BMX/recon and follow-up mammos?? Really still necessary?

Anonymous · August 2016

Not sure where to put this, so here goes. I have NOT had a mammo since my BMX/recon 3 years ago, but I just talked to my dental hygenist, who also had bc, and had a unilateral mx with recon. She says that she GETS regular mammos, of course, on her good breast. But she just told me they do her reconstructed breast too!

I've NEVER heard a recommendation from my MO, surgeon, PS or any other medical person that I needed mammos post BMX, since there is no tissue really to scan. But is that right? Do any of you get mammos post BMX? I"m wondering if I need to have a conversation with my MO next month at my checkup.

I also had fat injections in 2014, one year after my BMX/immediate recon. Would that make a difference in whether I should get mammos or not? I can't believe I'm asking this. I thought we were done with scans once we had no breasts.

I would need a US/MRI anyway, since I have/had dense breasts, and would be worried that something would be missed with a mammo. I had five yearly mammos over five years and all came back "clear" with a dense breast notation. All the while, the little ilc I had was wreaking havoc in my right boob.

Hoping I can hear from others about this question. I'm kind of shocked that it might be necessary and no one told me.

Claire in AZ

fredntan · August 2016

http://www.breastcancer.org/treatment/surgery/reco...

the answer is no. sounds like someone is ordering unnecessary scans just for the money

debiann · August 2016

I haven't heard of doing a mammo on the reconstructed side, but perhaps there is a reason? Maybe if she had a nipple sparing procedure?

I had BMX with DIEP recon. My BS said I will get a breast MRI at 3 years post surgery. I don't know if that means every 3 years or just once.

leftduetostupidmods · August 2016

Not only it's not necessary but it can damage the implant and other tissue. I'm sure if her PS would find out what's going on he'd catch on fire.

nash · August 2016

I have a mammo on my lat flap with implant reconstructed side every year. When I questioned it the first time due to the lack of breast tissue, I was told "it's to check the implant".

My onc, who is In the same group as my surgeon (who is a combo BS/PS) says he thinks the mammo on the foob is completely ridiculous and swears theirs is the only facility on the planet that does it. But apparently there are others!

Anonymous · August 2016

Hi all, I did have nipple-sparing surgery. But my PS did a biopsy of the tissue there before we detached them and they came back negative.

@Nash, that's what my dental hygienist said. She was told it was to see if there were any problems around the implant....?

Fredntan, I'd be suspicious of that myself.

Seachain, I also wondered about that. I asked her how they did it and she said they get enough to be able to scan...but it sure sounds sketchy to me.

Keep the responses coming, gang. This is one I'm really interested in knowing more about.

Arizona Claire

KBeee · August 2016

Imaging generally is not gone, but keep in mind, recurrences can still happen so you need to be vigilant with self exams.

Yaniza · August 2016

I had a bilateral mastectomy 2 month ago with skin/nipple sparing and was told that I would not need mammograms going forward.

LML · August 2016

I had a bilateral mastectomy in 2008, and I was told no more mammograms for me by my oncologist and gynecologist.

I was told by my PS that I should have MRI's once every 3 years to check the implants from reconstruction, but no one will order it! I have asked primary doctor, oncologist and gyn and they all point fingers to each other! Frustrating!

SpecialK · August 2016

I had skin and nipple sparing bi-lat mastectomy, with the area under the NAC cored out and sent to pathology. I have no tissue underneath the nipple, it is flat on top of the implant. I have never been told, or had, a mammogram since my surgery in 2010.

Mominator · August 2016

I'm the same as SpecialK: skin and nipple sparing BMX, the tissue under the nipple area was sent to pathology. Theoretically, I have no more breast tissue. BMX was November 2015. I'm due for my first annual GYN check up post-surgery soon.

I was told by BS, PS, and my regular GYN: no more mammograms. Just clinical and self breast exams. Any problems will be examined by ultrasound and/or MRI.

coraleliz · August 2016

I have participated in other threads on this topic. From what I remember, mamograms following MX were more common in Canada & Europe. There were stories of mamograms being done even on those without recon. Not sure it would work on me, no loose tissue. I also remember someone being treated at UCLA, had recon & was getting mamograms there.

