Breast reduction- pathology abnormal. Headed for PBMX

Mamihen

Hello, all-

I had bilateral breast reduction early September of this year. The pathology report came back with LCIS in both breasts and also atypical cells in the left breast. The diagnosis was between ADH and DCIS, it was sent out to another hospital and came back as FEA. My breast surgeon explained that there weren't enough cells in the sample for a definite diagnosis, and due to the breast reduction we don't know where to biopsy. Since the atypical cells showed ER positive, I discontinued my estrogen hormone patch (hysterectomy and oophorectomy last year due to prolapse) and started on Tamoxifen.

Because of breast density and family history, my breast surgeon and the oncologist recommended a prophylactic bilateral mastectomy to decrease my personal risk (IBIS v 7). I just found out that my surgery will be the end of January.

Due to the atypical cells in the ducts, we will not be able to save the nipple, but we are saving the skin. I am still healing from my reduction, so we are waiting another two months. Waiting for breasts to heal that I am not keeping is strange, but the plastic surgeons told me it's better to keep my own skin. Also not knowing whether it's DCIS in the left breast ot not made me nervous but since I am on Tamoxifen I am doing what I can at this point. I feel guilty even writing this, but this is all new and scary to me.

Reconstruction wise I decided to use my own tissue instead of TE and implant thereafter. I just don't want to be "sick" for the entire time between the two surgeries and the fact of having the do MRIs for leakage and exchanging the implants every 10-15 years doesn't sound good.

Due to my abdominal hysterectomy I am not a candidate for DIEP. I am almost decided to go with the TUG approach. My plastic surgeon's partner is trained in micro surgery and we will see after the MRA which blood vessels are looking better. I had suggested the PAP method, he prefers TUG but is open to discussion.

I am not scared of the recovery or the scars, all I fear is the long surgery (he estimates about 8 hours). My family tells me that's crazy, but I feel that way! I will have two breast surgeons performing the mastectomies, while the plastic surgeons will work on the flaps.

I have been pretty calm but there are waves of sadness. And I feel guilthy since I am so lucky to have found out a "good way" by elective surgery.

Luckily, I tolerate the Tamoxifen pretty well, just have headaches, cold spells and back pains to report. Figuring out help for after surgery (perhaps my sister will come since my mom is elderly and not sure how she'd deal with the JP drains) and am glad to have 2 months to get my ducks in order.

It would be great if I could hear from others who have gone through micro surgery reconstruction (esp.TUG or PAP flap surgery) What was it like? Anaesthesia? Recovery?

Hugs and hugs!