Immediate reconstruction with ADH or deferred?

Sweet_Pea

Hi all,

I'm still deciding who will operate on me, who to trust, basically, since I'm getting different information. I have a large mass (6cm) of atypical ductal hyperplasia (ADH) to be removed and my breasts are medium size, so I'll need reconstruction if I don't want it to be really obvious (I've decided that I don't want it to be). One plastic surgeon said he would reconstruct in the same operation and the next said no way, they needed to make sure there was nothing else there, carefully test the mass taken out, ensure that I didn't need any more taken out, treatment if cancerous cells are found or even a masectomy in the worst case, etc. He said if all they did was the lumpectomy, and all is well (it is just ADH and they are able to get it out with clean margins), they would reconstruct in 4-6 months to get the best results.

Does anyone have any experience or thoughts on this? I was initially disappointed because 1) I'd so like to have one operation more than two, 2) The next appointment with his team is later than I'd like and I'm looking to get this in motion ASAP...just lots of stress right now, I guess.

On the other hand, it sounds like sound advice. Any thoughts would be appreciated! Oh! I have another appointment tomorrow with a different plastic surgeon, we'll see what he says, although he doesn't have a "team" situation that I liked so much about the other hospital.

Lula73

if you're doing a lumpectomy then option #2 is the way to go. A lot of times they don't get clear margins and have to go back in. That's why option 2 makes more sense. Now if you were doing a mastectomy, I'd say option #1

Sweet_Pea

Thanks, Lula73. In the end they're looking at whether it has to be a mastectomy no matter what (because of the size of the área to be removed), and have decided to postpone surgery to do more testing (in both places, so I still haven't had to choose a team) and explore treatment options to see if they can avoid such an agressive operation.

The more I hear, the more I understand why a conservative approach of doing reconstruction later makes sense from a pathology point of view. Thanks again for your input. I agree, I'll try for later if there's a chance there's a lumpectomy. If it's a mastectomy, they've told me they'd perform immediate reconstruction, like you suggested.