Mammograms after reconstruction?
My friend had bilateral mastectomies and reconstruction. Now her pcp wants her to have a mammogram. She is questioning this. Has anyone had a similar experience
Comments
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Her pcp is wrong, no breast tissue no mammogram.
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Meow is correct. Routine mammograms are not done after mastectomies, though if there is a lump, they will sometimes try to squish the implant with a mammogram before doing MRI
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Heck, the only good thing I got out of bc was no more mammograms !
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I have mammograms on real side only now.
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If anything, she could have an ultrasound. But sometimes you have to be pretty firm refusing the mammos.
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I am not sure the insurance company woild pay for mammograms after a bmx. Besides there is no breast issue to analyze. I think perhaps there maybe benefit from an MRI.
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This is interesting to me. I had bmx with reconstruction in December and just had my exchange surgery a few weeks ago. When I saw my breast surgeon for my 6 month follow up, she scheduled a diagnostic mammogram to occur a year from that appointment, but no followup before then. My notes had indicated I would see her every 6 months for a few years, so the lack of a visit for an entire year concerned me (when I reviewed the notes a week ago), but also I was concerned about mammogram on a reconstructed breast, because that did not make sense to me. I asked about the mammogram issue then, and she said the wait was to ensure everything was properly healed from my exchange surgery. She also said she wanted to look for any changes in the area where my DCIS was before they became palpable.
Longer story, but I had re-excision for a close margin. The pathology report had an odd statement that I've been trying to get to the bottom of. I've asked her about it more than once, and she didn't understand it either. At this appointment, though, she said she thought the pathologist might be trying to cover himself. So when she scheduled a diagnostic mammogram, that concerned me that she is trying to cover herself. But I am a suspicious person by nature, and she has been completely straightforward with me so far and everything she has suggested has been aggressive toward addressing any risk.
I know it sounds like I've been completely irresponsible about this, but my mother had just passed away two weeks before I had the 6-month followup, and I have been dealing with the grief and handling her affairs and all that entails, plus everything else that goes on in a normal life, and I just could not add another thing to my plate. I stopped even reading this board for a few months, But as I read other posts on this issue, I'm concerned.
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It isn't common, but cancer can appear in the margins or scar tissue. In September I had a new lump on the mastectomy side. We suspected just a change to the scar tissue, but my PCP is aggressive so she wanted a mammogram. No cancer. But my BS ordered MRI and ultrasound, just to be safe. Again, not cancer.
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My gyno tried to schedule a mammogram for me the year after my surgery. I declined. She wasn't aware that mammograms weren't needed after a BMX. She just hadn't been educated on the subject.
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In my experience, a mammogram after DIEP reconstruction saved my life 7 years ago. My surgeon does recommend imaging after any TRAM flap type reconstruction. There is always, always some small amount of breast tissue remaining after mastectomy. Especially if a skin sparing mastectomy and even,more so if a nipple sparing mastectomy is performed.
I had a skin sparing bilaterally with immediate DIEP reconstruction. I did my year of chemo (Her2 pos) and saw my surgeon about 9 months after my last chemo for a mammo. There were 2 spots back by the chest wall, which would never have been palpable. One turned out to be nothing, the other was a cancer recurrence. Without that mammogram, I would not be here today with the agressive tumor I had going on. And my surgeon is no slouch, he is world class with a fantastic reputation. I always say that someone had to be the small percent with recurrence after mastectomy, so I guess it is me! Blessed to still be rocking it 9 and 7 years later!
So post recon imaging may not be appropriate in all cases, and I dont believe that there are guidelines for the situation in ASCO, so it is a roll of the dice and based on the opinion of your healthcare team.
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My follow up (post BMX/recon) has been MRIs to check integrity of implants (ordered by my PS about every 3 years--also will reveal any other problems like a recurrence) and ultrasounds to check scar tissue lumps and bumps (also ordered by my PS when I thought I had something that needed investigation). The last MRI report "detected no residual breast tissue" so that made me relieved.
No mammograms for me. I would refuse, since I would be afraid they might damage implants anyway.
Claire in AZ
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