tumor near chest wall - radiation after mastectomy?

I can't answer your technical questions, but did have radiation after BMX. Because my tumor was on the chest wall, I was not offered any options. I did not have to do chemo, though. Will be seeing PS on Tues to learn about recon options.....if any.

Hi, Christina.  My tumor wasn't near the chest wall, but it had acted pretty aggressive, so I had chemo, a mastectomy, and now I'm in the middle of radiation.  I am planning a DIEP reconstruction, along with a prophyllactic mastectomy on the healthy breast, six months after radiation is finished.  If you google "reconstruction after radiation" there are lots of photos of women who have gone this route.  It's perfectly acceptable.  

Radiation is there for clean-up of whatever cancer cells might have "strayed" from the original tumor and might be lurking somewhere.  For my own decisions, I wanted to do absolutely everything I could to wipe out this nastiness.  A friend said, "The chemo killed all the lice.  Now the radiation will kill all the nits."  

Go see your RO, and find a plastic surgeon who regularly works with breast cancer patients.  If you want to PM me, please feel free! 

Will do, Christina. :-)

christina,

I just got home from my PS consult and I am super excited by what I learned! I actually have an option that is palatable to me.

I have really been having trouble getting my head around the lat flap surgery which a friend's PS told me would be my only option. I just couldn't see cutting into perfectly healthy tissue and nerves to build a boob. However, the PS told me about recent findings on how fat grafting can help improve the condition of irradiated tissue and suggested that my chances of success going with fat injections --> tissue expanders --> implants were 80-90%. Yes, it will be a fairly drawn out process with 2-3 injections over the course of 6-9 months, followed by TE's and then an exchange. But I am happy to put the time in on the front end in order to leave my lat where it belongs and un-concave my chest!

I am scheduled for the initial fat graft the end of July and am very surprised at how happy I am (not a girly girl or pink ribbon fan).

Feel free to pm if you want to discuss further.

christina, if you go to the information side of BCO and click the Diagnosis & Treatment section, there's information about margins. I'll try to give you a link to that page:  http://www.breastcancer.org/symptoms/diagnosis/margins.jsp  Otherwise, just use the search feature in that part of BCO's website.

I had an unspecified margin for one of my lesions, and that was one of two reasons I had RT after a mx.  In other words, although the lesion was very tiny, it wasn't discovered until pathology in a bit of trimmed tissue that hadn't been inked.  But I had also been told from the get-go that I would probably need RT because of a positive node with extracapsular extension.  So for that reason, I was strongly encouraged to go with DIEP recon, which worked out great for both the RT and as recon I'm totally happy with now.  

So sorry you're dealing with all this.  I also started out with a lumpectomy, so I know how devastating it can be to have to wrap your head around needing more surgery, especially a mx, and then trying to figure out what kind of recon will be best.  All I can suggest is that -- unless you're already being treated at a major comprehensive cancer center -- that you talk to more than one PS -- preferably one at one of those major centers -- because many others tend to offer you what they know -- not necessarily what's new and/or best for your overall situation.     Deanna 

Just wanted to add another note Christina...I had my last expansion on my right side this week.  My PS added a bit more saliene, because he said that I will have some retraction and maybe some scarring. I'm not sure if this is a general feeling with surgeons, but that is what mine said.  I'm going to deal with that when I come to it...I need the radiation, so I'm just plugging ahead. 

Hi there,

Sorry you have to deal with this...I know how the worry can tear you up inside, as the same thing happened to me.  I had a small DCIS lesion that was very close to the chest wall and opted for a unilateral MX.  I was told that radiation was a possiblility, but because my margins were clean it wasn't warranted.  From what I understand clean margins are really important, and unfortunately you won't know what your margins are until the final pathology report.

 See what the radiation oncologist says, write down all of your quesions, and don't be afraid to get a second opinion if you are unhappy or unclear.

Best wishes...