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sharkness
sharkness Member Posts: 11

So many questions, so little answered.  I was diagnosed October 6th, with stage 3C Her2+, 36 years old, started chemo October 26th, did four rounds of ac, now I am on my 10th week of taxoyl/herceptin.  I have the surgery date set, April 6th.......

On a good roll right?!!! Okay I usually consider myself a very strong person, but I have to have a reconstruction decision by March 15th.  UGH What is that all about.  Please make your life changing decision now they say, especially when I have no clue what the heck they are talking about.  I will definitely have atleast a minimum of 25 nodes removed, a complete masectomy. I will have radiation afterwards, and do understand that this will affect the outcome of the reconstruction.  I guess what I am asking is will someone please guide me alittle on experience.  Sometimes it is like pulling teeth to get answers from the docs.

I was told I could either have sacers put in time of surgery, filler up then do radiation:)

Have the masectomy with nothing do radiation, wait 6 months then do a flap procedure.

Or do nothing!

I know I have a whole lot of living left to do and would love to do it with 2 breasts:)

Comments

  • lkc
    lkc Member Posts: 1,203
    edited February 2010

    Hi , I know , that they seem to just  through these options out there.

     Let me tell you what I know. I had a prophylative L mastectomy and bilateral recon 6 mos after my rad tx was completed. I had a R  mast for stage IIIC bc. I had saline implants in at the time of my orig dx, so they just switched them out at the time of my recon.  I  chose  this because I was already " expanded " by the implants, and I am small and did not have any extra tissue to do a flap.

    Please talk to you PS . who will let you know about the pro and cons of each proceedure. There is never a guarantee of sucess on the rad side, but i had no problems.

  • JacquelineG
    JacquelineG Member Posts: 282
    edited February 2010

    I was diagnosed stage 3c too and had bilat mastectomy and radiation. I had immediate reconstruction - expanders put in during mastectomy. I had radiation with expanders and then exchange surgery where implants were put in. My radiated side doesn't quite have the elasticity of the 'good' side but so far, implants have worked!

    Jackie

    p.s. you can PM me if you have any questions. Good luck with your decision!

  • SpunkyGirl
    SpunkyGirl Member Posts: 1,568
    edited February 2010

    I, too, did immediate reconstruction at the time of my mastectomy and had an expander put in.  That was in October, 2007, and I haven't  had any problems as a result of the radiation or anything else.  I was just about to turn 40 when my diagnosis came, so I can imagine the anger you feel about all of this.  Before my surgery, we thought I was just dealing with DCIS (though I had a small lump under my arm and knew there would be lymph nodes involved), and I so wanted to keep my breasts.  Who wouldn't??  But in the end, when I scheduled the exchange surgery, I had a prophy done on the other side, and I've never looked back.  I'm so glad they're gone.  Good riddance! 

    It is a tough decision, and it stinks to have to make it.  And most of the time, you're getting advice from people who've never been through it, and may never have to make the decisions you are having to make.  IMO, it's easy for a friend to tell you, "If it were me...."   Honestly, no one knows how they would be in your shoes, so you have to go with your gut feelings and do what is best for you.  I'm so sorry you're dealing with this!

    Bobbie

  • pupfoster1
    pupfoster1 Member Posts: 1,484
    edited February 2010

    So, my understanding of reconstruction is this:  if you have radiation you are NOT a good candidate for implants because of the high failure rate (skin becomes weak/fragile because of the rads).  You could have expanders put in at the time of surgery and then have tissue replacement later providing you have enough either in the lower tummy, back or butt.  This is a very complex surgery however, long time on the table (I was told 10 to 12 hours for both sides), 3 days in the hospital.  Also there is always the chance of it "not taking".  I am going with the second option as I will need radiation.  There is certainly no easy answer to your question, but please be sure to feel comforable with your plastic surgeon.

