Breast reconstruction at stage III

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Misstic
Misstic Member Posts: 115
edited June 2019 in Stage III Breast Cancer

Hello Ladies

I would like to know if some of you had a breast reconstruction after a stage III cancer. I had the implant illness when I was diagnosed at stage II so I can only consider autologous reconstruction (DIEP, SGAP or latissimus dorsi)... I am scared about a new recurrence because I read that surgery could be an increased risk of recurrence. And the next step for me, being IIIC, is stage IV. I would love to read successful testimonies or warning if any.

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited April 2019

    I had DIEP in 2013 and am well today. My sister, who had full-blown IBC, had her DIEP in 2015 and is also well. I know many women with Stage III diagnoses who have had autologous reconstruction and have had no recurrence. I understand your concern, though. Does your oncologist have an opinion?

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  • Misstic
    Misstic Member Posts: 115
    edited April 2019

    So happy to read you Elizabeth.

    It is a no go for my fisrt surgeon. He wants to do silicon based implant even if I had implant illness with a not textured one (which seems to me a craziness).

    I had a second opinion and this surgeon thinks the best is latissimus dorsi.

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited April 2019

    Surgeons will, of course, recommend what they know they can do. A DIEP can only be performed by a surgeon who is trained and experienced in the vascular microsurgery necessary.

    Tissue expanders and implants have a high rate of failure in radiated tissue. With my particular cancer and treatment, my only option was a flap-type surgery. I chose DIEP because after a full-term twin pregnancy, I had a generous amount of abdominal skin and tissue to contribute!

    You might look around for a plastic surgeon experienced in free-flap procedures, like DIEP. The nearest cancer center or university-based hospital can probably help you find one.

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  • Lula73
    Lula73 Member Posts: 1,824
    edited May 2019

    Misstic - the surgery increases risk of recurrence theory has been debunked. Do not let that bad data sway you. Muscle sparing flap procedures are better than those that use muscle. You use your Lats every day. You need them as you age for your posture, you need them to swim, you need them for many things. You don't need your tummy fat for anything. And the vast majority of the time the lat muscle is used to create a pocket for an implant to sit in...so you’re back to implants again. Definitely check out the latissimus dorsi board on here before deciding. Also, I echo sbelizabeth's post in that only a microsurgeon who specializes in DIEP can evaluate your candidacy for DIEP. Most PSs are NOT microsurgeons (Lat Flap does not require microsurgery). If they don't do DIEP, don't let them tell you you're not a candidate or push you into a flap that uses muscle. Do you know if that second PS does DIEP and is a microsurgeon? Most PSs won’t offer recon options they don’t perform themselves.

    https://community.breastcancer.org/forum/44/topics/751135?page=211#post_5362969


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  • karen1956
    karen1956 Member Posts: 6,503
    edited June 2019

    Expanders and silicone implants - expanders placed at time of bilat....exchange 13 months later - had 2 or 3 revisions - last one was in 2008, so my implants are 11 years old next month!!

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  • Misstic
    Misstic Member Posts: 115
    edited June 2019

    My MO announced me that, because of my IIIC stage, I have to wait for 2 years before reconstruction. I feel more accustomed to my concave mastectomy but it's hard to see my body like this.

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited June 2019

    Misstic, are you in the US? I'd heard that the UK's system wanted to be sure we lived long enough for recon to be worth it (!!) but the only required delay I knew about here was 6 months after rads are finished, to let the damaged tissue settle down.

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  • Misstic
    Misstic Member Posts: 115
    edited June 2019

    No Elizabeth, I live in Europe (France, where the health insurance is free). This is just a question of safety: I had a lump (5mm) which grew on the sternum after the mastectomy and it is very difficult for one of the best breast cancer center in France to figure out what it was exactly. I had a surgery, the test said it was mainly fat, "very rare cells" (sic) which seems to not be luminal anymore but they expressed a lot of proteins seen only in luminal cancers. The team is trying to understand what it is exactly. They asked for all my previous samples to understand what happened with this cells. So the surgeon told me during the last consultation I have to be stable for 2 years before I could get the reconstruction.

    Maybe an effect of the keto diet or Fulvestrant. The lump grew on a place who was not irradiated during RT. My first BC was DCIS + mucinous, a very rare condition.

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