DCIS - so confused on surgery option

Hi Carla --

I was in a similar position to you and decided to do a double mastectomy with immediate, direct-to-implant reconstruction (no tissue expanders), using alloderm, and silicone implants placed on top of the muscle (pre-pectorally) rather than underneath the muscle. The reason I chose that route was to have as few surgeries as possible and to reduce the recovery time. Not all surgeons will perform this as it is newer than the older, under-the-muscle technique, or using tissue expanders. I am only three days out from surgery but so far so good. I have full range of motion in my arms. I have some chest tightness and soreness and itching, but the pain is not severe. My plastic surgeon said she did some manipulation of the area of the pectoral muscles where they meet the implants so that the area will be smoother and you won't see a sharp line there. I have four drains in and that is the hardest part because I cannot shower until the drains come out. And I don't like wearing the surgical bra 24/7 because it is tight. But I can live with it for now.

If you decide to go the mastectomy route and can do nipple-sparing, you might want to look into that. That way the incision would be in the inframammary fold underneath the breast and it is almost invisible. That was not an option for me because my DCIS was directly under my left nipple. Ultimately I decided to have them remove both nipples so that I will get the most symmetrical outcome possible. My surgeon used a vertical incision so that she could lift and tighten each breast. I got smooth round Mentor silicone implants. I will eventually get nipple tattoos. On the plus side, once this is over I won't need to wear a bra anymore -- woo hoo! (I always hated wearing bras.) If anyone had told me years ago that I would get implants and tattoos I would have said they were crazy, but here I am!

Hi all. I'm also new here.

Briefly (long) 😁 history. At the time of my CA I was 36. I am now 38. I was diagnosed with Uterine Cancer back in May 2016. Early stage, Stage 1A.

I found a lump in my left breast about 6 months later and had a mammogram done and they found the calcification in my right breast. Go figure 🙄. They weren't going to biopsy the area but I demanded they do since I just got done having a radical hysterectomy for cancer. Well, glad I did because because they found the area in my breast to be Atypical Ductal Cell Hyperplasia.

Well because of my Uterine Cancer my breast surgeon and oncologist had me do genetic testing/family history. The genetic counselor found that I'm at a 43.4% chance of getting breast cancerin my lifetime 😬

My breast surgeon is recommending a Bilateral Mastectomy but Insurance will not cover reconstructive surgery which is $10,000 🤔

So a little over a year later my breast surgeon said I have to have a Lumpectomy. There has been little to no growth to this area.

I am going into Surgery this Friday for a Lumpectomy.

My question, finally is. Is it possible to have DCIS but with very little growth noted on a mammogram?

I'm so scared it's going to be upgraded from ADH to DCIS

I strongly recommend that you review images of mastectomy results so that you can really see what end result could be. I didn't have a choice as I had 4 high grade tumors. I'm sorry you find yourself in the situation. I haven't gotten used to feeling cold imp!ants where warm breasts used to be. There's a lot to consider and there could be lasting impacts besides amputation of the breast.

Best wishes for you.

Aprila- so your insurance company told you they don’t cover reconstruction after mastectomy or is it possible cosmetic procedures not being covered is getting in the mix somehow causing confusion?

it is the law in every US state if mastectomy is covered, recon of your choice is also covered.

There is also the option of direct-to-implant reconstruction at the same time as the mastectomy, as long as you are ok with being with about the same size or a little smaller, depending on the blood flow to your skin. I had 530 ccs taken out on each side and 550 ccs put in, pre-pectorally.

CarlaJG - I was diagnosed with DCIS last October and knew I would constantly be looking over my shoulder if I didn't do a BMX. I just didn't want the constant anxiety. I was able to go the direct to implant route but knew depending on what they found, condition of skin, etc I could have potentially woken up with expanders. I've had absolutely no issues and am so thankful for this option. The first few days you really have to take it easy, the drains are a major pain in the butt but I didn't find the recovery to be too bad. 4 weeks later I hosted Xmas Even and 5 weeks later I traveled up North for a long NYE weekend. I was diligent about the exercises and got back into yoga after week 6 and I think that made a huge difference in my recovery and range of motion. Glad you've made a decision you feel good about. Wishing you the best of luck, you got this!