    Good luck,
    Sharon :)

  • janincanada
    janincanada Member Posts: 258
    edited February 2010

    I did not have immediate recon.  I had a right mast, chemo, rad, herceptin. In Dec 09 I had my left breast removed and tissue expanders placed. Just the expander on the left (non-cancer side) and a lat flap on the right (radiated) side.  Check out the recon threads for a lot of info. My second surger was just under 5 hours for a mast, TE, and TE lat flap.  I was hospitalized for two nights and went home with 3 drains.

  • allisontom911
    allisontom911 Member Posts: 425
    edited February 2010

    I am in the same boat as you so to speak. I am leaning towards a single mx at first, then rads, then do reconstruction with mx on "good" side and recon there as well.

    I have 2 appts now with plastic surgeons to see what they say. I have read that implants do not take well on radiated tissue/skin. So we'll see what they say.

    Good luck to you! Like others told me, go with your gut.

  • rayofsun
    rayofsun Member Posts: 204
    edited February 2010

    wow i too am at the same crossroads. i had 4 acs, would have been done my taxols next week but three were delayed because of colds and fevers so now shouild be done march 17th. have been meeting with PS's 2 to be exact and am leaning towards bilateral masect, spacer placements, then rads. i too will have delayed reconstruction and am looking into implants or the diep flap,looks like more diep flap.my original the first breast surgeon and PS and breast surgeon don't do the procedure i wanted so in the process of a consult with the other. rads and spacers were more controversal but more mainstream now. my surgery should be mid tothe end of april. keep us posted.

  • Texas357
    Texas357 Member Posts: 1,552
    edited February 2010

    Nearly every plastic surgeon will tell you that implants-only will not work on radiated skin, and that you'll need some sort of autologous flap surgery for reconstruction. There are alot of women here who have had implants only after radiation and are happy with their results.

    "Implant failure" is measured by degrees. After doing some research, I discovered that even some very minor tightening, that does not require implant removal, is measured as implant failure. So when you see stats that say 50% (or whatever) of implants on radiated tissue fail, keep that in mind.

    It is a very personal decision, and you should ask a lot of questions. Know what kinds of procedures your PS is comfortable doing, and find peace in whatever procedure you decide to move forward with. I strongly suggest reading the different threads about the different procedures. See what those who have gone through them have to say.

    Good luck with your decision!

  • thenewme
    thenewme Member Posts: 1,611
    edited February 2010

    Hi Sharkness,

    As you can see, there's a huge variety of options!  Have you consulted with a plastic surgeon (preferably a breast-specialist PS)?  They can give you the options and recommendations for your specific situation, since outcomes depend on so many things.  

    For me, I had double MX with immediate expander placement, then chemo and expander fills, then radiation.  I finished all my treatments in July and still have the expanders in.  My PS wants to wait a full year for exchange to silicone implants, to make sure that all radiation-related tissue changes have stabilized in order to improve the results. All my PS checkups have gone well, and she is very pleased with my skin, and there is no evidence of any capsular contraction or negative effects from the rads.

    My best recommendation is to get the advice of the plastic surgeon ahead of time.  If you don't "click" with the first PS, then find another.   You need professional opinions of all your options so you can make a decision you'll feel comfortable with.

    Best of luck with this very tough decision!

  • sharkness
    sharkness Member Posts: 11
    edited February 2010

    Thank you Thank You Thank you for all of your advice and comments!!!

    As you all know this site is terrific for getting advice from all  inspiring women like yourselves. having gone through familiar situations, it is almost relieving to hear that their are many other women out there willing to share stories so that so many of us can take that with us to the decision tables.  One thing I did pick up on that i didn't even think of was to do the flap on the radiated side with an implant on the noneffected side.  I am going to ask my reconstructive surgeon(specializing in breast cancer patients) if this is recommended.  One other survivor I talked to during my chemo treatments, told me that she had gone through what I did, and had one side (affected side) with the flap and an implant, and the other side with just an implant.  It really is alot of information to digest and review like you all said for your own personal decisions. But i am a true believer that if all of us ladies stick together anything is possible.

    GIRL POWER!!! 

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