BRCA1 Positive - not sure about reconstruction after bilateral

Hi DLisa-

We want to welcome you to our community here at BCO! Our Reconstruction forum is full of really valuable information, we would suggest taking some time to read through the posts over there and connecting with members who have been in your shoes. It's a very personal decision, but hearing from others and getting to know their stories can really help!

The Mods

Hi DLisa53:

My situation is a little different, because I had bilateral breast cancer. I had a bilateral mastectomy without reconstruction at age 52. I also consulted a plastic surgeon, and my reconstruction options were: (a) saline or silicone implants (immediate to implant or two-step with expanders); or (b) latissimus dorsi flap (using muscle from the shoulder blade area). I chose no reconstruction because I wanted as little surgical intervention as possible, and did not want to experience any of the possible complications of reconstruction. I also did not want to deal with possible revisions or replacement of implants (due to their limited lifetime), to put anything under my chest muscle, or to cut into and move healthy back muscles that I use. I would not have elected any autologous tissue procedure, even if I qualified, because I did not want to impact a second site. This is just how I felt about it, and many people choose differently.

I found the information at the breastfree.org site created by BC.org member Erica (aka Barbara), to be one of the best sources about mastectomy without reconstruction:

http://breastfree.org

There you will find information about why others chose not to reconstruct, personal stories and photos (see menu at right), plus useful information about surgery, various types of prosthesis ("forms"), as well as going without prosthesis ("going flat").

I note that rates of reconstruction are around 50%. There may be some access problems, but many women choose no reconstruction.

http://www.medscape.com/viewarticle/830208

I have a pretty nice surgical result. I made it clear to my surgeon that I wanted to be as flat and smooth as possible. From photos I have seen, it seems that smoother results may be easier to achieve for a leaner person (you could ask about that). My surgeon liked angled incisions (versus horizontal), which was also my preference (looks like a gentle 25-30 degree angle up and outward).

By the way, I don't have any posture problems. While it is important to be cognizant of maintaining good posture (and not assuming a protective posture after surgery), wearing forms is not required (compare a little girl). I go flat at home, wear an "empty" bra with two pads for exercise, or wear size 1, extremely lightweight microbead forms most of the rest of the time. I have a pair of very nice silicone forms also, but I don't wear them too often.

Good luck whatever you decide!

BarredOwl

Age 52 at diagnosis - Bilateral breast cancer - Stage IA IDC - BRCA negative;

Bilateral mastectomy and SNB without reconstruction 9/2013

Dx Right: ER+PR+ DCIS (5+ cm) with IDC (1.5 mm) and micro-invasion < 1 mm; Grade 2 (IDC); 0/4 nodes.

Dx Left: ER+PR+ DCIS (5+ cm); Grade 2 (majority) and grade 3; isolated tumor cells in 1/1 nodes (pN0i+(sn)).

DLisa,

Please keep us posted with what you decide or let us know if you have more questions!

--The Mods