Why did you choose what you chose?

Trvler · February 2015

I am really struggling making a decision on what to do. Everyone seems so confident of their decision.

I am only stage 1-2 and I have existing implants. I have been told to have them removed but I could easily put new ones in with no TE's.

How did you choose and why? Why did you choose implants over fat grafting? I know some people don't HAVE enough fat. I get that.

Single….? Double???

Help!

lulud471 · February 2015

I know it's an extremely personal decision and there are tons of factors but here's my story. I had ILC in one breast. Very small: 1mm. I had the choice of lumpectomy with 7 weeks radiation & 5 years of hormone therapy or BMX with optional hormone therapy. Below are the reasons I initially chose BMX with immediate reconstruction using implants & alloderm (though that failed & I had DIEP two years later).

1. ILC is very hard to catch on any scans because it forms in more like a spiderweb fashion than a lump. I was lucky that micro-calcifications tipped us off to a problem, then needle biopsy showed LCIS then excisional biopsy showed ILC. I am a worrier, so I didn't want to constantly be worried that I had more ILC but it wasn't being found on annual mammograms. Plus I had dense breasts which can make it difficult to catch things on imaging.

2. ILC is more prone to causing cancer in the other breast, so that's why I did the bilateral MX. But I probably would've done both anyway because of symmetry and because I knew I wouldn't want to go thru it a second time if it did go to the other breast.

3. I don't usually tolerate medication side effects very well, so I didn't want to do the hormone therapy.

4. I wanted immediate reconstruction & the only form of that available in my area was implants with alloderm. It failed (body rejected implants), had healing/infection problems for almost a year then waited until I was healed for a year & ended up going 3 hours from home (Philadelphia) for DIEP where basically they use belly fat to create breasts.

Arm yourself with as much knowledge as possible to make the decision that's right for you AND so that you feel confident with it. However, if you are a googler, please be sure to stay with only reputable sites like Mayo Clinic & the like - not using information from people like me who may be remembering some of the facts wrong, etc.

While going through the year of infection problems, I was definitely questioning the decisions I made. But ultimately now I am very happy & my only regret is not going to Philadelphia for DIEP (I think they can do BMX with immediate DIEP).

I am actually very aggravated with a family member or two who have recently said my cancer was so small I shouldn't have done such a radical step. While it aggravates me, I really don't care, because I am the one that has to live with the consequences of my decisions. I wish you the very very best in your decision-making & in your journey! Godspeed!

Trvler · February 2015

Thanks for your input, Dillon! I have to run to the doctor now but I will review your post further later.

MerrellGirl · February 2015

Trvler,

It may seem that others are super confident in their choice, but almost no one gets there without first going thru where you are now. It is tough to know what to do. As Lisa said above, do your research if you're a researcher - otherwise scour these discussion boards until your gut starts to lead you toward a decision. I agree with Lisa, I wanted a bilateral mastectomy to reduce the chances of going thru this again with the other breast. I needed radiation, and my research showed implants don't do well in radiated tissue, so I didn't give myself the implant option. All along I've tried to make decisions that I will be happy I made in 5-10 years, even if the upfront costs seem greater to my friends and family. That meant traveling to New Orleans for a stacked flap procedure (I didn't have enuf abdomen tissue for straight DIEP). I am glad I made that choice, of the choices that were available. Start with the type of bc you had, and the likelihood of you needing radiation. Radiation changes a lot of things and really impacts reconstruction.

angelia50 · February 2015

I did implant because it seemed the easiest thing to do. The idea of a long surgery, which the flap is, and a longer hospital stay, just was not something I wanted to do. It was medically necessary for my mastectomy, so I had no choice on that surgery. I just had exchange in December, but so far, I am happy with my choice. Even if for some reason this fails, I cannot see me thinking I want to do the flap, its a major surgery and again, just not for me.

Chloesmom · February 2015

I chose BMX because I was afraid the ILC was hiding in the other breast even though lumpectomy and rads were recommended. After the fact the doctor said goodby hinged did BMX. As I would have been back with cancer there too. Once and done is my motto. No extra pain, no tweaking, no IVs with screening MRIs, no sleepless nights with mammograms, nothing pressing on my chest muscles making it hard to swim, no fussing with partial forms, no side effects from rads, Got a t shirt too with bathing suit pockets and forms for when I need boobs. The rest of the time I'm flat and free

AnotherLifeExperience · February 2015

I chose a BMX because I did not want to face this again if I could possibly help avoid it. I had already had 1 biopsy in the other breast a few years ago, and they were watching one suspicious area. Notto mention all the micro-cacifications and cysts present. I also did not want to do the 5 weeks of radiation. Once I made my decision, I felt at peace. I knew I had made the right decision for me.

