Hi everyone, I’ve recently been diagnosed with Paget’s of the nipple & high grade dcis over 7cm & I’m now worried there might be a third invasive cancer. The original plan on diagnosis was to have a mastectomy with immediate reconstruction & a sentinel node biopsy at the same time however this changed the next time I saw my bcn & I’ve now already had the snb & I’m waiting for results.
Can anyone tell me, if the lymph nodes are involved can I still have an mx with immediate recon or is this all likely to change? Thanks in advance x
Hi LozaB - I’m sorry i don’t have a definite answer but i’m hoping someone will come along soon and be able to advise you. As i understand it - it will still be possible because thinking about it some women will have MX and recon and then subseqently find out there is node involvement and at which point full node clearance will then be done as a separate surgery. The only thing i’m unclear of is if they know up front there is node involvement might the node clearance happen before or at the same time as MX and recon - not sure. Either way MX and recon are still possible regardless of positive nodes. Wishing you lots of good luck, L.x
Hi Lozab, firstly sorry that you have found yourself here.
I think the decision for immediate recon depends on whether or not you will need radiotherapy. Ie radio = no immediate recon as radio wrecks the recon. It also depends on size, location and grade of tumour.
My surgeon told me in my case that if no nodes involved then no radio, more than 3 nodes then deffo radio.
I was somewhat awkward and from scan etc it was uncertain so he offered me a third option for a temporary implant to preserve the natural breast pocket on the gamble that I would not need radio. Although I haven’t been given a definite answer yet they found no lymph node involvement so I assume no radio will be needed. I will have to have chemo, when this is finished I will have to go back to surgery for final reconstruction etc
So in answer to your question I think it would be unlikely you will be offered immediate recon if there is node involvement.
Best of luck, take care xx
Hope this helps. I have 3 nodes affected and was given the choice of immediate reconstruction. I was advised that if I need radiotherapy it may affect my reconstruction but this is not always the case. I considered long and hard about my options and have decided to have immediate Recon as the positives outweigh the negatives. If then recon is affected they can do a revision but unfortunately this is more surgery.
Good luck and all the best
Janey