Questions about reconstruction...need advice

Lakelivin

Hello all! Just recently joined and I'm kicking myself for not joining sooner. I'm a pretty independent person and I don't like asking for help or advice in my "normal" life. As I have discovered, being diagnosed with breast cancer can and will turn your life upside down intermittently. I do a lot of research on my own but thought why not ask ladies who have already blazed that trail? So thank you in advance!

So my journey began back in feb 2020. My surgeon said that I was simply going to have a lumpectomy and radiation and be back to work in a few weeks. I woke up from surgery with a JP drain and a 3 inch incision in my armpit. She said that went ahead and did the axial dissection because the 3 lymph nodes that she tested were positive. She took 24 lymph nodes. When final pathology came back she said that 9 of 24 were positive and that the inferior margin of the DCIS needed to be cleared. A few weeks later when placing my port for chemo (which she said I wasn't going to need initially) she attempted to clear the margin. Pathology on that came back positive for cancer cells, so now she is recommending a mastectomy (after chemo). I have many, many questions about the mastectomy and whether or not to do both and then whether or not to do reconstruction. After the mastectomy, I will have radiation. I am also curious if people have have breast reconstruction at the same time as the mastectomy and if you were happy with results after radiation. I read mixed reviews for both and I've read mixed reviews on the type of reconstruction to have done if you are doing it at the same time as mastectomy. I am really struggling with what to do (as I am sure most people have been in that same boat). I just don't know that I want to wait to have reconstruction. I am in the medical field (physical therapist) so I need to be able to lift and move patients, so that also plays a role in my decision. Have not met with radiation oncologist or a plastic surgeon yet due to covid-19 but those appointments are to be scheduled soon Meanwhile I started chemo on April 7. I am on AC-T but my MO insisted I do the Taxol first (again due to covid-19). Overall I'm I have a great attitude about this whole situation and have been able to maintain it since Feb. I just think it's time to reach out and make some connections with other people who likely have experienced some of the same questions that I have and may have some good advice that they are willing to share. Thanks so much for welcoming me to the group.

BCat40

Hi Lake,

I think you'll get a lot more clarity after you meet with the PS. I was originally going to have DMX even though cancer was only on the right side, because the PS told me that in order to make the left side match the reconstructed right side, I would need a lift/reduction on that side. So I figured if I was going to have to be cut into on both sides anyway, just take them both and reduce my risk of future cancers. (It turned out I didn't need a mastectomy after all so I am just having radiation after LX). Also, your PS will be able to tell you the risks and benefits of different types of reconstruction options given the fact that you are having radiation. Usually if you are trying to do implant reconstruction, they'll put in an expander until after radiation and let the skin settle down before going back in, potentially taking out scar tissue and then placing the implant. But it is a much higher risk of complications for implants after radiation. Many post-radiated women do flap reconstructions for this reason.