Oncoplastic Surgery

Dreamer1

Does anyone have experience with oncoplastic surgery? I have two cancers in L breast, each of which is small and not palpable, but they are 4 cms apart. BS1 said she can do one big lumpectomy on both ca, but she is concerned about cosmetic result and sent me to plastic surgeon, who urged L mastectomy with lift in R breast. BS2 said she can do one big lumpectomy on both spots, and use BioZorb device to fill the dent. Anyone have experience with this? Right now the plan is to have 4 weeks of rad, probably no chemo (fingers crossed). By way of background, I am less concerned with appearance, more concerned with getting the ca out and also trying to minimize recovery time/time away from work.

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Dx on 10/15/2019 one month before 59 after routine mammo and then US biopsy on L, 1.5 cm IDC w/DCIS, Grade 1, Stage 1A, ER+/PR+, HER-

Dx after 4 MRI-biopsies 10/29/2019 with 2 cm DCIS on L

Yogatyme

Dreamer, if you are less concerned about cosmetics you may want to consider doing what BS suggested. Lumpectomy, while not easy, is an easier recovery than mastectomy.

Bejeweled

Dreamer,

I am not specifically familiar with the Biozorb and it may be different than what I did; however, in case it helps... I was given the option of lumpectomy or mastectomy and I really had a hard time deciding what to do. Breast surgeon told me that she felt confident in lumpectomy, but at the time, there were thought to be 4 masses a few cm apart, and she said she would need to do a rather large lumpectomy and she felt that I should consult plastic surgery about options. Plastic surgeon was wonderful and said he could "fix" whatever I decided upon.

I ended up deciding on the lumpectomy (variety of reasons) on the left, with an immediate oncoplastic reconstruction procedure. So the breast surgeon did the large lumpectomy and the plastic surgeon did the reconstruction, remolding and shaping the left breast - including a lift, and then did a "balancing" reduction and lift on the right so they would match. He left the left side slightly large to accommodate potential contracture from radiation in the future. As it turned out, it was just one large mass instead of several small ones that appeared to be separate on imaging, but pathology said were completed connected.

I had this surgery 2 weeks ago (10/28) - all as an outpatient - and am recovering pretty well. I have some incisional pain, but am just using Tylenol and Motrin for it. The worst part for me were the drains that were left in a little over a week.

I hope that helps in some way!

Dreamer1

Bejeweled, thank you, this is hugely helpful! Sounds very, very similar to my situation. I would also prefer lumpectomy vs mast. for a variety of reasons (primarily extent/risk of larger mastectomy and also recovery time/impact on work). For the lift on the R side, how much would you say it has added to discomfort/recovery time, etc.? I have been struggling with doing surg. procedure on R, since it is "healthy" and it would be for cosmetic purposes only but since now it seems likely that the surg won't be for a couple more weeks, that will bring it closer to December and I will have a longer available recovery time as I have three to four week work "vacation" that I can use for recovery time.

My BS #2 said for lumpectomy she wasn't planning on using drains, and that she could do it herself w/o plastic surg - she works at big academic med center where BioZorb has been used for few years now. We actually didn't discuss any R surgery but I'm thinking of bringing it up now. For your R reduction on lift, how much was reduced, and is it perhaps not as noticeable because of the lift? I'm only A cup to begin with so idea of making even smaller doesn't sound great but at my age (turn 59 soon) perhaps I could benefit from a lift, too.

My experience with BS #1 and the PS she sent me to was not good - BS1 said she could do large lumpectomy to get both spots, but the PS she works with said the results would be terrible, that I wasn't a candidate for oncoplastic surgery because I have history of keloids, so PS only recommended mastectomy plus lift on R side; I was totally bummed about this recommendation and that's why I was so happy that BS2 said she felt confident about doing lumpectomy.

Dreamer1

Yogatyme, thank you, both BS1 and BS2 can do lumpectomies, my question is whether I should I have oncoplastic lumpectomy, which involves lift on other side as Bejeweled described.

Bejeweled

Dreamer,

Hmm, our situations are somewhat different in that I was a DD, so I had plenty of breast tissue outside of the lumpectomy to be used to reshape. But in answer to your specific question, the surgery on the healthy breast didn't really add much discomfort to the overall situation. There is incisional pain of course, but I would have had that on the left anyway. The drains were far worse, so if you can avoid that, that is wonderful.

In case it helps, one thing that the plastic surgeon said to me during my consultation was that if I chose to not do any reconstruction immediately and just see how it went, he could do some things later on to help if I wasn't happy. For example, he said that he could do fat injections (taken from other places in my body) into the breast to fill it out if there was an indentation or something like that.

Right now, I am pretty happy with the surgical route that I took. The procedure included a lift and I am very happy with those results, although I am still somewhat swollen and don't know for sure the final size. I am guessing I will be more of a C to a D cup when all is said and done.

Dreamer1

Bejeweled, thanks so much. I'm glad that the oncoplastic surgery has worked out well for you. My surgery has been moved up to next week - I'm so happy to be getting "the things" taken out.

Bejeweled

Wonderful! I felt the same way about getting the mass out of my body. Wishing you the best in your surgery next week. I will be thinking of you!

Dreamer1

Hi, Bejweled, Thanks for your support. I had the lumpectomy yesterday late morning and was home before 5 PM. I'm working off and on today! Waiting for pathology, hopefully be back before Thanksgiving. BTW, as I was being wheeled in to OR, the surgeon said, Oh we might not use BioZorb, I'm not exactly sure why, but my hubs said the S told him it was because my breast had plenty of fat in it for her to work with. She probably said it in a different way;)

Bejeweled

Dreamer - so glad! I am happy you did well and are feeling good. One step checked off!