Mx and prosthesis for small-breasted woman?

I am small and did lumpectomy first for my 1.6cm tumor.  It ended up that I had pretty extensive DCIS so after chemo I did the mast.  Everyone is different but for me dealing with a prosthetic is a non-issue.  I did a right side mast only so I do have one breast.  I am a 34 A/B.  I have a variety of forms-one fits in a pocket of mast. bras, one I use for swimming, and the other one sticks directly to my skin.  I am incredibly happy with all of them.  I cannot imagine ever changing my mind as far as reconstruction goes but I did explore all of my options first.  It sounds like you have a good doctor since she is encouraging you do to the same.  As soon as I talked to the ps I knew that not reconstucting was the right decision for me.  If you have not already done so, check out Barbara's website, www.breastfree.org.  Many of us on this board have shared our stories there.

Barbara, I hope you don't mind me referring people there. 

Carol, thank you for mentioning BreastFree. Since there are always newbies coming to this forum, I really appreciate you and others here letting women know about the site, which hopefully complements the support they receive here. I think your story on the BreastFree site is particularly relevant for Otter, since your sizes are so similar. There are several other stories by small-breasted women as well that might be helpful.

Otter, I'm also small, although I had a bilateral mastectomy (cancer in both breasts diagnosed three years apart). I've found a number of comfortable options for breast forms (prostheses). Like you, I have very sensitive skin, so I haven't yet tried the contact form Carol mentioned. But one of these days I'll give it a try. What I have found is another form, called an Airway Tritex, which is a silicone form with a very soft, comfortable microfiber back. You could probably easily wear the Tritex with the bra you describe. Since you're sensitive like me, you might find a regular silicone prosthesis would feel sticky and/or irritating in a bra without a special pocket. The Tritex can be worn in a regular bra or a mastectomy bra, so it's very versatile. 

I mention a number of other comfortable options on my site and provide links to the major breast form manufacturers, so you can check out what's available. There's so much, it's almost overwhelming, and there's more in the pipeline. I just spoke with a new company that's about to put out a "Comfort Line" of silicone breast forms with fabric backs, a similar idea to the Tritex.

Although many larger women do very well with breast forms, I do think you're right that it's easiest for us smaller women. In your situation, if you decide to have a mastectomy, I think it would be worth at least delaying reconstruction, to see how you like being breast-free. Reconstruction is always an option later on. I agree with Carol, though, that your doctor is doing the right thing suggesting you meet with a plastic surgeon to explore your options.

By the way, I was first diagnosed at 54 (I'm 58 now), so we're in the same age-range.

Barbara

p.s. Trish makes a good point--even regular silicone forms can be worn with their covers in regular bras, which makes them more comfortable against your skin.

I'm about the same age as you and built similarly (though I'm probably much taller) and have adapted well to a nonrecon bilateral (rarely wearing prostheses, but then I rarely wore a bra before the mastectomy). Something you might want to take into account in your decision: the toll reconstruction takes on your body either through the additional surgery for autologous recon or through adaptation to a foreign body for silicon or saline implants. I see many, many accounts of pain and failure on these boards, and although I also read comments expressing satisfaction about the cosmetic results, I know that for me, the additional assault on my tired, battered body was not worth the medical risk or the cosmetic benefit. Throughout this cancer ordeal, one of my struggles has been to see my body as my ally again rather than as my enemy. I see that it's trying its best to heal, and I'm trying to help it do so, and forgoing additional physical stress was part of that strategy. (In the interest of full disclosure, I was a poor candidate for either recon since I'd had radiation so implants were problematical, and I'm thin so autologous tissue is not ample, but the plastic surgeon was willing to give it a try.) That said, you can reconsider at a later time if you find going breast-free uncomfortable or embarrassing. One further thought: many women who have had a single mastectomy say they wish they'd had a bilateral—partly for the relief from anxiety about what might be lurking in the remaining breast and partly because of the symmetry a blilateral gives. Good luck with your decision. It's a difficult one.

Hello Otter

13 years ago I had a lumpectomy and rads.  I am also small breasted.  With the amount of tissue taken and effects of radiation my right breast is rather deformed.  I have been recently diagnosed with DCIS in my left breast.  This time I am opting for mastectomy...no reconstruction.  I did meet with a ps and I just don't want to commit to the time for recuperation that reconstruction involves. or the additional surgeries. 

Get as much info as possible on all your options....its a tough decision, but once you decide be confident that your solution is the right one for you.  Good Luck....hope your MRI reports are favorable.

He may be thinking it will be a little weird.

Most husbands manage to overcome these kinds of thoughts once they get in the sack and all warmed up! 

Hi,

Even though I wound up with a bilateral mastectomy, I can see some good reasons to try the lumpectomy route first. That's what I did when I was first diagnosed with cancer in my right breast in 2004. I actually didn't get clean margins the first time around, but the surgeon wanted to try again (I had DCIS plus a small invasion). I was a 34B and it was amazing how much tissue she removed, yet my breast still looked good. After the second wide excision, clean margins were obtained and I went on to radiation. I enjoyed having my breast for another three years. I could still wear the same bras and, miraculously, my breast still filled out the cup.

When I had a second diagnosis of cancer three years later (extensive DCIS) that created a new scenario for me. I needed a mastectomy for the new cancer, so I decided to have a prophylactic mastectomy of the already-treated side. That meant I'd no longer need mammograms or, in my case, hormonal medicines.

In your case, however, whether or not you have a mastectomy, you'll still have your other breast, so mammos and other careful surveillance will still be necessary. So why not try the lumpectomy route and see if you get the good margins and if your breast still looks good? 

Lumpectomy surgery is generally ambulatory and a very easy recovery (the SNB will probably be a bit harder). When I had my more recent diagnosis, I had two wide excisions (lumpectomies), before it became apparent that I needed a mastectomy. The wide excisions were really not a big deal--I recovered well in a day (after the second one, I went to a gallery opening the next morning and felt fine). So doing the lumpectomy first wouldn't subject you to a great deal of unnecessary trauma.

The only negative thing about lumpectomy/radiation is that, should you ever need a mastectomy down the road and want reconstruction, the radiation will limit your options (implants don't do well with radiated skin and muscle).

All these decisions are so hard. Good luck making a choice.

Barbara 

OK ladies, I'm trying to read up on this, do you just order your proths off the net or are there actual places you can see this stuff?? I'm in canada and so far haven't had much luck as to response on where to get these things??? Bras and stuff too. How soon after mast can you start using a proth. Thanks girls.....need to shop...Viv

Hey Otter , yes I'm trying to. After my surgery I will return to work in 3 weeks post-op if I can so it would be more comfortable to have something to wear so that everyone is not looking at the chest to much to know what I mean. Looking for suggestions here. How you doing and what have you decided??

Yes, I think going to a fitter is a must.  I think I waited until about 4 to 6 weeks and that was fine for me.  In the meantime I used the camisole with the fiberfill stuff.

My fitter was great.  She took into account my lifestyle, size, age (40 at the time) , etc.  And, as Otter pointed out, there are many shapes, sizes, types, etc.  I ended up getting one for regular use and then a second one for swimming/running.

I have never been to Nordstroms for mast. bras or prost. but I know they have fitters there.

Carol, the forms you are using really interest me, I wonder if they are available in canada??