DCIS again one year after Partial Mastectomy (DCIS diagnosis)

brandy42

I am 46 years old.

I was diagnosed with 2 small spots of DCIS on the right side late last summer. I had a partial mastectomy on the right and a bilateral reconstruction for symmetry. I did 16 radiation treatments and completed them this past December. I was also placed on Tamoxifen.

This summer they found ADH from a biopsy of suspicious calcifications from a mammogram. They did a right side lumpectomy and the pathology showed DCIS and LCIS.

My breast surgeon wanted to just do a right side mastectomy but I am almost positive that I feel that I should do both sides. I know the risk is greater with each of those for invasive to show up in either breast.

I am very disappointed and confused. None of my mammograms showed the DCIS - from what I understand LCIS does not show on mammograms. My surgeon can't say for sure if this is new or if it was always there and just didn't show on the mammogram.

I would also love advice on reconstruction. I think I am leaning toward a flap (?) using fat from my stomach. I am pretty sure I want to do the reconstruction when I get my mastectomy. They explained it is a longer surgery and recovery will be quite a bit harder also. But, I want to try to get this all done in one surgery, if possible. (I know I might need adjustments later - he explained that). This will be surgery #3 within a year.

I am also pretty nervous about my final pathology. Apparently I have dense breast tissue and it's possible that this was hiding in there. What else could be hiding?

Any advice would be so much appreciated!! I already found the member tips for surgery and printed it and I am working on gathering up what I need for surgery

Thank you in advance

abigailj

So sorry to hear you’re going through this recurrence. I also had dense breast tissue. Diagnosed with IDC in one and ILC in the other..,was given choices - lumpectomies or BMX with either implants or DIEP. I chose BMX with immediate DIEP partially to avoid living in constant stress of something else developing.If you’re a candidate for DIEP (blood vessels in abdomen need to be in good shape, enough belly fat, probably some other factors too) and can use a good experienced PS that specializes in DIEP I really think it’s worth the longer healing time. I’m 63, ex-smoker, had skin/nipple sparing BMX with immediate DIEP recon June 23, flaps removed July 8, had some wound healing issues so abdominal scar revision August 10 and despite that totally happy I went this route. I also had nerve grafting so hopeful I’ll regain a reasonable amount of sensation. My recon breasts feel comfortable, have sensation around periphery and look pretty good already despite my age and long smoking history. I’ve working from home part time for 4 weeks already and going back to full time next week if that helps as a benchmark. I wish you the best!

brandy42

Thank you Abigail

I appreciate your reply! I am not sure what my procedure is called? I know they will be taking the fat from my stomach and that I have to have a CT scan before my surgery to get a close look at the blood flow/veins (something like that?).

I am pretty nervous about it all. But also anxious to get all of this taken care of and hopefully put it behind me!

abigailj

it does sound like they’re evaluating you as a candidate for DIEP flap. If you decide to go that route please make sure PS has a lot of experience as this is complex microsurgery and will also do nerve grafting so you have a reasonable chance to recover sensation in the reconstructed breast(s). Also the PS should show you pix of other women on whom he/she performed this surgery. Lastly it is a longerrecovery although if you’re pretty fit/active, haven’t used nicotine in any manner within past year, and are younger than me I’d bet you’ll heal more quickly than I did. I wish you all the best and happy to answer any questions you have.