Radiation after Recon - problems?

Hello all. I have been reading about problems with own-tissue reconstructions if followed by rads. Things like hardening and necrosis and changing shape etc. Can anyone tell me good and bad experiences of changes in recon breast shape etc after radiation?

I am due to see consultant on Friday for results of second biopsy and MRI scan, but thought I’d ask for your personal experiences first.

Thank you for any info you might have.
Emma
xxxx

Thank you, Dahlia. So it looks like he’ll probably offer me recon after my radiotherapy. You are rso right, survival is priority number one. I won’t take any risks either. THanks for your thoughts.
Emma xx

Hi Emma

I had a mastectomy and immediate LD recon without implant in October 06 followed by chemo and rads. I was worried about having radiotherapy on the reconstruction as I thought that as I had a mastectomyI wouldn’t need it. However, my oncologist wanted me to have radiotherapyand assured me that it would not cause a problem. I asked him many times as I was a little worried! He did agree to spread the radiotherapy over 25 sessions instead of 15 as he said this would better for the reconstruction. Anyway, I finished rads in June and so far I haven’t had a problem.

I hope this helps.

Good luck for friday.

Love Lollie x

Hi Emma

Like Lollie, I had a mastectomy and immediate LD reconstruction without implant in August 06, also followed by chemo and rads.I had it spread over 25 instead of 20 because of the reconstruction. I finished rads in May and have had no problems either.

Best wishes for Friday.

Love and take care
Thistle

Hi Thistle and Lollie. Thanks for sharing your experiences. That’s very different to what I read in Cancerbackup.org. There’s all this stuff about rads being really bad after recon. I am so confused now. I’m not panicking, though, because I only have to wait until Friday before I see my very approachable consultant (or “god”, as I like to think of him!).

I’m so glad you haven’t had problems with your recon.
Love
Emma

Hi Emma

I have an implant in the one that stretches the skin an expander, I am having rads on number 8 of 25 no problems so far and at the end of it if you have the implant expander, it is replaced in any case…and the doctors keep checking you every so often to make sure everything is ok.

Lucy
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Thank you Lucy. That’s not a permanent implant, is it? That’s to stretch the skin and then your permanent implant/your own tissue is put in?

Hi Emma

I’ve had conflicting advice about immediate reconstruction. I have high grade DCIS over a large area and have to have a mastectomy. The original surgeon I saw said I could go ahead with immediate reconstruction as he thinks I’m low risk for radiotherapy. However, I’ve opted for DIEP, which he doesn’t do, and have been referred to a plastic surgeon in the next county. Hs advice is against immediate reconstruction even if there’s the tiniest risk of needing radiotherapy. As he says, you only get one chance at DIEP! And he says they don’t respond well to radiotherapy as the bloods vessels shrink, risking failure. Also, I’m having my lymph nodes removed from under my arm and this complicates the recon. Therefore I’m having skin-saving mastectomy with a temporary expander on 17 September, followed by reconstruction within 4 weeks (although I’ll believe that when it happens, given some of the stories I’ve heard abut cancelled ops) if the histology is clear.

So I guess it depends on what recon you’re having.

Best of luck!

Deborah x

Thanks Deborah. I saw my surgeon today and we decided on surgery. I am to have a large lumpectomy and then a mini-flap recon 2 weeks later, then rads and possibly Tamoxifen. He didn’t seem that worried about rads after the miniflap. If they don’t find a good clear margin, however, I’ll have to go back in for a left mastectomy and immediate recon. Can’t remember what he said about that, but basically he didn’t seem that concerned about rads after recon. I have been looking on too many sites on the internet, that’s my problem!

Hi Emma

No it’s not a permanant one at this stage, its one to stretch the skin, my consultant said I can have the new one in about Jan/Feb next year because of the rads

Lucy
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Hi Emma,

I am glad that your surgeon put your mind at ease, the internet is a powerful tool and you can get a bit carried away with the negative side of things…

Lucy
XX

Oh, I see, Lucy. Gosh, there are so many different options and outcomes, aren’t there?! Yes, the internet is powerful. i certainly got carried away with the negatives in the first one or two days after dx last week. It’s amazing how much one’s mind changes and adapts to things once you’ve had a good talk with the surgeon (“Mr God”). Of course, I know that things might still not go swimmingly smooth, but I just feel better about everything today.

Hi Emma

I am glad you feel better about it now, try to stay up, its easy to get down…but you seem as if you are one of those people who are able to see the positive side of this disease and thats good…I am nearing the end of this journey now and have tried to keep positive through out, I would say it definately helps you get through…

best wishes for the future
Love
Lucy
XXXX

Thank you, Lucy, and I am really trying to stay positive. For the most part, I have managed it so far. It can’t do anything but help, can it? I am so glad you are getting near the end of your journey, so pleased for you.
All the very best
Love
Emma
xxx

Hi Emma

I too am glad I am near the end of my journey of treatment, its been a long old slog from mid Nov last year I can tell you, the chemo was the worst thing for me ever - the rads is a doddle apart from the travelling which makes me tired, I don’t know how I have gotten here so far. I think it just takes strength and a positive attitute which you seem to have and be on the right track, don’t let anyone sway you from that…all the best my love to you too…

Love as always Lucy…
xxxxx

hi had mastectomy and reconstruction at same time. I think they thought that would be it …but i did need rads. This has left a hardening in my breast. My surgeon ha told me to massage it but nothing seems to be happening. The only good thing is the look it fine and you cannot see where it has altered so am not too concerned

Hi. I had a mastectomy and immediate recon (using implant and LD flap from my back) at the end of July on the basis that, at the time, the doctors thought it was unlikely that I would need radiotherapy. Unfortunately the cancer they cut out of me was bigger than they originally anticipated so now I will definitely need radiotherapy (once I am through with chemo) - which is gutting as I understand there is a definite risk that my implant will harden with the rads and undo a lot of the good work that has already been done.

My surgeon says that if it does harden, they can replace the implant and see if that works - although there will still be a risk that a new implant will also harden, in which case I might have to look at other options (e.g. a new reconstruction using a tummy flap). I am trying not to get too pessimistic or overwhelmed about this just now, as the doctors say that it is very individual as to whether people get problems or not … and fortunately they have seen quite a few people at the hospitacl get through radiotherapy unscathed.

I would be interested to hear from more people with experience of this (or updates on the above postings), especially when the time comes for my radiotherapy early next year.

Claire

Hello Emma,
Just to let you know my experience.
I had my first mastectomy in April 05 with immediate recon using back flap then 5 weeks of radiotherapy.
I had a second mastectomy and recon, again using back flap, in Sept 06 and this is quite different from the first. The first has shrunk and hardened a bit which I believe is due to the radiotherapy.
The good news is that I have just had liposuction to my stomach to get fat to syringe into the first recon to soften it and make it a better shape…this has worked and looks better already. I need a second op like this but it was not really a problem with a couple of days in hosp and a few weeks off work…the worst thing was having to wear a really sexy-not girdle for 6 weeks afterwards! So even if radio does a bit of damage it is sortable…
I think having the recon at the same time as the first was an ok decision as i had been advised to have the second done due to strong family history and did not fancy having 2 more ops or a mastectomy and 2 recons at the same time.
Good luck…
Buff

Hi, I had it done at the Glasgow Royal Infirmary and the surgeon was Eva Wieller-Mitthoff. I didn’t realiase this was not widely available.She just started doing it about 2005 and when I was in there were a few women having the procedure…one whose implant had hardened twice and had travelled from the far North of Scotland so looks like it is not only a Regional Centre for this but perhaps the leading centre in Scotland.
Buff