I got diagnosed with DCIS, intermediate grade a couple of weeks ago now. I’m still processing it all and feeling pretty down if I’m honest, but I have determined to research as much as I can so I know what is available to me.
I’m 48 and naturally small breasted with a 54mm area of DCIS so the whole breast needs to come off. I feel a little guilty (just me?) focussing on the cosmetic outcome but I have complete trust in the doctors to deal with the cancer side of things. I think looking as normal as possible after is going to be essential for my mental health in terms of moving on.
I saw the surgeon re a DIEP last week and it sounds like a huge operation that I don’t fancy on top of everything else. They also said I didn’t have enough fat to create a proper sized breast so the results would be lopsided.
I am currently looking into implants and I am thinking of one implant in my reconstructed breast and a smaller one at a later date to balance me when everything has settled, this seems a lot less invasive compared to the DIEP operation. The hospital are really pushing me for the DIEP and I don’t understand why.
Has anyone had this done?
I had a right mx (large area of high grade DCIS) with immediate implant last year - you sound a similar build to me, slim and small breasted - the plastic surgeon I saw came to the conclusion an ‘own body’ reconstruction would not be feasible (partly influenced by scarring from previous surgery on my belly) so I went with the articficial implant. I’ve been quite happy with how it looked apart from recently I have developed some ridging around the breast and have an appointment tomorrow to get it checked out to see if it needs any treatment (sometimes the body can form scar tissue around the implant which then causes problems, I think its a bit luck of the draw as far as I can gather).
Re why you feel the team is pushing you towards a DIEP - has anything been said about plans for post surgery eg radiotherapy? Generally an implant recon and rads don’t make a good combination. Keep asking questions, reading the info leaflets etc until you feel you have a full enough picture to decide for yourself. I put off surgery for a few weeks while I made my decision - with DCIS its not immediately urgent.
Hope that helps a bit, do ask if there’s anything else you think I may be able to answer from my experiences x
Don’t feel guilty about being concerned about the cosmetic outcome. Some people seem to get on just fine without reconstruction, I have met several women who have no desire to reconstruct and are totally happy with that decision. For me however it was a big deal. In fact one of the first things I said to my surgeon when I was given the news that I had cancer was “can I have a reconstruction if I need a mastectomy?” I felt vain but it was important to me. I had an eating disorder many years ago in my late teens and one of the most frightening things for me when I got the news was that any change to my body might bring it back.
In the end I did need a MX as my cancer was multi focal. Like you, the thought of the DIEP really scared me and I was quite certain that I didn’t want another part of my body compromised. I was also told by the plastic surgeon that as I’m quite petite that I would be uneaven. Fortunately the onco plastic surgeon who was also my main consultant specialised in implants with strattice mesh technique and being a modest B-cup was told this would work well for me. I was fortunate that it was unlikely I’d need radiotherapy so went for immediate reconstruction with an implant and have been very pleased with my decision. I have said several times on this forum that I’d prefer to have my old boob back (cancer free obviously) but I am hugely grateful with what I ended up with and I believe having immediate reconstruction with such a good outcome really helped me get through the rest of the treatment with my sanity intact.
That said, I do know that my implant has a shelf life and that in the future I’ll probably have to have more surgery. I’d got to 51 years of age and managed to avoid any surgery until this and was terrified. I can honestly say it was a lot less traumatic than I imagined, so much so that in the future if I do need more surgery, I would consider the DIEP - subject to having piled on a few pounds that is. I’ve also read many stories of women who have had the DIEP and are delighted with the results - it is considered the gold standard in reconstruction. My impression is that individual consultants tend to have a certain bias towards their own speciality which is why yours might be encouraging you down a certain route.
Hopefully someone will be along who has had a DIEP to offer you advice shortly.
Good luck with your decision. I remember finding it very stressful having to make mine so do feel for you. I am sure it will turn out well for you in the end.
Let us know how you get on.
I’m pretty happy with the symmetry at the moment. The surgeons did an excellent job of lining them up so to speak although I dare say that with time gravity will change that and some adjustments will be necessary. I think being small breasted initially provides certain advantanges in our cases, at least with regard to implants. My surgeon was very clear that symmetry/tidying up would be offered to me as standard should I want it in the future. I think that despite the fact that curing disease has to be their primary objective, we are really fortunate in the UK that our NHS offers reconstruction and sees the psychological benefits of it as an intrinsic element of the treatment Don’t feel bad about pushing for what you want. I found the team that treated me really sympathetic to my concerns in this respect.
When I was going through all my soul searching re which reconstruction to have, one thing my BCN said to me has stuck with me and makes me feel more optimistic about the future: having an implant now means that if/when it needs replacing the option of an own tissue donation is still available further down the line so that avenue is still open. Also, there’s likely to be additional developments in surgical techniques in a few years so who knows what we might be offered in a few years time should it be required.
Hope this helps a bit.