Meow13 · August 2016

Yes I have both MRI and mammogram on DIEP side too. As a matter of fact I just had a biopsy on DIEP when MRI showed something. It turned out to be nothing but fat necrosis. They did think it would be unusual to find anything since it wasn't breast tissue, but I sure dont want biopsy on every scare. Im on high surveillance more than usual since I didn't do recommended chemo just did AI drugs.

Meow13 · August 2016

I had the maximum amount of skin taken because my 2 tumors were close to the surface. Thankfully no skin was involved but my risk of breast cancer returning to the reconstructed side are low but not zero. My insurance still pays for the monitoring.

SpecialK · August 2016

kayb - My nip sparing literally just left the nip as a decoration with all tissue scraped, which - you are correct - is different from a subcutaneous MX. Interestingly, there is no updated description of this type of procedure from an insurance perspective and I have seen a few nip sparing surgeries denied due to insurance thinking this is not an appropriate type of surgery, and assuming it is cosmetic.

Anonymous · August 2016

So I'm confused....still, a bit.

As I mentioned I had nipple-sparing BMX but like others the underneath the nipple tissue was sent to the lab for examination and all was fine.

I had fat injected into parts of my radiated breast to even it out a year after my BMX.

Should I ask my PS about this? He's not an oncologist, but he has years of skilled experience and I like him. The doc who removed the tissue is a general surgeon and not an oncology-surgeon, so I'm not sure I'd trust his advice. He's a great surgeon but not well-versed in something this specific.

Who should I ask about this? It seems there are two schools of thought about breast scans post-BMX. I am high-risk with the # of +nodes, but I also hate being hyper-managed by my medical team, too.

I wouldn't agree to a mammo--would want an MRI because of my previous breast density and tendency of ILC to hide and not be visible on mammos--which failed me for 5 years anyway. No one ever told me to do it every three years to check silicone implants, which is what I have.

And what about that fat tissue in my breasts now? Wouldn't that be considered tissue of sorts? Or is fat considered something else? Shouldn't that be monitored since it is a group of cells of a sort?

And yes, Kbee, regular monthly breast/underarm tissue exams go without saying, although others will benefit from your reminder. It's how I finally found the ILC in the first place, after five years of clear mammos. It was nearly in my armpit, and lying on top of my rib. I don't know if I would have found it otherwise, but being thin, there it was.

Claire

Anonymous · September 2017

Old thread but here's an update in case anyone else found it and wondered: I saw my PS earlier this past summer to make sure all was well in the reconstruction zone. It appeared fine after his physical exam, but he said, quote, that "it had been 4 years since my surgery, and although my surgeon was highly skilled (they've worked together for decades) there is still the chance that some breast tissue remained, and so we should follow it in case there was any tissue still there with an MRI, baseline type." I told him I'd ask my MO at my next check up, and did, and she agreed with him and ordered it, and I had it done a week ago.

The result showed no remaining tissue that the imaging could see, which was a relief and also reinforced my trust in my breast surgeon. I'm not going to stop with monthly exams of course. I know that there are always going to be microscopic cells that no scan can ever see, but at least what there is to see is okay so far.

claire in AZ

beach2beach · September 2017

thanks for the update. Interesting. I'm only a month + out but I was wondering whats down the road. I go back to BS in 6mths. The PS told me at 3years to get MRI because I had immediate implant done at time of surgery. When I go back to the Oncologist in 2mths I am going to see what she recommends.

Thanks and glad all is good!

nash · September 2017

I was told I was having a mammo on my foob "to check the implant".

SummerAngel · September 2017

I was just at my gyn last month for the first time since just after my reconstruction and she tried to order a mammogram. I flat-out refused. She said she thought, by the way my foobs look, that I might have remaining tissue. Um, no. My surgeon is well known for leaving nothing behind. I'll wait another year or two and see if I can get an MRI to check the implants.

Sassa · September 2017

I had reconstruction with implants. I do not have mammograms, but my oncologist orders yearly chest x-rays to make sure the lungs and chest wall under the implants have no problems.

BMX/recon and follow-up mammos?? Really still necessary?

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