Breast cancer with implants

Vainandafraid

Hello—this is my first post. I am a 48 year old mother of 2—18 yr old boy and 15 yr old girl.
I had a breast augmentation in November of 2007 to put things back where they were before breast feeding. I had my saline implants placed by a wonderful plastic surgeon that also did many reconstruction surgeries after breast cancer. That was in Boise, Idaho.
Fast forward to the summer of 2018. We had relocated to San Antonio 10 years earlier. My left implant sprung a leak, and I required a revision surgery. I had had a mammogram in October of 2017 which was within the year window of my surgery. My mammograms were always clear. I had Ideal Implants (new 2 chambered saline implants that feel more like a real breast—but still saline for safety) placed in September 2018. I did not get a mammogram that fall because the implants were so new—and I wanted to wait. My waiting continued until the late winter of 2020. I knew I was overdue for a mammogram, but then covid hit. I didn’t want to make a routine appointment when there were so many folks ill. I put it off until the summer. There was an area I had a concern about—it was a thickening on the upper part of my right breast. I was confident it was scar tissue as I’d had a fair amount of work done on the capsule during my revision. I was also lifting weights so it seemed the muscle shape may have changed slightly. Wanted to get it checked out to have peace of mind.
I scheduled a mammogram for August 17. After the initial squishing, I was sent to wait for a few minutes. Those minutes stretched longer, and I tried to put a damper on my thoughts. I was retrieved by another nurse to have an ultrasound. I had some alarm bells going off in my head—but tried telling myself they were just being thorough. Not long after—the radiologist came in to say I needed a biopsy—now. I was starting to have a bad feeling—but pushed it away. After the biopsy, I was told it would be a week to get the results. I tried shoving dark thoughts away that week. This was a Monday. On Saturday, my husband and I brought our son to college. Excited for him, but sad to leave him.

Then the following Monday morning I got a phone call with my biopsy results. I was sure it was scar tissue—but the nurse said a lot of words that got jumbled in my mind. I know now she said I had invasive lobular carcinoma. That sounded terrible to me! The shock and the tears took over. My husband took to this site for research to try and understand my diagnosis. I kept thinking, how did this happen? I’ve been the picture of health. I feel fine! How can I have cancer? I have two teenagers that I want to see grow up, get married, and have children of their own.
It was a week later before I spoke with my doctors. Both my appointment with my oncologist and radiation oncologist were over the phone. While they sounded very nice—the possibilities they were throwing around, all freaked me out. I spent most of the day crying. The thought of losing my breasts, possibly losing my hair, and going through medical menopause all sent me reeling. I have prided myself on my appearance my whole life. I love to style my hair and wear makeup. I obviously wanted my breasts to look pretty as I’ve had them enhanced twice.

After I met with my surgeon last week, I began to feel a bit better. I had an order for genetic testing and an MRI. I had the MRI this morning. I’d never had one before. Was a little nervous initially—but it went well. Don’t have the results yet. The genetic tests did come back all negative—so I am relieved.

I meet with the plastic surgeon next week. I don’t know if a mastectomy with reconstruction would yield a better result or lumpectomy with some sort of reconstruction afterwards. My understanding is that if I have a lumpectomy, I’ll need to have radiation. However, if I have a mastectomy, I will not need radiation. My biggest fear is it coming back somewhere else down the road. So while I am vain—and don’t want to lose my hair or breast, I will do whatever I have to do to live. I think there’s still a lot of fear of the unknown. What is the surgery like? I’ve had breast surgery twice so would it be similar? Would I need expanders if I’ve had implants under my muscle for over a decade?

Any others of you that have had implants when you received your diagnosis? What did you do?

I’m thankful for this forum. I have read numerous posts before writing my own. So many of you that have just been diagnosed share my exact feelings of fear—wanting to wake up from this nightmare.

I pray that we will all get through our treatments, support each other, and are able to help those that are diagnosed in the future.

Moderators

Hi vainandafraid, and welcome to Breastcancer.org!

We're so very sorry to hear of your diagnosis, but we're so glad you've found us. You're sure to find our Community a helpful source of advice, information, encouragement, and support -- we're all here for you!

Others should be by soon to weigh in with their experiences, but we wanted to make sure to welcome you and let you know we're here if you need anything at all!

--The Mods

Mangosan99

Vain, sorry we have to meet under these circumstances. I was so drawn in by your story--this was almost the same path I have been down with a few key differences. I, too, have sub-muscle saline implants which I acquired in 1996 (!) when young and flat chested...lol! My left implant sprung a slow leak in 2017 (I know, they lasted forever!)--I had just moved and had a lot going on so tried to ignore it as long as I could. In late 2019 I found a great plastic surgeon, who does mostly BC reconstruction, and was scheduled to have my revision in March 2020. Two days before surgery, elective surgeries were cancelled due to COVID. Fast forward, the revision was rescheduled for mid-June but then my mammogram was now overdue. An attempt to get that quick "formality" out of the way led to multiple biopsies, many dark days, and a borderline ADH/DCIS diagnosis.

So, now, my new reality. I have two deflated implants (they deflated the good one the week before the first scheduled surgery to determine the volume and prepare the pocket) and precancerous lesions/possible cancer in my left breast. That, with my mother's history of BC twice as well as several other risk factors, I was faced with a menu of treatment options ranging from lumpectomy to BMX.

I have opted for a skin/nipple-sparing BMX with direct-to-implant reconstruction. I had no interest in a lifetime of high-risk screening, radiation, and tamoxifen. And, it seemed like already having implants and the need for a revision made this decision easier.

My PS has agreed to try direct to implant but has cautioned I may end up with tissue expanders depending on the viability of my skin after the mastectomy. She acknowledged the pockets are there and will need to be filled but doing so may stress out skin that has just lost the majority of its blood supply.

My surgery is Sept 17 so I hope to be able to give an optimistic report and that being a seasoned breast implant vet is in our favor. Finger's crossed! Oh, and for more comparison, I just turned 52 and am very fit--dreading the setback of having T-rex arms for the foreseeable future!

Vainandafraid

Mangosan—I so appreciate your sharing your story with me. I have been scouring the boards and various sites explaining the direct to implant mastectomy. I meet with the plastic surgeon next week so I want to go in with lots of questions.
Initially when I was going to do my revision in 2018, I met with a PS that suggested using Strattice to support the implants. Turns out it wasn’t necessary in my case—but I wonder if it would work well after a mastectomy. If I could get the tumor out and essentially keep my breasts looking similar to how they do now—that would be ideal. I would hope to be spared radiation if all the tissue is removed.
You shared that you wouldn’t need tamoxifen after your surgery. Is that because of the type of tumor? I’m afraid it will be part of my treatment whether I have a mastectomy or lumpectomy/radiation. I haven’t brought myself to read any of the boards about endocrine therapy. I hate the idea of going through immediate menopause and all that may go along with it. I’d gladly do it if it keeps chemo at bay though.
I wish you all the best with your upcoming surgery. I will be praying for you on the 17th and for a great outcome. Please keep me posted on how it goes after having implants for years. It is my hope that having had them will be a benefit in the reconstruction!🙏🏼

Mangosan99

Vain, yes, since I currently do not have evidence of invasive disease and will minimize the chance of recurrence with BMX, tamoxifen is not currently part of my treatment plan. Thank you for the well wishes and I will come back with a report after surgery.