HELP! Recon. Tummy or Back flap !!

Here we go again…2nd time … Reconstruction Dilemma Tummy / Back

Hi

Initially diagnosed 2009 after a good friend who had recently been diagnosed persuaded me to have a lump removed which had already in 2004 been given a label of being nothing to worry about. To my horror it was removed and to the surprise of all it was found to be 13mm Grade 1 ductal carcinoma E/R Positive HER-2 Negative… had a wide local excision & Sentinel node performed. Radiotherapy and Tamoxifen which I stuggled with and ceased after 2 1/2yrs. Have a slight weakness in my arm shoulder with what I describe as muscle strain in my arm since 2009.

Have had a number of benign lumps n bumps over the last 10 yrs removed or markers put in place following yearly mammograms, yearly scans ceased 2016.

Screened in August 2019 recalled September biopsy confirmed M3 16mm invasive papillary carcinoma grade unclear poss 1 or 2…

Really struggling emotionally this time round… Go tomorrow to confirm which procedure to go for have been told they are not considering an implant due to previous radiotherapy so its a procedure involving a back flap which seems to be their preferred option, surgery date has been given or if I elect to have a tummy flap procedure I need to see a different team, and further delay.

Here is my dilemma tummy apears to give the best results from what I have read on line, however I am 90% sure I will opt for a reconstruction of my other currently cancer free breast at the earliest time [I think only allowed 18-24 months after] but I dont think it is possible to have the tummy used a second time. My question is has anyone had a tummy flap on one and a back flap on the other are they so different or do I go for back flap my second choice so both breasts are as similar as is possible…

Sorry its long winded but any advise experience would be good to have… :slight_smile:

Hi, I’m sorry I carnt help in the way of advice, but happy to stay in touch, support and share the experiences as they unfold as you and I are going through the same trauma. I was diagnosed with a grade 3 hormonal breast cancer in 1989, I had a lumpectomy to the left breast, chemo and radiation, a little later it was decided that I would benefit from radiation to my ovaries to significantly reduce my oestrogen levels. Now over thirty years on and after a routine mammogram a 1mm cancer found in same breast different area, this has been diagnosed as another primary. I have looked at all the options to hand and after consultation with the surgeon, plastic surgeon and key nurse, it was decided I would not be suitable for the tummy flap as I had not enough elasticity in the skin in that area. I have been offered a back flap instead, this has the advantage of the flesh from the back being moved round to the front to create the breast with the blood vessels intact, unlike the tummy flap where the blood vessels are severed and have to be reattached in the breast area. I am then having a breast reduction approx year later on my good breast. The reason I chose that, rather than a double mastectomy was that I would be able to still have a mammogram on that breast as my risk of a further primary cancer was moderate and the hope is if that happens it will remain in the breast area where it is easier to treat rather than appearing in another major organ.  I also have slight lymphedema in my left arm and aching in my left shoulder where the flesh at the back seems to have receded in comparison to my other shoulder.

After the consultations and having been told the risks involved I am dithering and wondering if I should consider just having the mastectomy with a prosthetic and leave well alone, although I have become rather unhappy with my partial prosthetic over the years. Like you,  I am now hoping to speak to other women who have experienced the same operation as I have been offered and any advise that they might give me.

Sending you a huge hug and hoping we can stay in touch xx