Reconstruction questions

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Dovely
Dovely Member Posts: 91
edited October 2018 in Breast Reconstruction

Hello ladies. I am basically finding out on Friday if I get to keep my boobs or not. Nutshell of my story: 2cm IDC tumor in left breast that my surgeon is confident can be removed via lumpectomy and she's forecasting radiation and inhibitors. BUT, when getting pre-surgery MRI, 4 small lumps appeared on both breasts in almost the same spot on both sides, different quadrant than cancer. All four are less that a cm. I am having them biopsied. Could be fibroadenomas (I already have a benign one near the cancer and have SUPER dense tissue) or it it could be more spots of cancer.

Here is where I'm at: if cancer is in both breasts, I'm getting a double mastectomy with recon. If right breast remains healthy and another cancer is found on left side, either uni or bi (hard decision, leaning towards bi). If (fingers crossed) all lit up MRI spots are all benign, lumpectomy as planned.

She says I'm a great candidate for a skin and nipple sparing direct to implant, being young (42), thin and good breast shape. I would love to hear stories of those that have had that (and also, silicone or saline) as well as pros and cons of uni or bi if one breast definitely had to be done and one was still healthy.

(Posted this in two topics because I wasn’t sure which would be best)

Comments

  • Lula73
    Lula73 Member Posts: 1,824
    edited October 2018

    Hoping the biopsies come back benign. Did your dr talk with you about other types of recon besides implants especially since you're on the young side of the fence?

  • Mamabear80
    Mamabear80 Member Posts: 6
    edited October 2018

    Hi Dovely. These decisions are so tough. I had a similar diagnosis initially. 36 years old at diagnosis, Left breast, IDC 2cm as well as DCIS. Because there was more than one spot and a strong family history I decided on a double mastectomy. I was shocked to find that even with the double mastectomy I did not have clear margins (which is rare). I went back into surgery to have even more tissue taken and thankfully after that my margins were clear. I did have skin sparing but not nipple sparing. I had my full reconstruction with silicone “gummy bear” implants and new nipples completed in June and I am so happy with the results! They feel great and friends and family are shocked at how natural they look. I’m definitely scarred, but thankful for the outcome. The process and options can be overwhelming but it helped for me to really trust my team and practice patience. It was worth it. Hoping the biopsies are benign and that you have a successful surgery/reconstruction process!

  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited October 2018

    I had BMX with DTI - silicone. The cancer was only in one breast and actually gone after chemo. I opted to remove the other one because some areas had shown on MRI before treatment and one remained afterwards. It was not concerning enough to biopsy, but I didn't want to rescan in 6 months and follow. I was also concerned about symmetry and figured I didn't want to have to do extra surgeries for matching purposes.

    My feeling is that with some cancers and some boobs - lumpectomy is a great choice. For others, not so much. My lump was at 12 o'clock on a smallish breast, found by me 4 months after clear mammo, and triple positive. BMX, while not perfect, was the right choice for me.

    Feel free to ask any questions!

  • Dovely
    Dovely Member Posts: 91
    edited October 2018

    Thanks for the responses! Right now I'm leaning towards if any more cancer is found in either breast, to just do a BMX.I am having genetic testing done, great grandmother died of BC at 50 but no other cases of that or Ovarian in the family.

    One question about the implants: I am really thin, but I have actually a b/c cup currently (used to be a 30d in my twenties) but breast feeding and age has made my upper breast area bonier and the “meat" of my breast lower. Does the “gummy bear" implant alleviate the issue with an obvious line?

  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited October 2018

    Do you mean the anatomical or shaped implants? That's what I have. There is still a "step off" because no matter how tapered they are at the top - it still isn't flawless. Fat grafting would help with that.

  • Dovely
    Dovely Member Posts: 91
    edited October 2018

    Yes I think that's what mean. I just have such a bony chest. I am trying to focus on no more cancer rather than the superficial stuff that clearly is not even remotely as important. But... I had great boobs (especially in my younger days) and I'll miss them and it's hard to imagine what it would feel like to have a replacement

  • VegGal
    VegGal Member Posts: 507
    edited October 2018

    Fat grafting will take care of the "skinny bones" and one can be thin and still have plenty of "donor fat."

    In my case, I had dense breasts and a tiny speck of DCIS in one of them. I'd had call backs with previous mammograms, and I hated the stress. By doing a BMX I am forever free of any mammos, and for that, it is a HUGE relief.  I also avoided radiation, which for me was a big plus as well. 

