRCA1 mutation so I had a BMX with expander placement on July 26 rather than a lumpectomy plus rads.

The final pathology on the breast tissue from the BMX showed a microinvasion, so slightly more advanced than they thought based on my biopsy. Knowing that, I'm glad that all of my tissue was removed.

Since you already have implants, maybe ask your PS if you are a candidate for direct-to-implant?

Good luck with whatever you decide

BethL

I had small implants when diagnosed. They were placed as a result of a large lumpectomy and asymmetry from previous breast cancer. My size never changed from them but my is thought they may make direct to implants a possibility. I told him they were very small but I don't think he believed me. After surgery he was like yea... They weren't doing anything for you. So I did expanders to implants. I chose to have bilateral for symmetry. That's always been my priority but everyone is different.

AmieM

Hello Luvrun,

I was diagnosed with DCIS in May 2016. I didn't have breast implants. But, I am not sure if I made the best choice...

I decided to have single mastectomy on the DCIS side. I can't take Tamoxifen, because I have Factor V Leiden and I am at risk of developing blood clots. My surgery was successful, lymph nodes clear. I recovered very fast. I have a tissue expander in place. But now I am facing another decision, how to match my natural breast. I am small, 32-34 B bra size. My surgeon offered to place a small implant in the natural breast to match the reconstructed one. I am schedule for surgery in September and I am worried: how about if the implant in the natural breast will interfere with the breast cancer screening? How about if the implant on the healthy breast will rupture during a mammogram? I regret not having BMX. If I could turn back time, I would choose bilateral mastectomy. Good Luck!

jwilco

I had implants already when I was diagnosed with IDC. I had LD recon direct to implant, no radiation, only on the BC side. The other side he reshaped it (lifted slightly), replaced the old implant with a new one and did his best to match them. I often wish I had done both to get a better match but at the time I was so sad to lose one that I didn't want to lose both. Plus for me I had skin sparring but due to prior breast lift couldn't keep my nipple. I'm so happy I still have the one.

As far as screening after, due to BC I get a mammo on my non-BC side and then ultra sound on both - all in the same visit. So I feel really good about the screening, even with implants

I will say this....my original implants were how I found my BC in the first place. On my left side the implant was getting hard due to capsular contraction. I was feeling around trying to decide if I should get them redone and I felt the little bastard of a lump.

Good luck in your decision.

TarheelMichelle

My implants were also how I found my recurrence. Having implants under my chest wall caused pressure against my lungs and bones, which is where my tumors were.

Luvrun, have you sized up your opponent?Do you understand what Stage 0 is? Do you understand that oncologists often resist even calling it cancer? Do you know what size this pre-cancer is? The reason I'm asking is not to make you mad. I worry about this, but I'm passionate about saving our breasts and I must speak out! I don't want to be disagreeable but there is no need for you to have your breasts removed. You do not have breast cancer and removing your breasts as a precaution is a huge step and there have been so many advances in breast cancer treatment recently. I'm starting to freak out with worry and wonder about why so many women want to get rid of their beautiful breasts.

I was diagnosed Stage I, had my implants 7 years earlier. Had a lumpectomy with radiation. Surgeon had a hard time getting clean margins but he did. No hardening of implant or thickening of tissues after radiation. When my breast cancer returned, it was nowhere in my breast and has not spread to my breast since.

I lost weight after my Stage IV diagnosis and had fat grafting to replace lost tissue in my left breast. Before weight loss, the difference wasn't noticeable. I wore a prosthesis for about a year. The fat grafting was a great success.

I know it's a personal decision. I feel that many women would be able to keep their breasts forever if they would trust in a lumpectomy. Research shows I am right. You will not live longer with a mastectomy. Please, read the statistics. And save yourself from all that surgery. Even if you have a recurrence, your treatment will be systemic and you won't need surgery then either.

I am Stage IV and have my own boobs (plus my implants ;-) and have never had chemo either. This is modern cancer treatment. I go to the top cancer center in the country. Mastectomies are becoming obsolete. Women don't have to sacrifice their breasts to get the best, most thorough treatment.

