Diagnosis -Surgery Changes

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calhoun38
calhoun38 Member Posts: 1
edited October 2014 in IDC (Invasive Ductal Carcinoma)

I had a bmx scheduled in a few weeks.  Based on pathology and MRI all were confident there was no further treatment needed. Immediate expanders planned. Now I'm told it is recommended to only do the one side if nodes are positive, heal and do the other side with both expanders in a second surgery.  

Seems like there are second thoughts about negative nodes, possible chemo that might be needed  haven seen this mentioned anywhere in the forum so, wondering if anyone has experienced?

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  • ml143333
    ml143333 Member Posts: 658
    edited October 2014

    I had a BMX in August with immediate implants.  I was node negative.  When I told my surgeon what I wanted to do, she was fine with whatever my decision was and actually preferred the BMX.  Because I was node negative, and had a BMX, no radiation was necessary.  I am undergoing chemotherapy because my Oncotype score came back in the intermediate range (23).

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  • Sunflowercat
    Sunflowercat Member Posts: 177
    edited October 2014

    Delaying expanders is sometimes done when the person needs radiation.  This way there's no risk of the radiation damaging the expanders (or implants) and you can let the skin heal so the PS knows what they're really working with when it comes time to reconstruct the breast.  There are several factors that can indicate if you need chemo or not and it really depends on your tumor pathology and node involvement.  If you have negative nodes an Oncotype test can determine if chemo would help you.  

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited October 2014

    Just for purposes of clarity - Oncotype Dx can only be used if you are ER+, regardless of nodal status. Are they planning to make this decision based on your SNB in the OR since your MRI imaging appears to be negative?  That would involve having the plastic surgeon there ready, only to possibly be waved off if the SNB is positive.  I am not sure most plastic surgeons would agree to that.  I would ask about having the BMX with TE placement even if the SNB is positive, filling, overfilling the side that needs radiation, having rads and then waiting a while for exchange.  I would rather radiate already stretched skin than try to stretch skin after radiation.

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  • Maureen1
    Maureen1 Member Posts: 614
    edited October 2014

    So sorry to hear your team is having second thoughts about your plan, it helped me to have a plan and get my mind and body ready for what I was facing, I hope things come together for you soon...I wanted to know the pathology of my lump before I made a final decision about mastectomy so I had a lumpectomy and an axillary node dissection first.  After I completed chemo I had a skin sparing BMX with immediate reconstruction with implants. I have been very satisfied with the immediate reconstruction. I had to go back once to release a capsular contraction but that was a minor procedure. I did not do radiation even though I had positive nodes. In my case the RO said it would only give me a 5% reduction in the risk of local recurrence. Since I had great margins with my lumpectomy and planned to have a BMX the RO and MO didn't think radiation was necessary in my case. Some of the best advice I got was to remember that it was my body, my decision so make the decision based on the facts at hand and don't look back or second guess yourself...I'll keep you in my thoughts and prayers as you prepare for surgery, (((Hugs))) Maureen

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