Hello, I have found the support, advice, humour and honesty on this site very useful. I was diagnosed 1 month ago with IDC and DCIS, stage 2 a, ER positive. I had WLE 2 weeks ago with SNB. All went weforms part from a nasty cold virus post op. today I went back to clinic to find that the lymph node is clear, but they could not get clear margins from the DCIS. As I am small breasted , the advice is a mastectomy. I’m ok with this, but not sure whether to stay flat and use a prosthesis or have immediate reconstruction. As I’m slim, my only option is a silicone implant. I think I could opt for both breasts and enlarge a bit, as I’m currently a 32A/AA. Or just have a single small silicone implant. I am a keen horse rider and would not be able to ride for 5 months post reconstruction , but worried that I may regret not having it if I go for prosthesis. I’m 48 years young and very fit and active, so this has all been a lot to take on board. Any advice would be welcome. Thanks
Zuleika
Hi not sure if I’ve posted this in the correct place, or if anyone has seen it?
any advice is wwelcome thanks
Zuleika
Dear Zuleika
Welcome to the BCC Forum. I’m sorry you haven’t had any replies yet. You might find it helpful to post in the “Living with breast cancer/ Reconstructive surgery” section. You’ll find it by looking down the menu on the left hand side of the page.
You may also be interested in our one to one support service. They may be able to put you in touch with a trained volunteer who has had a particular treatment. I’ve attached the link for more information:
breastcancercare.org.uk/breast-cancer-services/someone-talk/one-one-support
Very best wishes
Janet
BCC Moderator
When women are making the decision between lumpectomy and mastectomy and BMX, and when they are deciding whether to have reconstruction or not, the focus seems to be mostly on cosmetic appearance. Yet after the surgery is done, I’ve read many posts that say “Don’t get me wrong, my reconstructed breasts look great, but…” and then the women go on to talk about problems with pain, movement, contortion, flexibility, loss of sexual sensation, etc. etc… When we are losing a breast, many of us think that what we need is something that physically replaces that breast. Many women choose to have BMXs because they believe that the result will be better symmetry. At the time that we are making these decisions, we don’t tend to think of the physical implications of a MX and reconstruction to our bodies. Too many women don’t want to think about that. And ultimately, as it affects our lives, that turns out to be a whole lot more important and impactful than the physical appearance. Those who are making a decision about types of reconstruction need to remember that the goal should be a return to a high Quality of Life; I doubt that anyone really wants to have perky pretty looking reconstructed breasts that negatively impact their quality of life. But this rarely seems to come up; cosmetic appearance is almost always what those making this decision want to know about.
I’ve certainly read on many different threads where it’s the MX surgery itself that results in pain and difficulties with movement (due to altered mechanics), and not just cases where reconstruction is involved. But from all the posts I’ve read over this past year (a very unscientific sample) I would say that overwhelmingly, these problems are evident mostly in cases with reconstruction (particularly implant reconstruction but sometimes other types as well), than in situations of MX surgery only. The simple fact is that when someone has implant reconstruction, their muscles are compromised and that may lead to problems down the road, particularly if one is an athlete but even for the average woman. Not everyone is affected, but many are. I suggest you become informed about implants and how the muscular alterations can to impact your mobility.
Thank you Liliac Blue, I really appreciate your comments. My initial reaction was to go for Mx with prosthetic. I’m so not sure. My options are very limited.
Best wishes
Zuleika
Hi Zuleika. I like you was thrown the curve ball yesterday and also need an mx. They mentioned a stattice with implant being the best option for me as I too am small breasted. I have an appt with BCN to discuss different options and to look at pictures next week. Have you been given that support too? Lilac_Blue, your comments are very thought provoking and I was going to do a photo research on the web but perhaps this is a backwards way of doing things so thank you.
I wish you luck with your decision and I’m sorry I haven’t really been of much help as I’m in the dark as much as you. Xxx
I had an implant reconstruction a couple of months ago and I didn’t think it made much difference to my recoery from surgery. What is the main potential issue with reconstruction? Why might they cause problems?
I would much prefer a reconstruction than a prosthesis - one less thing to worry about.
Thanks aj, we are in the same boat and it’s helpful to know that I am not alone in this. I am waiting for an appointment next week with the BCN next week to discuss further, which I think will help. good luck with your decision, I would love to hear how you get on.
