BRCA1+ - what next?

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pabrocc
pabrocc Member Posts: 1
edited June 2014 in High Risk for Breast Cancer

Hi!  This site looks very promising for information however I noticed that many of the posts were a couple of years old.  I hope to get some response that is more current.  Please send any advice you might have!

 I am 48 yrs old and post-menopausal and just recv'd a BRCA1+ result as have my 2 sisters.  I  have been advised to have an oopherectomy as well as prophyllactive dbl mastectomy.  I am so torn as I have no signs of cancer at this point.  My family history is strong for ovarian cancer but not for breast.  The other kicker is that I am 3 yrs post bariatric surgery and have lost 120 lbs which leaves me with a lot of extra flesh and skin around my middle.  All this has led me to consider strongly having a procedure called DIEP flap where the vascular components and tissue from the bdomen be used to reconstruct the breast.  Sounds like a great solution, right?  The problems are:  I don't know if the skin and vessels are usable because of the stretching of the tissue through the weight gain and loss, it's a very long surgery (14-18 hrs just for the breasts), it cannot be done in combination with the oopherectomy (which in my opinion is mandatory because of the family history, a long 6-8 week recovery, etc.  Now I'm trying to decide if I just do the ovaries and worry about the breasts later or do the breasts first so not to interupt the tissue with laperoscopic surgery again which could destroy the pertinent vessels.

Anyone have a similar situation that they would consider sharing?

Thanks!

Patti 

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  • howhm02l
    howhm02l Member Posts: 147
    edited August 2012

    I am sorry about your test results.  I recently found out that I am BRAC2+.  I also have DCIS so the bilateral mastectomy is a given for me.  I will be having DIEP reconstruction and have to admit that I enjoy the thought of MUCH smaller breasts and a flatter tummy.  That said, however, it was an easy decision for me to have the BMX because of the DCIS in the left breast.  As for the ooph they have recommended, however, it's a much tougher decision.  No one in my family has ever had ovarian cancer, and I'm only 40.  I am concerned about risks associated with losing my ovaries.  On the other hand, there is no effective screening for ovarian cancer so I don't want to wait too long.

    One place to start is the FORCE website - it is dedicated to women with family histories of breast and ovarian cancer.

    You could also have a consult with a plastic surgeon to see if you are a candidate for DIEP. There are LOTS of women here who have had DIEP or are about to have it.  You may want to post on the Reconstruction board as well.

    Heather

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  • Moderators
    Moderators Member Posts: 25,912
    edited August 2012

    pabrocc, welcome to BCO. Here are a couple of other places on the forums where you my want to read and post:

    BRCA1 and BRCA2 Positive

    Breast Reconstruction

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  • peanutsgal
    peanutsgal Member Posts: 161
    edited August 2012

    I too have lost 120 pounds from gastric bypass and am preparing for pbmx.  I had my consult with plastics this past week.   I was told that since I have had both c-section and open gallbladder surgery I would not be a candidate for a diep flap procedure.  His issue seemed to be more with the gallbladder incision over the c-section one.  I don't think there was really an issue with the viability of the skin/tissue from the stretching, etc.  I would call your plastic surgeon and just ask him or his nurse practitioner their advice/ recommendations on how you should proceed.  Don't know if this helps, but had to comment since our experiences seem so similar.  Good luck to you. 

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