surgery on mastectomy scar

tovahsmom

I had my breast removed in 2019 for IDC. I had radiation for a second time in the same area because I had DCIS 10 years prior. I have now developed atypical vascular lesions that have to be removed. The problem is, the skin has been radiated so the doctor can't use sutures. He tells me the surgical site will run the risk of infection because I will have an open wound. He may or may not take skin from my leg to graft over it.

Had I just had a lumpectomy in 2019, the surgeon would have more tissue to work with, but because I opted for mastectomy, there is very little to work with.

Does anybody have any experience with this?

Elle2

Hi Tovahsmom - I don't have experience with atypical vascular lesions, but I do have experience with radiation. I had 8 weeks of radiation therapy after my DCIS diagnosis in 2008. In July 2021, I was diagnosed with IDC in the same breast as before. What I have learned in the treatment discussion this time, is that there is a higher rate of necrosis (the tissue does not survive the transfer and dies) in breast skin that has been radiated. In your case, it has been radiated two times and now that tissue will have a much more difficult time remaining healthy, with good circulation, good blood flow etc. Once a breast is radiated, plastic surgeons don't want to use it again for reconstruction. Now, one of the options is to use flap surgery or DIEP, taking tissue from your stomach or back to graft over the breast for reconstruction. So it isn't the mastectomy that is causing the problem with the healing of the wound, but the radiated tissues that are no longer healthy and run the risk of infection or dying off. In discussing my upcoming mastectomy, I wanted to keep as much of my nipple and skin as I could in reconstruction, but was advised more than once, not to even consider it due to the radiation.

I hope this information is of help to you. I wish you all the best and hope you are in a better situation having all the facts on your diagnosis by now.

LivinLife

After my mastectomy the surgeon used a negative pressure wound vac over my complete incision and I had BMX with aesthetic flat closure..... I still had stitches though I wonder if the negative pressure wound vac might open some options for you. I have a history of rare and serious infections so that's why it was used....