Hiya,
I wondered if you lovely, knowledgeable, helpful, experienced ladies can help me?
How do you decide which surgery options to take?
I saw my surgeon about 2 months ago regarding surgery.
Im going to have a mastectomy but being quite large busted (38E cup) I stated my fears of being “lopsided” until im able to have reconstruction, also my fears that the cancer will return in my remaining natural breast in the future. Also that im concerned that the prosthesis for boobs my size will be quite heavy which he and breast care nurse confirmed will be.
The surgeon understood where I was coming from, so we discussed me having a bilateral mastectomy either at time of initial surgery or just removing the diseased breast and removing the other one as and when I have recon done and have a double recon (cant have immediate recon as I will be having rads, im having chemo before surgery due to the lump being quite large).
I said that I felt quite strongly about having both breasts removed. I cannot imagine life with just the one breast. Maybe if I wasnt so big busted I may not feel as bad? I look at myself in the mirror and pull one breast to the side to see how I would look with just one breast and I dont think I could cope with it. I know it would only be short term (poss 6 months to a year ish…) but its still a long time.
My breast care nurse came to see me last week and she seems to think that for best recon results I should just have the diseased breast removed and wait until recon to have the other one done. She said that if I still have the breast it makes the recon easier for the surgeon as there is more skin to “play” with and I will get a better result, but if I feel so strongly about it I can request both be removed. She also said that I will limit reconstruction options if I removed both.
Im due to see the surgeon on Tues 24th with my decision but im now so confused I dont know what to do for the best? One minute I think ok I will just remove the bad breast but then when I think of how life will be with one breast I then think no, im gonna get rid of both, then the words of the breast care nurse pop into my head. It like the little devil & angel sat on each shoulder!!
If I remove just the one and I feel I cant live with one breast im stuck until recon, yet if I remove both im limiting my recon options.
I feel that no matter which decision I choose will be the wrong one, so how do you decide something as big and important as this???
Has anyone else had to make this decision and how did you choose which one?
Im sorry to go on and on in this posting!
Julie x
Julie, like you I have large breasts (34G) and I too am facing a mastectomy later this year, although I have not discussed with my surgeon.
I’ve had very similar thoughts to you, and I am going to ask the surgeon if he can do a breast reduction on my good breast so it will more evenly match the recon breast. As I haven’t actually discussed this with him, I don’t know if it can be done, but it might be worth thinking about.
Have you also asked to see some photos of ladies with only one breast? I saw some the other day and while it did look a bit weird to begin with, I think it is something you could get used to - there’s sort of something animal-like about the breast bone which I thought looked strong and good. Think of the Amazon ladies who cut one breast off in order to be able to shoot their arrows better!
Good luck with your treatment. I start my chemo on 6 August and am worried about it, but hey ho. So many brave people on here I take courage from them.
Hiya,
My surgeon said that my remaining breast can be reduced but I had a reduction 10 years ago and over the years have put on weight so my breasts have got bigger. I suffer with a weight problem and always put weight on my breasts.
One worry I stated to the surgeon was that I was worried that over the years with weight gain/loss my natural breast will get big again while my reconstructed breast probably wont. The surgeon saw this as a very valid point.
I have thought long and hard about having both removed as I want to lower the chances of the cancer coming back in my other breast (which im sure a lot of you can relate to?) I feel that if my breasts are made of up the same “stuffing” (whether it be an implant or hopefully my tummy!) they will both react the same to weight loss/gain.
My problem is do I initially just have one removed or both??
Hi Julie
If you do have a DIEP it will go up and down as you put on or gain weight. Do check though with your PS what your options are for reconstruction because if you are very overweight? they sometimes wont do the major ops for fear of problems - a DIEP can take anything from 5 to 9 hours - so you have to be fit. I had an immediate DIEP and the only skin that was taken away was the nipple and a very small area around it so the results are a normal looking breast when I’m in a bra - you may be able to keep the nipple as there are no signs of bc in it. Is this an incentive now to loose and keep off the weight? Although I know that for some people the desire to eat when worried is their way of coping - I just lost all appetite - but we are all different. I hope I haven’t made you more confused but the decision can only be one that you are comfortable with and you do need all the info you can have - do you cope for 6 months to a year with one breast and have a better cosmetic result on one of them or do you have both removed and have the same result on both and how will you feel with that weight suddenly gone? Very difficult decision so glad it’s not mine. I wish you well and hope you end up with something that you are able to live with comfortably.
Love
Beverley
Would it be possible to have immediate reconstruction and bilateral mastectomy? I know in Guildford Mark Kissim did a bilateral back flap immediate reconstruction cos it was filmed for tv
You’d probably need to go to a different hospital tho.
there’s someone who calls himself Dibs or something similar who specialises in Dieps who works at st george’s tooting
I think it’s best to go and see a surgeon who does a lot of the kind of surgery you want as their results are likely to be better, as more practice, more skill
Mole
Hiya,
thanks for your replies.
My surgeon is quite reluctant to do an immediate reconstruction as I will be having rads and there may the possibility that the rads will affect the reconstructed breast. He said that if I really wanted to he would do it and we can “fix” any problems at a later date if the rads do have an effect on the recon. I said I would rather wait.
The initial discussion was that he was going to see if I could have a sentinal node biopsy to see if the cancer had spread to my nodes. Apparantly there was no sign of any affected nodes in the scans or when physically examined so he felt that if I could have the biopsy and the results were clear I wouldnt need rads so I could then have an immediate recon.
In the Doctors meeting they have said that as my tumour is quite large and im only 37 they wanna go ahead with rads just to give something else to throw at the cancer so no immediate recon.
If I didnt have to have rads he suggested an op that was a bit like a reduction, He would remove the inner part of the breast and use the skin to make a pocket to house an implant, or the DIEP. If I had to have rads he said my only option would be the DIEP. My breast care nurse seems to think he mentioned the back flap but he didnt.
I do know that my breasts will still go up and down with the DIEP but at least they will both gain/lose at the same rate as my breasts will be made up of the same thing if that makes sense?
Im not overly overweight. I do have enough belly fat though, surgeon said I would end up with 2 lovely little B cups!!