Simultaneous Prophylactic BMX & Oophorectomy/Hysterectomy?

Hi Mybuddymypalb2-

Welcome to our community! We know it's not an easy decision, but it sounds like you've made the right decision for you.You may want to check out our forum on members who're at a high risk for breast cancer, there's lots of info there and some threads on prophylactic procedures you may find helpful: https://community.breastcancer.org/forum/47

The Mods

ShimmerGal- combining the oophorectomy with the mx at the same time will be up to the surgeon and likely will depend on what type of recon you're having. If you're going with no recon or implants the likelihood of combining the 2 is high. If you're going with natural tissue reconstruction then they would likely put the oophorectomy off until stage 2 (typically 3 months later) due to volume loss issues. I had BMX with immediate natural tissue recon and then had all the baby making parts removed in stage 2. Stage 2 is a much easier surgery too. If oophorectomy is done laparoscopically or lap-vag the recovery is much easier than open abdomen.

Love the new username, ShimmerGal! where are you looking at going for DIEP?

ShimmerGal- you may want to see if NOLA accepts your insurance. I’m assuming it’s tricare (but could be wrong). Pretty sure they take it. If nothing else it would give you a choice of facilities/docs to select from.

Here's the rundown of how travelining to NOLA for the surgery works. You also have a phone consult with their patient liaison Liz, Vickie will verify your benefits, and you will send photos of yourself via their secure email system. Vickie will tell you how much you need to pay to cover your out of pocket portion if any. When she gives you that number, and you pay it, that's it. They do not balance bill you if insurance doesn't pay what they thought they would. The center can also help you with lodging in an area hotel, you can rent an Airbnb or stayalfred or see if Hope Lodge has availability.

You need about 9-10 days in NOLA for stage 1:

Day 1 is travel day in

Day 2 is pre-op

Day 3 is Surgery

Day 4 & 5 are in Hospital

Day 6 is discharge

Day 9 is post-op visit

Day 10 is travel day home

You need about 8 days for stage 2:

Day 1 is travel day in

Day 2 is pre-op

Day 3 is Surgery

Day 4 is discharge

Day 7 is post-op visit

Day 8 is travel day home

You can always fly in the night before pre-op vs the day before and fly out evening of post-op visit to reduce the number of days. Unless you have major complications you will not need to travel back to NOLA until the next procedure is scheduled. Minor issues are handled via phone & email if pics are needed.

I don't know if you have schollage kids at home or not but if you do... You can leave the kids with a trusted friend or family member or bring them with. The center has a Murphy bed in your room if your DH wants to stay with you if it's just you two. If you bring the kids, DH and the kids can visit you during the day as they would do if you were at a local hospital and head back to the hotel or Airbnb afterward for the night. The patient to nurse ratio at the hospital there is 1:1, in a pinch 2:1, so its nothing like other hospitals where 1 nurse has 10+ patients. You will be well taken care of and promptly when DH isn't there. Once discharged, you'll stay at the hotel or Airbnb until post-op visit. Stage 2 is far less complicated and much easier and faster to recover from. A trusted friend or family member can definitely travel with you for that one if needed. My dad watched my kids for stage 1 and DH went with me. DH stayed home with kids for stage 2 while my mom accompanied me. We had intended to take the kids both times but they had things going on at school that they were very excited about and did not want to miss during stage 1 and our 12 year old had started a new school (traditional school where he had been in a more montessori style School) and was still transitioning when stage 2 happened and we felt he'd be better off staying the course at school. In short, it's definitely doable and almost all of us that have gone to NOLA traveled for it. (I'm in NC.)

I would certainly not do the mastectomy and the oo at the same time uhg you would be under for a really long time. My mastectomy and expanders install was like 6 or more hours and the recovery was long like 5 to 6 weeks.

My swap to implants was done with the TAH but the surgery rooms would not let me do orthoscopic at the same time so I did open abdominal and would not recomend that to anyone.

I also have the PALB2. If you need support or to talk to someone feel free to pm me. I two years out so it's helpful sometimes to talk with someone who has been there.

I think that is worthy of getting more information. Early menopause is wretched. Do you have a family history of cancer? They are still studying preventive dosing of tamoxifen etc. In my situation my mother's sister died of ovarian cancer at a young age so the MO OBgyn felt strongly about the OO.

I also think that time is on your side. Yoi have time to work through the process and get the information you need. Keep with the screening. They are not sure but the speculate that PALB2 acts more like braca2 but it's really all a guess. You Can Also Look up the specific gene abnormality from your report it might be helpful. The force website has some good info.

I have talked to some women with brca2 who travelled to get a DIEP. I did not have that option because of the cancer diagnosis unfortunately time was not on my side. I could have opted for a dbl mastectomy mastectomy then revisited the reconstruction after I was done with chemo.

It's a big shock give it time to sink in and be kind to yourself.

Hello! I just want to have an opinion from you all. I am carried a BRCA1 and my doctors said that i have to do a mastectomy and hysterectomy. I talked with a PS and he said that is better idea to do the mastectomy first and then wait to heal then we can do the reconstruction. I have big boobs so he is hoping my skin will shrink and my nipples go upper in place. He recommended the silicone implant for my breast reconstruction and then he will use a fat grafting for better shape. Any advise would be very appretiative.