Bonnie3615

your situation is exactly like mine!

Feb 2014 diagnosed with DCIS stage 0 in right beast! Did lumpectomy followed by radiation therapy!

Feb. 2016 after MRI found it returned! Same breast DCIS again. Did a double mastectomy this time. Had expanders put in at same surgery. I'm now in the filling stage. Very painful process.

Happy with decision, just want this to be done.

Moderators

Hi Bonnie-

Welcome to the community, and thank you for sharing your story! We hope the pain from filling is short-lived and not too much to handle. We'll be thinking of you!

The Mods

LAstar

Hi, Luvrun -- I hope you are finding your way. DCIS can be a tricky diagnosis for several reasons. Grade is very important in determining the appropriate treatment. Some folks with Grade 1/low-grade DCIS choose to watch and wait. Grade 3/high-grade DCIS has been associated with a high risk of invasive cancer and is usually removed and treated with radiation. Lumpectomy may be sufficient if it is not yet widespread, but DCIS spreads through the ducts and can require mastectomy more often than higher grade cancers which present in a more discrete lump. My DCIS was distributed throughout my breast and I had to opt for MX after 2 unsuccessful lumpectomies. Lumpectomy + radiation has the same survival rate as mastectomy but a higher recurrence rate. There is a lot of misinformation about DCIS overtreatment online -- if grade is not part of the discussion, ignore it. Best wishes in finding the best treatment.

Luvrun

Thanks, LA Star, for your input. I have an appointment tomorrow with the breast surgeon to go over things and the size/grade of my DCIS is in my list of questions. So, we'll see ...

Luvrun

Thanks for your reply. Your response is very helpful and I'm appreciative.

Just so you know my friend had cancer 9 years ago and chose single mastectomy with reconstruction. She also had an implant put in the other natural breast. She said if she had to do it again, she would have chosen bilateral. It's never too late to re-do. She's thinking about it one day.

MommaGin

Luvrun, what did you decide to do? I hope everything has worked out well for you in reconstruction. I am newly in a similar boat, trying to figure out how to handle recon after having had implants for 20 years, then DCIS diagnosis in 1 breast. However, like Jwilco and some others, I opted to keep my healthy breast and had a UMX at the end of Jan. 2018. I may feel differently after I'm finished with recon, but right now, I feel very good about my decision to keep the healthy breast, and two of the top recon PS in Houston have assured me they can attain symmetry for me. Would love to hear how things went for you. I hope to hear you'e doing great.

Kimpossible914

I have breast implants and a few years ago during a mammogram some calcifications were found. I went through several rescreenings. Released to merely annual monitoring. This year January I had my annual screening and nothing found. In May I noticed a small "knotted" type hard spot and immediately went to the doctor. This spot, however, was in the opposite breast. The calcifications were in the right breast and back against my chest wall. Within a 2 week span of time, a biopsy was performed, confirmed malignancy and lumpectomy with 2 lymph nodes removed. Following surgery my condition is confirmed as DCIS Stage 0. Margins good. Nothing found in lymph nodes. Now I am trying to decide on radiation and hormone therapy. At this time, I am skeptical of both treatments. I am not even 50 years old and haven't gone through menopause. I am concerned the radiation will result in a mess with implants and then going back in for more surgery. I am also not a fan of inducing menopause and its side effects. I am a math person and numbers matter to me. The math says I have a 80% chance of this being addressed without further treatment. To reduce the other 20% chance it can involve breast implant surgery, possible full MX with loss of my nipple, imbalance of hormones, weight gain, etc. The outcome is I still have a 2 to 5% chance of reoccurrence. And not to mention the calcifications in the other breast. I may go through this on one side and turn around and do it on the other down the road. Please help with some advice.

LAstar

Kimpossible, what is the grade of your DCIS? Nuclear grade matters a lot for recurrence rates.