Reconstruction delay’s mastectomy

Hope all are well, thank you for posting being reading a lot and will continue to read about everyone’s experience. I feel for everyone on here and pray. It’s tough. I’m 36 years old. Stage 0 DCIS +ER/+PR 10cm area of micro calcification and intermediate-high lump left breast dx 01/02/24, repeat slide read by MDACC. Seen onco surgeon 02/14/24. Mastectomy of left only but still waiting on genetics testing for possibly of double mastectomy. Had surgeon write a list of plastic surgery people she has seen on her surgery days and picked one. You can tell the onco surgeon face lit up when she wrote down the name of a particular surgeon and they did admit later on that surgeon would be a good fit for me. But they only have Fridays together. This is at MDACC in Houston where everyone else is saying all of the reconstruction team are good but it’s true the senior level surgeon will all have those wait times at least…

Would you wait until 05/11/24 for that specific surgery team? About 94 days out? Or would you go with the soonest available with reconstruction team ~45 to ~65 days(guessing on the dates on soonest available). Oncology PA admits into not ideal but it’s not bad either when we’re going back and forth about what to do. Saying they wouldn’t have presented that option if it wasn’t okay.

I found lump in Nov, found pcm to refer Christmas time, mammo before new year, bc 01/02/24

Thanks for reading

I wanted my double mastectomy to have a simultaneous DIEP reconstruction but couldn’t get my PS of choice to meet with me very quickly. I ultimately decided to just get the double mastectomy and then do a DIEP later. It was tough doing both surgeries but I wasn’t comfortable waiting the amount of time I had to in order to get it done at the same time. But then I had a grade 3 lump. If your’s is less aggressive you might be more comfortable waiting that amount of time. I think it would be up to you. If your doctors weren’t comfortable with the choice they wouldn’t have offered it to you as an option.

Thank you for your reply! Hope you are ultimately doing well, really awesome you are past all this, post op. I wish I understood my lump better, like after biopsy it’s hard to feel if it’s bigger from first time I found it before Christmas. I saw grade 2-3 on pathology report I think meaning intermediate-high. Jan mammogram 9.7cm area, repeat Feb mammogram 10cm like did it grow or is that the small allowable area radiologist to radiologist measuring error

Yeah I got impression 4ish weeks flat forever.
4-8wks PS unknown yet
Did you have a good idea prior to that you could have diep? I have no idea at this point. My family is like…in case you do get that double…wait for choice PS. It’s so hard to decide what I want. Maybe I could get better idea when they might give me a name on Monday and possible date for sooner. Then I would look at that name and decide. But ultimately playing that game will put my original choice PS another week.

Grade 2 to 3 is pretty aggressive. Now in saying that even the aggressive breast cancers are less aggressive by nature than other cancers so it’s not like you’re dealing with ovarian for instance. But if you some grade three in there you’re probably having some pretty decent cell division and I’m not sure if you want to wait around a while with it.

As far as whether I knew I could get a DIEP, yeah. I had stomach fat and I knew I was at least 19% body fat and that’s usually all you need to have a successful one. And I was willing to go flat for awhile to get the cancer out of me quicker. Anyway hopefully Monday will give you some more information so that a path forward becomes clearer. Good luck and if you have any questions afterwards or just need to talk through things, we’re here.

Omg thank you for your answers. This is such a hard decision. How in depth DIEP work up? I’m thinking coordinating 2 surgeons on 5/11/24 is probably just implants and maybe after PS meeting me if it was a DIEP maybe even longer wait? Is this the right timeline logic? You don’t just sign up for DIEP overnight they gotta really look at you. Does this sounds like a confusing question?

My aunt is friends with the pathologist that did the re-read of the slide and she said that that person tend to overgrade…

For me, and I’m in the US, the work up took like five minutes. If you haven’t had abdominal surgery before and they can pinch some decent fat in your stomach you’re normally good to go. I didn’t even have to do any scans myself but they wanted to. I just refused it and they went ahead anyway. So it’s not the workup that takes time. It’s the scheduling. What’s the earliest they can get you in? I mean May isn’t right around the corner so for me I’d want to go a little quicker unless I could have some treatment beforehand.

Thanks for reply! Sorry for delay in reply. I was able to change PS and will be scheduled April 1, which sounds way better. Did you have a node biopsy? If so how was that, I think there was this option where they inject a dye, and in a separate procedure if final pathology report shows invasive then they would go back and get the some nodes out.

I had what they call a sentinel node biopsy. It’s when they inject dye at most 24 hours before surgery and whatever nodes light up from the dye they take out during your surgery. Those nodes are then sent to pathology which check and see whether they are cancer free.

Oh that’s what I’m having, they said on average about ~5 nodes are taken out. How has your body responded to that?

Have you heard of this other option, where they inject this magtrace dye that stays in your body 60 days(can’t remember), they don’t take your nodes out at same time as mastectomy, but they go back in later separate procedure if the final pathology report shows a little invasive?

Btw, how are you doing nowadays? Hope you are well. Ty for the knowledge. I’m guessing we are same age based on profile name. But maybe not

I am 50 so you are probably a little younger. And I’ve heard of magtrace but never looked it up to see exactly what it does and how it differs from other procedures. For me, they found two nodes with the dye and took them out through the same incisions they did with my double mastectomy so healing at least there was extremely easy. No noticeable lymphedema. As far as how I feel, I feel great. Although I went through chemo I had a complete recovery :slight_smile:

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Thank you again for that bit of information! Yes I’m a little younger, I am glad to hear you are doing well!