Reconstruction with diep flap or to stay flat?

Hi everyone,

I’m hoping someone can help and advise me as I am really struggling to come to a decision about my treatment plan. So end of June just after I had covid I noticed a lump in my right breast, thinking nothing of it I went to see the GP who referred me to get it checked. The mammogram didn’t pick anything up but the Dr felt something on examination so sent me for an ultrasound. A lump was picked up, the Dr said I think this is cancer, a biopsy taken from breast and underarm. 2 days later we travelled on a family holiday and had to await the results on my return. The biopsy confirmed a ductule and lobular cancer provisional grade 1 HER 2 negative estrogen positive. I then had to await a MRI scan and results a week later. The MRI picked up another 2 suspect areas so was sent for another ultrasound with biopsy. Only one of the areas was picked up on the scan and a biopsy taken. The results showed cancer on a 4mm nodule. My treatment plan is a mastectomy or mastectomy with reconstruction using implant or own tissue.

When I went to see the consultant about my treatment plan I had my mind up that I would have a reconstruction not knowing the length of time for surgery,recovery,and risks.I am struggling so hard to make a decision and need to decide before next week as will be seeing the consultant again.

My dilemma is do I deal with just the cancer for now and have the mastectomy as that is non negotiable and needs to be done or do I have the diep flap reconstruction at the same time. I want to look normal again but feel I may be putting myself further at risk by having the reconstruction as it’s a long surgery purely for cosmetic reasons. Am I taking an unnecessary risk for the sake of vanity. 

Implant is not something I would consider as the breast would have to be made much smaller and higher and not symmetrical.

I knw its a decision only I can make but I would really appreciate some feedback from women who have gone through this.

Hi Sab, welcome to the forum . You could also post this in the surgery section of the forum , hopefully you will get people sharing their experiences there too .

forum.breastcancernow.org/t5/Surgery/bd-p/4445

Hi 

I had a mastectomy with immediate diep , tissue was taken from my abdomen . 

I was given the option of nipple sparing but I didn’t see the point of leaving it as my cancer was in ducts so I didn’t want risk of any cells being left . 

I didn’t want implant as I wasn’t sure what the life span of it was & also even with a mastoplexy to lift my other side up to make me symmetrical with time the natural side would drop but the implant would stay high up . Things improve every year and it’s 6 years now for me but that was my reason .

I’m very happy with my reconstructed breast and I do wear a bra for bed as advised. 

I had this kind of reconstruction at the same time as the mastectomy and woke up with a breast, not with a nipple but pretty good as far as I am concerned compared with having a knitted knocker or a falsie from Orthotics also known as Surgical Appliances.

Yes it’s a long surgery but as I wasn’t awake I didn’t notice this.

I was very well looked after and I had a big wobble after the first night as you have to be woken every hour and the breast has to be kept nice and warm to ensure the blood supply keeps going. They have to connect up a vein and an artery from the flap of skin they take from your tum to an artery and a vein in your chest. Mine worked fine. I am 67 but I am quite fit and my skin isn’t bad. I eat well too, lots of fruit veg and not too much fatty food. I do enjoy the odd cherry bakewell courtesy of Mr Kipling

I don’t think it’s vanity either. A lot of women leave breast cancer until it’s very late as they are so scared of having to have part of your body removed. It’s like losing part of your sexuality as far as I am concerned. How would a man feel if he had his penis removed? I know that happens for some people who have penile cancer. But it must be devastating. As far as I am concerned aesthetics matter. I would prefer to have two beautiful breasts, I am prepared to put up with two perky less than perfect breasts but I prefer some degree of symmetry. So do the world’s artists. Some of the best oncoplastic surgeons are artists, mine certainly is.

Seagulls