So anxiety-ridden and fatigued...

Dear Janathan,

 Always hard to read the post of anyone who has gone through this once, and now faces it again. I am so sorry, and heartened to read you have a supportive family. I don't know if you visited bc.org in 2002. It's a wonderful place for questions just like yours, and for further and wholesome support.

I had invasive with extensive DCIS and was advised to have a mastectomy. I had a positive node, pretty involved, so elected to have radiation. My tumor grade was II. In 2001, the OncotypeDx or Mammoprint were just coming on the scene, so none were done. 

In your case, one of these genetic tests may greatly help to further elucidate treatment in stage 3 DCIS, although maybe they don't offer it unless it's invasive. Still I would inquire. 

Radiation and mastectomy limits reconstruction. It doesn't forbid it, but a good percentage of women have subsequent trouble with scaring (fibrosis) or capsular contracture (hardening of the chest wall with fibrosis) or even blood supply problems causing failure of the skin to accept the expander. I wonder if a second plastic surgeon might be of benefit to you. All types of autologous or self donating sites are used nowadays, and we almost all have at least one area which is large  enough. One that comes to mind for example is latissimus dorsi or Lgap. Often a plastic surgeon may be more comfortable with one particular surgery, and hence direct the patient to that type or no other. That would be a compromise given today's plastic surgery expertise.

I did have radiation, tissue expanders, and then silicone implants but the interval between was long for medical reasons which I think greatly helped. It worked ok for me, but given what I now know, I'd encourage you to get a second plastic surgeon's opinion to discuss the full breath of options.

Best,

Tender

i too am saddened to hear your news- you make it past the flippin 5 year mark and beyond and maybe take a normal breath every once in awhile and then bam- life sucks sometimes!! my first dx was in october of 04- ILC- 0.9 cms with no positive nodes- i had a lumpectomy and radiation and was told at the time if i would even consider wanting reconstruction i should opt for a mastectomy because the radiation made it virtually impossible to do reconstruction- i did not want a mastectomy and knew even if later down the road i lost my breast i would not want any kind of implants- that cancer was in my left breast- in august of 05 i was dx'd again this time in my right breast with DCIS- a very small cluster- i cannot begin to tell you how incredibly p___ed off i was  at my body- i knew with the ILC i had a good chance of the ILC showing up in the other breast or even a different kind of cancer but i did not think it would be less than a year later- i again opted for a lumpectomy however God was watching over me and the surgical tissue was benign (ran two seperate specimens to be sure) no DCIS at all- radiologist and oncologist both say this is not uncommon to find DCIS on mammotome but benign breast tissue on pathology- i had 6 more weeks of radiation and i am in my 5th year of arimidex (for the ILC)- so i share your sorrow and your frustration but you will find lots of support here and lots of opinions on reconstruction and plenty of good advice from all the well meaning women here who feel your anquish as you work your way thru this- good luck in your journey and keep the faith ladies-

ILC   october 04   0.9 cms  0/5 negative nodes  lumpectomy radiation  left breast

DCIS  august 05  found on mammotome -surgical pathology benign- lumpectomy radiation

Hi Nancyluvspi and everyone:  I had a recurrence Sep-08 too and it was found out when I was on the table during a reconstruction operation.  What a nasty way to find out there was another lump on my mast. side.  I am now going for a tram flap in November as implant is no longer an option for me after radiation.   Could you tell me  more about your recovery journey, was it tough ?  I believe if I can rough it out on Chemo, Mast. etc. I can do this too.  I am a size 2 and my PS said I should be OK for tram too.