Lumpectomy with breast reduction

Although my situation was quite different (a DCIS dx, which was downgraded to ADH after the third pathology opinion), I opted to have an excisional biopsy (essentially a lumpectomy) along with a reduction.  I actually was able to dig up some research that strongly suggests this lowers future risk as well, which was my   primary motivation.  Found a great oncoplastic surgeon and went from a 34D to a 34B.  Over 800 grams of tissue were removed.  Cosmetically, I couldn't be more pleased and hope I have helped myself from a medical perspective as well.  Dr assured me that, worst case scenario, should I need a BMX in the future, I am now a better candidate for a nipple soaring procedure being smaller breasted than I was before.   Also, so far at least, imaging has seemed to be easier.

phillygurl, my own experience has been that doctors who do not do this procedure themselves (and it's not widespread, by any means) typically look at me like I have 2 heads when I describe the route I have chosen.  It's been remarkable to me that even in NYC, where I live, my doctor at NYU was dismissive of this procedure that is done frequently at NY Presbyterian Cornell.

phillygirl (I am a Philly girl too!), I totally agree with momschi.  You will find doctors who can only do certain types of surgery only recommend those types.  If this is what you want, then go with a doctor who can do it.  I had completely different circumstances, had to have a mastectomy and radiation.  I was told by my ps that the flap surgery was the best way to go because it is the best chance of not failing because of radiation.  A woman from my chemo thread had implants with radiation.  They did fail like my ps said was a good probability.  She went to a small hospital where implants were the only option, so of course they recommended it.  I think it sucks that doctors would not be forthright, but make sure you get your questions answered and good luck with your surgery.

I had a bilateral reduction and no drains either... 3 weeks later I went for a 25 mile bike ride.  Recovery was really not nearly as bad as I expected.

When I was first diagnosed with DCIS, I asked my BS if lumpectomy + reduction was an option.  She stated we would do the lumpectomy first, followed by rads and then ultimately meet with the PS to discuss reduction.  After two lumpectomies with + margins and now considered high grade, multi-focal DCIS, I'm scheduled for BMX in two weeks.  I guess that means I'm getting a reduction after all .  Hope you are all doing well post-op.

Glad to hear you are still hanging in there.  Can't help with the chemo question. But I am sure it's somewhere on the board. I'm surprised you still have some open areas. Make sure you tell your Dr. before you start chemo, don't know if it matters but I would check anyway.

I go in for Lumpectomy on Tues. Not so worried about the surgery itself as the margins after. Hugs to you. Stay in touch.

Hi all,

I am newly diagnosed with Stage I Grade 2 IDC. I just had an MRI this week to make sure nothing else was amiss, and the results showed that we are dealing with just the one tumor in my left breast, 1 cm. Still waiting for the results of PR and ER tests.

I met with my breast surgeon last week and he offered the possibility of a lumpectomy with breast reduction, done at the same time. He would perform the lumpectomy and sentinel node biopsy, then the plastic surgeon would take over for the breast reduction. I was concerned that there was not a "medical" reason for the reduction, but he said that it can help during radiation and for future mammograms. My breast tissue is quite dense and lumpy and I could not feel my tumor. It was the mammogram that found it. Even the surgeon said he couldn't really feel it, (It's deeper into my breast.) The breast surgeon is not "pushing" this surgery, but he is offering it as an option.

I noticed that many of you had the reduction done at a later date, well after your lumpectomies. My surgeon spoke as if it was a normal procedure to have both done at the same time. I meet with my surgeon again tomorrow, during which time we will determine what kind of surgery I will have. Any thoughts?

I was also happy to read that some of you recovered from the breast reduction surgery in a matter of a few weeks. I am a pre-K teacher and I don't want to miss too much time from work!

Thanks in advance for your replies.

Thanks for your answer, rettemich. It was reassuring to read that you are glad you made the decision to have breast reduction.

Since my original post, I have seen a plastic surgeon who agreed that I'm a good candidate for the lumpectomy with reduction. I will have to wait 4 weeks until I begin radiation, like you said.

My surgery is scheduled for a little under two weeks. I've been told that I will have drains and that I will go home the same day. Yeah, I would probably feel better spending the night in the hospital, but I might not have a choice. I'm already freaking out about any added charges, copays, "allowed expenses," etc.

I told my school that it would be "at least" two weeks before I return to work, but I am concerned it may be longer. Yesterday, I had to deal with a combative little boy who hit me a couple of times, and as I knelt down on the carpet to talk to him, he stomped on my fingers! Yikes!

How long did you have your surgical drains? I was told it would be only a few days. I have a follow-up with the plastic surgeon four or five days after surgery and it was my understanding that the drains might come out then.

Can't think of anything else right now.

Thanks again!

Update:

I had my surgery the morning of Sept. 24. After reading some of these posts, I was so happy to learn that my BS waited until after I was under to inject the dye and place the wire!

I have a follow up appointment with my BS (or, actually, one of his colleagues in a different office because my BS is traveling) this Wednesday, about two weeks post- surgery. However, I saw the PS five days post-surgery, and he removed my bandages and drains. I see him again next week.

So, what should I be looking for/asking when I see the BS this week? Because it isn't the BS who did the actual surgery on me, I feel like I may not get as much info as I want. I will get the results of the sentinel node biopsy, find out if my margins were clear, and I want to ask, what's next? I have not had the Oncotype DX test, and it has not yet been discussed. After reading about it recently, and hearing from a friend of my husband's that she's glad she had the test, I feel like I should ask for the test.

As for how I am feeling, I mainly just feel "tight" and a bit achy from under my armpits to the center of my chest. Tonight, I started feeling a few quick, sharp pains in/around my right nipple. I'm guessing it's just from my nerves starting to wake up. Some of my breast skin is sensitive to the touch, and some is numb. Some of my sutures are quite noticeable, and in other areas, I can't see them under the skin. I'm still sleeping on my back for the most part, because it's a little uncomfortable on my side. I am wearing Moena cotton bras 24/7. I unhook them for an hour or two a day.

I am supposed to return to work a week from tomorrow. I am a preschool teacher and I'm worried about all the up and down activities and occasionally having to physically engage one or two children who are still learning that they can't barrel through the classroom knocking over everyone and everything in their paths. Not to mention the group hugs I often receive!yikes! Also, do you have any idea how often preschoolers poke their teachers in the chest? Lol.

I know this is rambling. If anyone wants to ask me more about my experience, I'm happy to share! Feel free to offer advice to me, too!