Can TE protect heart/lungs during radiation - DON'T want recon

dillydilly

Hello Ladies,

I'm in a different subject area but want to say I SO appreciate all the helpful information and I have decided to do the BMX. Feb 28th. I'm 50 and just want to be cured. Dr. says stage 2 maybe 3, nervous about the nodes. You never really know how long ILC has been sneaking around undetected.

When I told my surgeon I did not want reconstruction at the time of surgery (I think I will choose to not do it, but it's hard to say until you're there), he mentioned that having the TE in place IN CASE I need radiation will protect my organs. Does anybody have any experience of knowledge about this? I read a couple of thing supporting this but I'm not sure if it's based on studies and there isn't much info on it.

The surgery right now is scheduled with the PS "installing" the TE. I reluctantly agreed. I have 10 more days and I just don't know if it is worth putting it in just for the organ protection and then taking it out later, plus if they leave extra skin (thinking I may change my mind and use the TE for their actual purpose), then, I'll have to get that skin tightened up too (not sure, does that sound right?)

Also, when I left PS, my appointment was to just get info and then think about it. When the surgeon talked me into it, he said they will coordinate with the PS and basically said...see you on the 28th. It just occurred to me today...the PS is planning on putting this thing in me in 10 days and they don't even know my preference, size, etc. Am I supposed to call them? Is it possible I have been left out of this decision?

But my main question is about protecting the organs...To use TE temporarily, or just skip it.

Hope all you beautiful ladies are enjoying the weekend. Hugs

ksusan

I haven't heard of this as an option and it raises a lot of questions and concerns for me. Is there someone you could see for a second opinion?

My surgeon wouldn't even install a port during my BMX because it was probably, not definite, that I'd need chemo. He characterized it as unnecessary surgery.

dillydilly

Hi Ksusan, Thanks. What is the port you mention? He said I would have drains...is there something else?

Hope all is well with you now...after chemo/rad, are you cancer free.

OCDAmy

I had TEs and then went through rads. Are they going to fill them? I was never told they would protect me but was told they could get really hard and need to be removed.

ksusan

"Port" means a small access device for chemo.

dillydilly

Not sure how old this is. I'm so confused and don't want to postpone surgery.

Appreciate your input. Luckily, he is good about me asking questions, but I surely don't want to upset somebody who will be taking a scalpel to me.

in the Johns Hopkins Patients' Guide to Breast Cancer, on page 52.

If the patient has undergone mastectomy surgery and has a TE in place, it is advisable to have the radiation, if needed, done while the expander is still there and let it take the radiation hit, then post radiation, replace it with the permanent implant

Runrcrb

Dillydilly,

RE your concern about "PS doesn't know my size, pref" - tissue expanders are one size. How much they fill them later drives your sizing question. I had a single mastectomy with tissue expander placed at that time. The TE is placed under your pec muscle - the "expansion" part is to create the space for the implant later if you go with that for reconstruction. Mine was filled during surgery and then I had one fill afterward. For me the benefit was having something to fill my bra while I went through and recovered from treatment. If you aren't sure about reconstruction, talk to your PS - is it easier to put in TE now and then clean me up if I decide no reconstruction or no TE and then have to do it later in order to complete reconstruction.

As to protecting your organs - not sure I'm buying that. You should have that conversation with the Radiation Oncologist. Radiation does come with risks and your radiation oncologist can explain the details to you - better than anyone else on your medical team.

The "port" is the port-a-cath. For those who are getting chemo, the port is inserted in your chest (above breast, below collar bone) allowing for easy needle insertion for your chemo. Beats the hell out of getting an IV in the arm every time. It is typically inserted on the non-cancer side (if only one breast is affected). Mine was inserted during my mastectomy because I already knew the lymph node involvement and that I'd be undergoing chemo. My breast surgeon put it in. It was removed about 6 weeks after my last chemo - removal was a 30 min outpatient, local anesthesia thing. I went to work, then had my radiation and headed up to the outpatient surgery floor. And went to work the next day.

and yes - you want the expander in during radiation, not the final implant or flap.

Icietla

Hi dillydilly. I am concerned too. I think you should consult with a Radiation Oncologist about this issue, not a Doctor whose area of practice includes breast reconstruction.

>>extra skin<<

Translation: apparent breasts.

Please read down this page__

https://community.breastcancer.org/forum/82/topics/818608?page=18

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May 21, 2016 02:59PM - edited May 21, 2016 09:25PM by Icietla

[...]The first two Surgeons from whom I sought help about my situation used reference to so many other women's different preferences (i.e., preferences for reconstruction for themselves) to make judgments about my preference for myself. I will say more later about all that experience. It was all very discouraging.

.[...]

Jedrik, Nomatterwhat – Yes, it is indeed a crying shame that we have to go through more surgery for what they so easily could and should have done for us in the first place. Nomatterwhat -- Yeah, that f-word at about the middle of your post – I was feeling it but not saying it. There could have been an even heavier price to pay for the Surgeon's failure -- my Oncologist nearly sent me – was very inclined to send me -- for radiation treatment for my still having these breasts, of which I had repeatedly and nicely asked to be relieved.

https://community.breastcancer.org/forum/82/topics/818608?page=18#post_4719655

dillydilly

Not sure how old this is. I'm so confused and don't want to postpone surgery.


Appreciate your input. Luckily, he is good about me asking questions, but I surely don't want to upset somebody who will be taking a scalpel to me.


in the Johns Hopkins Patients' Guide to Breast Cancer, on page 52.


If the patient has undergone mastectomy surgery and has a TE in place, it is advisable to have the radiation, if needed, done while the expander is still there and let it take the radiation hit, then post radiation, replace it with the permanent implant

ksusan

"If the patient has undergone mastectomy surgery and has a TE in place, it is advisable to have the radiation, if needed, done while the expander is still there and let it take the radiation hit, then post radiation, replace it with the permanent implant"

This appears to refer to avoiding damage to the permanent implant. It doesn't say anything about the TE protecting the heart or lung.

dillydilly

Thank you all for you help, I'm so glad I'm off tomorrow to look further into this and talking to the rad onc is a great idea. ksusan, i see what you mean now, about the article. I feel so fortunate to have you lovely ladies helping.

The PS & surgeon both say it's better to do the TE at the same time as BMX, I understand the whole "eliminating another surgery" but in my heart, I just don't want to go thru so much more...just for...boobs. I'm 50. They landed me a great husband, they fed my babies, now, they are trying to kill me and I just want them gone. in as few surgeries and treatments as possible. I just want to be healthy and not spend any more time on operating tables and in doctors' offices. The only reason I agreed to the TE was because of the "protecting the organs" comment. I would be more comfortable without them.

I'll let you know what Rad Onc says...I may not even need rads, won't know until I wake up. Nite-nite