Screening for local recurrence after BMX + implants

mellee

I've been told that after a BMX, there is no need for further mammograms. But then how do you screen for local recurrences to the chest wall?

I know that recurrences can happen in the mastectomy scar and in any remaining tissue above the implants, but what if the recurrence is under the implant? You wouldn't be able to feel that on a self-exam.

Can anyone chime in with their doctor's recommendations and what you do to keep an eye on things?

mellee

Forgot to mention that I had nipple-staring bilateral mastectomies. Does that change the mammogram recommendation?

SpecialK

mellee - I am actually hoping you had nipple sparing rather than nipple staring BMX, lol! Having NS-BMX does not change the mammogram recommendation, as your nipples should have been cored out and pathology done at the time of surgery. Recurrence to the chest wall I think would be best screened for by MRI or PET, but that is a conversation to have with your oncologist as far as whether it is felt to be necessary to do that type of periodic screening in light of your genetic assay results, grade, the type of surgery you have undertaken, and any other risk factors that pertain to you as an individual. It might also be a good idea to ask your PS if periodic MRI to check implant integrity is planned, if so your chest wall would be visualized - two birds with one stone.

mellee

Yes, fortunately I did get nipple-sparing (not staring). LOL

Thanks for the recommendations, particularly the MRI for implant integrity. I just read something that said it's often easier to get insurance authorization for that over screening for cancer recurrence (at least in the absence of symptoms)!

Beesie

Do you have sub-pectoral implants, i.e. are your implants placed behind the chest muscle? If so, then your chest wall is in effect pushed up to be right below your skin, and the implant is behind that. So a chest wall recurrence will show up as a lump just under your skin. With the smooth surface of your breast from the implant and with no breast tissue in the way to hide the lump, if you do breast self-exams, a lump will be noticeable when it is extremely tiny. My breast surgeon explained this to me and said that this is actually one advantage of sub-pectoral implant reconstruction.

mellee

Yes, the implants are behind the muscle. I didn't even think of that, but I guess that makes sense. My pecs used to be underneath my breast tissue and now they're on top of my implants. Good to know. Thank you!

MinusTwo

My MO did a CT with & w/o contrast every 6 months for 3 years. I pushed for a PET/CT after 3 years, like my first MO told me to do. Now it's just blood work unless I have issues.

DCISinAZ

my MO is having me do ultrasounds for screening in addition to self exam.