Mx and breastfeeding/pregnancy questions for newbie

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lust4life
lust4life Member Posts: 21

Hi everyone,

 I will be having a mastectomy on my left breast and SNB this Thursday after I was told I had a high grade DCIS all over my (smallish-B-cup) breast. I have stumbled across this forum in my pre-op research (which also included You Tube surgery- possibly not the best viewing!) Anyway, I am feeling fairly upbeat about the operationand LT reconstruction, if apprehensive, and was  wondering about a few questions...for those of you who have had this procedure, how long til you get (on average) the'all clear'/things settle? I am askingthis as I would love to complete our family and as I amnearly 40, time isnot on my side! I have breastfed my other children and would like to breastfeed with the remaining breast- has anyone done this? I guess the body compensates (although the lopsidedness must be extreme at times!)...I am also thinking about having the healthy breast removed after I have breastfed as I don't know about the cosmetic effects of having one fake and one real breast- even with 'corrective' surgery to the other breast, over time it is bound to 'sag'. I think I would rather have this removed using the TRAM method (from the stomach, rather than the back which is what I am having done- they wouldn't do a TRAM on me as I am planning another child). The other thing that concerns me is the risk of being pregnant/having those hormones affect the other breast/the possibility of it recurring in the other breast- my surgeon seems to think this is very low, but other sites I have read seem to suggest it can be higher-confused!!

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  • mrsnjband
    mrsnjband Member Posts: 1,409
    edited April 2011

    I'm not sure how soon after (I'm thinking treatment), but yes you can breastfeed on the non-effected breast. NJ

  • Emaline
    Emaline Member Posts: 492
    edited April 2011

    I would think as soon as you are done with painkillers, and not doing radiation and/or chemo, you should be clear to nurse.  I know when I had my son, I was on percocet after the c-section and I was allowed to nurse.  My daughter, who was a VBAC, she mainly only ever nursed from one side.  I never had a problem with milk supply, I mainly had over supply problems.  She would nurse from one side, and I would express from the other with Medela PIS. This is actually fairly common. Some babies will nurse some from both and then the mother will express from both but some babies and some women prefer to just nurse from one side and you express from both.

     As for corrective surgery, well I'm actually looking forward to that.  I'm 41 and while I'm not horribly saggy, I could do with a lift :)  I have opted for an implant on the left and then when I do the exchange, they will lift and  reduce the other one.  No they will not be perfect but no matter what you do, it will never be a real breast again.

    Edited to say: I have no idea the affects of Tamoxifen and nursing/pregnancy. That is a good question for the doctor.

  • Jelson
    Jelson Member Posts: 1,535
    edited April 2011

    Check on the Young Women with Breast Cancer board which is under Support and Community Connections- there are several threads dealing with or anticipating breast feeding.

    good luck!

    Julie E

  • sunshinegal
    sunshinegal Member Posts: 209
    edited April 2011

    I'm in a somewhat similar position, in that my husband and I want to start a family. I was diagnosed 3 days before our wedding, at age 36, so we had lots of questions and anxiety about what would be possible (or not).

    The first order question is to obtain medical 'clearance' to attempt getting pregnant. If you have invasive disease, the common wisdom seems to be to encourage women to wait 2 years post-treatment to start trying for more kids. This is apparently related to a higher risk of recurrence during that window, and the worry that being pregnant can compromise the treatment options available.

    For women with pure DCIS, like me, once medical treatment is complete, no 'waiting period' is necessary and you can try for pregnancy right away.

    Now to the question of breastfeeding: I had a single mastectomy and went for a smaller reconstructed side (down to a C-ish cup from DD/E). We talked a lot about what to do about the good side: prophylatic mx & reconstruction, or reduction/lift? I ruled out mx quickly; it was too much for me to consider removing my remaining (and so far perfectly healthy) breast.

    Reduction/lift poses some pretty significant risks for breastfeeding purposes. Sources I've read indicate, at best, a 50/50 chance of breastfeeding, but my surgeon told me I should plan on NOT breastfeeding if I do the reduction. So my husband and I decided that we were going to put off reduction/lift on my good side until after we've had kids and I've done the best I can at breastfeeding with only one breast.

    This means that I am going to live with a lopsided chest for a few years, which is a little bit awkward but so far seems worth it.

    Good luck to you!

  • lust4life
    lust4life Member Posts: 21
    edited April 2011

    Hi Sunshine gal- sounds like we are in a very similar position with regards the DCIS/unilateral Mx and breastfeeding. My surgeon also advised that she could do a lift on the good breast, but advised against having this until after completing our family as it would most likely cause problems with breastfeeding, so basically I am thinking that this will be a very long term project as once we get the 'all clear' and try to conceive/breastfeed, there will be a long period of reconstruction etc involved afterwards to get them symetrical.

    I'm curious to know why they offered you a mx on the good breast for DCIS? I haven't been offered this (possibly becaues I made it clear I wanted to conceive/breastfeed?) and when I enquired about it she said the risk of it in the other breast is not that high, however I have read different opinions on this. I've been thinking that after breastfeeding I may consider having the other breast removed at a later stage, if my surgeon will do this, I'm not sure if she will.

    Thanks.

  • sunshinegal
    sunshinegal Member Posts: 209
    edited April 2011

    Hi lust4life,

    In the early stages, I got a second opinion about mx from a surgeon who sounded the alarm bells - when she heard my family history and the size of my tumor, she advised me to consider a prophylactic mx on the other side. To be honest I didn't like her alarmist tone, particularly since we didn't have final pathology back on the tumor on the bad side. So I went back to my original surgeon/plastic surgeon combo, who both (in passing) told me that it was still my choice if I wanted mx on the good side. My breast surgeon kind of pooh-poohed it, though: mammo/MRI are totally clear on the other side, not even any suspicious areas to be concerned about. True, there is an elevated risk of a tumor on that side, but the extra risk is within my comfort zone. I have a hard time imagining life without my good boob...or maybe I should say I can't imagine choosing to lose it when I don't absolutely have to. I am pretty sure that if I decided to do it, my breast surgeon/PS team would do it for me. I'm not sure whether surgeons get to decide "no" if it's something we want...does someone know?

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