Mastectomy or Teerapeutic Mammonplasty

LindaA LindaA Member
Sep 17
I new to this site, l was told 2weeks ago l have DCI grade 2 33mm Tumor Left UIQ and they need to operate. They have discussed that l may be suitable for a Therapeutic Mammoplasty and radiotherapy if the 2nd area in my breast comes back clear from vacuum biopsy l had last week. or Mastectomy with reconstruction.
This is all so scary, first coming to terms with having cancer without thinking about the surgery and making the best choice with the best results. I know my health is more important than how l look.
Has anyone else had Therapeutic Mammoplasty and how was the results? , l have discussed having both breasts done at the same time but have read that having radiotherapy after can make the breast smaller still.
If l have a Mastectomy what is the best option for reconstruction an implant or flap.

Hello Linda


I had a TM on 29th May, I was initially diagnosed with a large tumour (6cm), in my left breast, I’m quite large busted, especially on that side, the right less so…They said I needed a mastectomy because of the tumour size, but a follow up CT scan then showed that the tumour was possibly not that big…if not, they proposed a TM, as I would have sufficient tissue left, after removing the bad bits, to reshape the breast.


It seems to be the thing these days that surgeons do what they can to conserve the breast, as per NHS guidelines, this is what I was told, anyway. So I went down for the op not knowing what I would have…and came round to be told it was a TM.  ( I didn’t look! ) The later path results showed that of the 6cm, 3cm was the tumour and the rest was made up of old scar tissue from fibroadenomas, a papilloma, and some DCIS. So they were able to cut a load of tissue out and give me nice clear margins, and the TM is really good…yes, there’s more cutting involved than a lumpectomy, but it’s basically a cosmetic breast reduction…gives you a lifted shape and, for someone of my age (64), probably the boobs you had 20 years ago !  (I was offered an equalisation in the other breast but honestly, they look equal enough now, as the right breast is smaller anyway, if still more droopy I suppose ! ) 


It sounds pretty major, the surgery, as mine meant that the nipple had to be cut out and repositioned, but honestly, it’s really healed well and in time, the scars will hardly show. (I had worse discomfort in the scar under my armpit where they did the full ANC to remove the nodes, than the TM wounds. 

A couple of weeks after the op, I was asked if I’d consent to having photos taken, proper page 3 stuff with an official hospital photographer ( thank goodness it was from the neck down! ) to be able to show other newly diagnosed BC ladies how a TM looks. ( Do they have such pics at your hospital? I was given the impression they do this at all hospitals where TMs are offered, as not all areas will do them…)


I do hope this gives you some information, - you are welcome to ask me for any further details, wishing you all the best…?


(Apologies, but I don’t know about mastectomy recons, however there are ladies in here who certainly do, and I’m sure they’ll show up to help…) 



Hi Thistle
Thank you for replying. It does help. I’m so pleased things went well for you, you did make me laugh about them taking your photo ?
I went to see my Bcn yesterday she told me that the results from my biopsy is B3 Papilloma which is a relieve. They will discuss me today and confirm on Monday. She also went through the different implants should l go down the route of having a Mx or l need a Mx. She did show me pictures of the TM but really didn’t have many because of the NHS cyber attack they lost lots and are starting to build them up again.
Did you have Rad after yourTM? If so was there much shrinkage ? If l go down the TM route they did say they may be able to reduce my other side at the same time but l have read some surgeons will only do the this after things have settled down after the Rad on the problem breast. I’m a 34 E.
I also worried about the cancer returning after having this procedure. But l hoping that if the get a good clear margin the risk of this will be low.
Hugs Linda

Hi C
That you for your reply. I’m so sorry to hear your now having to go through Chemo after what’s your been through already. I hope all goes well.
I swagging towards the TM , I’ve been told l have to have Rad after my Op and the Rad can course some shrinkage of the breast and it can become smaller to the other one that is without cancer, did you have Rad after your reconstruction ? I’m going back to see the doctor tomorrow to discuss my path report from a biopsy last week, l was told yesterday that it’s a Papillioma they were discussing it today so I’m hoping this won’t be a added problem. I’m worried about making the right decision my consultant spoke about Mastectomy when l was given the news, she saw l wasn’t keen to lose my breast and suggested the TM. I’ve been backwards and forwards to the hospital since Feb because of blood discharge from my nipple. I was originally told after my assessment that l had duct ecstasia but they had picked up another area that needed a biopsy, l had a core then a vacuum and was told l had abnormal cells and the area was just just 12mm and was AAA , they said l would get yearly mammogram for next 5 years incase of changes and that it wasn’t cancer. I ended up have a Total duct excision to sort the bleeding out , which again l was told that was clear. Just when l thought l would be okay, l got a call telling that that wanted to do another mammogram and more biopsy, after all that they said all was okay but in the weekly meeting a consultant requested l have a MRI, more to confirm all was okay. That’s when the cancer showed up in the area that was 12mm but is now 33mm.
Wishing you all the best x

Hello Linda 


Crumbs, you did have a lot going on, all those tests,biopsies and procedures, ?, - as to your question about shrinkage, I was an E cup too, or thereabouts, the left side breast was very definitely bigger…I finished rads on 24th August and have not noticed any shrinkage, fair dos, I was pretty pink and lumpy/bumpy around the scar areas well before rads, this worried me a bit as the radiographers, who often weren’t the same staff each day, were concerned about the pinkness as well. They kept pointing it out, (‘ ?you are so pink after just 1/2/3 sessions? ?’ ) and the skin did feel leathery as I had been warned it would be, but after rads, and not before…! 

I found out from a friend who had had a cosmetic reduction that her breasts stayed pink for months after the op, just like mine was, with no pain or obvious inflammation that would signal an infection. It was just pink !

To my relief it got no worse with rads, and now all I have left is the sludgy brown ‘Rads Triangle’ that marks where the zaps hit to the tattoo marks, and the skin is slowly going back to normal after much moisturising and drinking of water (essential !! ) I’m back to using Vit E oil on the scar tissue, or Bio Oil if you prefer, and it’s softening it there too, which is great. The worst scars for me were the ones under the breast and the node removal one, under the arm, but moisturising during and after rads treatment, and using Polymem dressings to cushion the scar under the breast, worked a treat, and it’s feeling loads better and softer. 

Rads are supposed to tighten the tissue and make the breast feel hard, but thankfully, for me, that has not lasted - fingers crossed it continues to improve…


I hope, again, that this info is of some help.


Thistke xx 

Thank you Thistle
Things have changed since my last post. I was called in last week and told they got more results back from the biopsy taken. I now know l have Her2 by don’t know yet which + or-. I now have to haveChemo for6 months then the Op but hopefully that now will be a lumpectomy followed by Radiotherapy . I should be starting next week.

Hi Linda


Sorry to learn the plan has changed for you, it’s disorientating when that happens isn’t it - as you gear yourself up for something and then it doesn’t happen ! Sounds as if they will be shrinking your tumour with chemo first then?, initially that was going to happen to me before I got my HER results, which were negative, and that changed the ball game completely…


I hope that your chemo goes well for you, check out the chemo threads on here for loads of advice and encouragement… they are really packed with info and so supportive…

Sending you all the best, take care !