Black swan, thank upon, it is helpful to know about your recovery as that was one of my questions. the issues with silicone are related to problems with the implant itself, infection and need for replacement in ten years time.
I wish you all the very best !
Zuleika
Hi Zuleika
I would recommend you do some real research, in terms of the types of reconstruction available to you.
In my view, the decision to have reconstruction is never as simple as it first appears.
It is not only about the physical, but the emotional aspect also.
Some women are happy being flat chested and lead a very high quality of life regardless.
Whilst others just know they cannot face being flat and need something to fill their bra.
What that ‘something’ is, is down to how well you are advised and consulted by your PS.
Do find one who knows his/her stuff. Ask to see photos if it helps. Ask questions and more questions before you make that final decision.
The implant based reconstuctions can lead to future problems, as with any kind of reconstruction, but you must be made aware of these beforehand. KNOW what you are dealing with, so you can make an imformed choice.
Think about what you want from a reconstruction and how it will add/take quality from your life.
Remember that you may lose physical sensation/your nipple.
I had an LD recon nearly 2 years ago and so far have sufferered no complications with it and have a full range of movement.
What i do get is some back tightness occasionally.
Recon will never replace a breast - it is what is says -reconstruction and that MAY take some time to accept. depending on how straightforward your procedure is (mine has been very long and drawn out).
Very best of luck
I hope all goes well, whatever you decide to go for.
Naz xx
Naz, thank you very much for your advice, you are quite right, I need more info. I appreciate your comments.
very best wishes
Zuleika
I don’t want to confuse you further, but I had mx with no recon but had snb. I had no pain in breast area after mx, but some discomfort in axillary due to snb, even though only three nodes were removed. I’m really happy I had mx, but as my remaining breast is quite large (I was 44d) I find wearing my prosthesis isn’t very comfortable due to the weight necessary in a larger one, as it has to match the other. If you have quite small breasts, you wouldn’t necessarily have this problem. Only you can make the decision of course, but I hope my comments have been helpful in some way.
Good luck with your decision, and your surgery.
Poemsgalore xx
Thanks Poemsgalore, it is useful to hear your experience. At the moment, most views are supporting no reconstruction. I have to consider future screening and need for redo implant in 10 years time. I keep wavering between the 2 options. I do know what you mean about the SNB, my wound was much more ppainful than the WLE wound.
Onwards and upwards !
Best wishe
zuleika
Hi again Zuleika
You could always delay recon for later if you wanted, just so you are clear in your own mind what you what is available to you and what it might look and feel like etc? Lots of ladies opt for a delayed reconstruction, just to give their bodies time to heal and settle down.
If you have implant only recon, the recovery time is usually much quicker than some of the other types.
The implants are also of good quality,but may need replacing after a few years.
I guess it depends what you are expecting from reconstruction, which can sometimes be a little tricky to know, when you have to make these decisions.
Take your time
Naz x
Hi Naz
thats a good point, thank you
Zuleika,
I had a delayed LD flap recon. I had wanted an immediate recon but could not have one due to planned rads. I finally had the recon three years after my mx. Like you I was very small - AA - with no body fat to use so needed an implant and the PS offered to give me an implant in my good side too, which I did. I am so pleased with the result, and with an implant in both sides I am very well matched.
Strangely, you may think, women who have delayed recons are happier with the results than those who have immediate recons, despite the cosmetic results being better with immediate ones. This is because with an immediate recon you are comparing the result with a real breast, whereas with a delayed recon you are comparing it with a flat numb chest, plus you have had to live with prostheses for a while and the wardrobe limitations that go with that.
I don’t know anything about horse riding, but I swim (60 lengths a session) and I run and have no problems with the recon. The only issues I have are guarding against lymphoedema, which arise from the mx not the recon.
Remember that whatever you decide, you will have to live with some sort of compromise - by that I mean with no recon, you have to live with a flat chest/prosthesis, with a recon you will be living with an implant and/or tissue taken from some other part of your body. The decision you need to make is which compromise works best for you.
Thanks Road Runner ! You make an excellent, balanced viewpoint. I really appreciate it.
60 lengths !! That’s impressive
Thanks Road Runner ! You make an excellent, balanced viewpoint. I really appreciate it.
60 lengths !! That’s impressive