    During pathology, my cancer free breast was noted to have dilated ducts and lots of fibrous tissue. It wasn't completely normal and my "gut" tells me that it was "only a matter of time" before it would have issues as well. 

    Good luck with your decision. 

  • Dovely
    Dovely Member Posts: 91
    edited October 2018

    VegGall, I’m totally with you on your decision making process. Just this agonizing process and the future of risks, my type of tissue, andsurveillance is leaning me towards bmx. Thanks for sharing your thoughts.

  • hapa
    hapa Member Posts: 920
    edited October 2018

    I had NSBMX about two months ago. I am 42 as well, and on the thin side (BMI ~20). I posted pictures of my outcome over on the pictures forum, but in a nutshell my prophylactic side is a little messed up and will need a revision, but my PS says that will be an easy surgery with minimal recovery. The asymmetry isn't noticeable in clothes, and my husband doesn't think it's worth fixing but I they're not his tits so I'm fixing them anyway. I went for bilateral instead of uni because I wanted to keep them matched and not have to worry about one sagging while the other stays perky as I age. My implants are pre-pec and the edges look odd so I will probably have fat grafting sometime after the revision surgery (which will be at least six months after I finish rads, which starts next week). Lumpectomy wasn't ever an option for me, but I wanted them lobbed off regardless as they obviously couldn't be trusted.

  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited October 2018

    It's really impossible to imagine what it will be like. I ended up having to make a list of pros and cons of either decision. Even though I had chemo first and plenty of time to decide - I was still debating when time was up!

    Whatever you decide will be okay. While there are no good choices, there are also no bad ones. Does that even make sense?

    And keep in mind that the initial few months after surgery takes some adjusting to. And that things change over time. I was not very happy right after surgery and was convinced that I would need a complete redo - too big, too wide, too flat. Things change and settle over time. I'm glad that I really didn't want to go through more surgery because that kept me out and now I'm pretty happy with things.

  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited October 2018

    I had a similar situation at first. I had known cancer on the left side and needed a mastectomy for that as radiation was contraindicated for me. I wanted to keep the right side because I knew I would miss having sensation. I ended up having cancer on both sides so both had to go. I looked into my options but DIEP was out because I didn't have enough fat for it. I ended up with standard round very high profile silicone implants, nipple reconstruction and tattooing, and fat grafting, and am very happy with the results.

    If I hadn't had cancer in both breasts, though, I would have kept the healthy side. I DO miss sensation, quite a bit.

  • Dovely
    Dovely Member Posts: 91
    edited October 2018

    summerangel, looks like we’re similar. I have it in both too, just found out. BMX on Wednesday, meeting with PS on Monday. Any advice

  • rachelcarter35
    rachelcarter35 Member Posts: 368
    edited October 2018

    Dovely the 'superficial 'part of this - feeling okay when you look in the mirror is important. I remember while making these decisions feeling uncomfortable about it....like I was being too vain - but this is hard enough without at least coming out of it feeling reasonably okay about our bodies if we can. So give yourself permission to figure out what works for you aesthetically. Its part of the process., advocating for yourself on all fronts.

  • Dovely
    Dovely Member Posts: 91
    edited October 2018

    rachel, I think you're right in that. It is important to feel good when you look in the mirror and also accept that while they're not exactly what you were born with, they would have and have changed considerably over time anyway. I think we get a free pass for all this superficial stuff as survivors

  • LiveWellToday
    LiveWellToday Member Posts: 35
    edited October 2018

    hi. Did anyone have radiation on their tissue expanders and what were the results

  • CaliKelly
    CaliKelly Member Posts: 474
    edited October 2018

    livewelltoday, I had radiation on my cancer side while I had tissue expander, initially didn't seem to affect it at all, skin stayed nice, smooth. So after healing from rads, I had implant surgery, under the pectoral muscle. The "good" side got small implant to kind of lift it. All looked ok for about a year, then the radiated side kind of tightened up and got higher, felt harder. Also hated having pec muscle over my boob. I like to weight train and that muscle kept jumping all over! Looked mighty peculiar!😄 Dovey ,I had cancer in one breast, so I only had one removed. Figured if it ever pops up on other side, do it all again. I couldn't see cutting away something that was healthy! Anyway ,ended up with L.D. flap and fat grafting, which, dissipated. Will get more grafts when I revise scar. Looks pretty darn good, but still working on It!

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