LICAP decision

Hi, I have IDC grade 2 in my right breast, 2 tumours which may not jot be joined. Er+ her2-. 2x2x4.5cn so quite big, and close to nipple although they can’t see nipple involvement on scans. I have sought private advice after experiencing delays during diagnosis with NHS and after the delays my mum has had with her current breast cancer treatment (delayed chemo).

The private surgeon recommended immediate LICAP followed by radiotherapy and has done a sentinel nodes biopsy yesterday, and has said broadly 30-40% chance of chemotherapy depending on histology. He said LICAP would mean he could take more out and reduce risk of extra surgery/ mastectomy.

I was all set with this plan, then saw NHS surgeon yesterday as it was already booked in. He said immediate LICAP potentially carries increased risk of complications which could then compromise next stage of treatment (ie delay radiotherapy/ chemotherapy), and that he’d recommend minimal surgery initially - lumpectomy with remodelling and some fat transfer, but that my breast would likely be half the size after (I’m a B cup currently, healthy breast is slightly larger already), and that I could then go back for LICAP or other surgery to improve appearance/ symmetry later.

I suppose my main question here is what are people’s experiences of radiotherapy following LICAP - was it ok or did radiotherapy affect the flap? And is it common to have complications following LICAP that delay the next stage of treatment?

It’s all very overwhelming!

I had a lumpectomy and Licap reconstruction last March followed by 10 sessions of radiotherapy six weeks later. The reconstruction surgery was successful and healing was excellent. I have had the common later-stage side-effects of radiotherapy (tightening, some shrinkage and tenderness in the irradiated area) and am having private physio for that but it hasn’t caused flap failure or anything like that. Overall, the reconstruction has given me the volume and shape so that my surgery can’t be detected if I’m clothed and, although it’s not identical to the other, even unclothed it’s SO much better than it would have been without. My surgeon routinely does Licap at the same time as the lumpectomy. I hope this is useful info - I know how confusing and worrying these decisions can be.

Hi, thanks so much for your reply, it’s so reassuring to hear from someone who has actually had this done and has been satisfied with the result. The more I’ve read the more it seems to be fairy common practice so that’s also reassuring! Xx