Trvler · February 2015

Ok, I am really kind of confused but here's the situation. I have existing 30 year old implants and the plastic surgeon told me I should, without a doubt remove them and either replace or do the diep. I was leaning towards DIEP because I don't really want any more implants and this was my chance to get them out. But then I met with the surgeon and he thinks I should leave them alone and go for the lumpectomy since I was BRAC negative.

He says there is a 50% chance I will have to replace the affected implant after radiation.

Jerseygirl927 · February 2015

Ok, here is my intake on breast implants etc. I was a bra fitter for 10 years, doing sizing, lumpectomies, mastectomy fittings etc. On the whole most people were never satisfied.....fresh new implants, hard, lopsided, uncomfortable, etc. no one seemed to be happy. Now I just developed my cancer, and in thinking back, I new I was never going for the implants, or the fatty belly pockets etc...put me in a comfortable bra, put the insertion in, whatever size you want to be, its done and over....besides having that fatty tissue in my body, where possible tumors or other breast cancers could occur, tells me I dont want to be doing this again....I am young enough but the pain and worryness, would always be with me...still is....unfortunately..

SpecialK · February 2015

Read Beesie's post mid-page on Dec. 29, it has some good food for thought.

https://community.breastcancer.org/forum/96/topic/816245?page=1#post_3835034

MinusTwo · February 2015

Special - thanks for posting the link. Lots of very valuable food for thought.

Susug · February 2015

Trvler, I have existing implants was undecided on what to do. After talking with BS and oncologist I decided to on lumpectomy and radiation my doctors suggested that also. My twin sister had a double mx but hers was more advanced than mine and it was in her lymph nodes. I do think it is more how you feel about it. No one can make that decision for you. Some don't even have a second thought they go for the DM for pease of mind . I did have the genetic testing it came back negative but if it had been positive I would have gone with the double mx. Also they did A MRI on both breast after lumpectomy and my other breast was fine.i will be thinking of you during this difficult time Hugs Sus

Trvler · February 2015

Susug: HOw old are your implants? How did radiation impact them? How much of a 'dent' is in your breast? I am concerned that I am going to have a huge unfixable gouge in my breast. I have very little tissue of my own in my breasts. It's largely implant.

Also, if the radiation impacts the implant, I will have to have a possible second surgery to have the scarring removed.

SpecialK: I had seen that page before but I will read through it again.

I am thinking of getting a second opinion, both from a surgeon and the plastic surgeon.

I like the surgeon's approach to dealing with nodes, which is to do as little as possible to avoid SE's. But I think he is making me to feel like I am being unreasonable with concern about a) my existing implants and b) my appearance. I know if I had stage 4, they would be like, you are going to maybe die and you are worried about your appearance? But now I feel like it is 'get rid of your cancer and how can you even think about your appearance"?

Susug · February 2015

my implants are 10 yrs old.my lump ( 4 mm)was very close to the nipple so my scar is in the edge of my areole so there is not an indention. I had a MRI after my lumpectomy they said my implants were intact. The radiation did not affect my implants at all.( 6 weeks of rads). Trvler this cancer we are dealing with is out of our control BUT our appearance and the the way we look and feel is in our control please don't let anyone not even a doctor make you feel guilty about caring about wanting to feel good about yourself . Just because we have this crapy bc doesn't mean ours live a are over. Call me vain or whatever but I care about the way i look everyday some days I may not feel good but by damn I'm going to try to look good.Do you know the size of you lump

Trvler · February 2015

It's really confusing to me because I think there might be more than one lump totaling 2.9cm, the biggest being 1.1 cm. They are located to the far left of my left chest cavity. The PC thought the nipples could easily be saved but the BS wasn't so sure. I just don't like how much they disagreed. It doesn't make me comfortable. I have had small surgeries before and I was always surprised by things like the size of the scar. If there is going to be a big gouge out of my breast, I want to know ahead of time.

Why did you choose what you chose?

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