reconstructive surgery - pros/cons and when

I had lumpectomy just over a week ago and heard yesterday that I should have a mastectomy. What about reconstructive surgery? Is it worth having and is it better to have it done at the same time as the mastectomy? It seems like a good idea to have it all done at once, but are there downsides to this? There is an awful lot to take in and decisions to make!

Hi Miyoko,

Welcome to the Breast Cancer Care forums where I am sure you will receive valuable support, information and advice from the many informed users of this site.

Breast Cancer Care have written a ‘Resources Pack’ for anyone newly diagnosed with breast cancer which you may find helpful to read, it is filled with information to help you better understand your diagnosis, test results and the various treatments available. You can order a free copy from the following link or you can ask for a copy to be sent to you via the helpline.

breastcancercare.org.uk//content.php?page_id=7514

There is information in the pack about our other support services, including our helpline, tel no 0808 800 6000 which you may find useful to use at some point if you need to talk anything through or just need someone to lend an understanding ear. The helpline staff will also be able to talk to you about the various methods of reconstruction.

Hope this helps.

Kind regards,
Jo, Facilitator

Hi Miyoko

I think it all depends on what other treatment you are having, I am having a mastectomy on Thursday but wont be able to have immediate recon because I will be having chemo and rads after due to the cancer being grade 3. I believe the problems with recon is to do with the rads causing probs. I am sure that someone will come on here shortly and confirm this and any other options available.

Sending you hugs

Karen

XX

hi i had lumpectomy then a mastectomy. as i was having a mastectomy all cancer would be gone so didn’t need radiotherapy so was offered a recon at same time. it was gt hardly any pain etc i had op about 7 weeks ago and feel almost like new. i don’t work so have recovered in my own time. my new boob is gt i had muscle from back and over Xmas no one could tell. i have a good size and shape and a lovely cleavage i am 38c. i must admit when i came out of hospital i looked like a lopsided Jordan if you know what i mean. they told me to prepare for worse re looks etc as all have own ideas. i was prepared mentally that anything was better than nothing. i couldn’t bare to look at nothing. although if i had have to have two off i wouldnt have bothered as it would have been equal i also know if i had to go back for another op i wouldn’t have done. i am suffering with wound not healing but that’s an allergy to dressings so no ones fault. go for it. i was shocked how little pain there was when i woke up. you must do the exercises as you stiffen up very quickly. good luck
x juliex

Thank you all for your comments.
Jal 777 your experience is encouraging. I too wonder whether I would in fact go back for further surgery later and I would like “something there” too.
Karen - Thanks for your comments. I am grade 3 too so perhaps I won’t really have the choice. Very best of luck for Thursday. Top tip (in case you don’t know already) - however long you are supposed to be in hospital, take enough stuff in for twice as long - I learned this the hard way when I had the lumpectomy! Be thinking of you.
Jo - thanks for the info.
miyoko

I had mastectomy Dec 05 and recon Dec 07.

Not all hospitals offer immed recon (mine doesn’t) the Plastics surgery takes place in another hospital 25 miles away and even then my PS consultant will not operate until 1 year clear of rads. It can also depend on how urgent they want to operate, I have read threads on here before that ladies have been offered quite different waiting times for mastectomy or mastectomy with immed recon as it involves more scheduling for surgeons and theatre time.

Personally I hated being one boobed and am very pleased with my recon, if I have a better result for the wait then it was worth it, I had the free tram flap (tummy muscle, no implants) and going back to work as soon as my 8 week sick note expires.

Debbie

Debbie. Thank you so much. Your information made me realise I know hardly anything about reconstruction. I’d better start finding out. I don’t know if it’s just me, but the breast nurse answers my questions, but doesn’t volunteer information - and I’m probably asking the wrong questions!
miyoko

Hi Miyoko

I have a mastectomy ANC and Reconstruction on 10th January this year and have been diagnoised with Grade 3. I wanted reconstruction from the start. Its sore but my boob is all me no implants and I am a 40DD and I have showed it to all my friends. Speak to the BC nurse and she can give you the information my consultant went through everything with me and my family showed me pictures told me where he was going to take the muscle from etc. I am glad I have had it done, sore and uncomfortable but I am pleased. My next step is chemo starting on the 13th Feb.

Hope this helps

Sharon

Hi Miyoko

Thanks for the tip but already had wle and was kept in 5 days, have been told to stay a min of 5 days this time so could be even longer boo hoo.

Karen

XX

hi i hated hospital before breast cancer and only been in to give birth. i had lumpectomy and sentinel node and was told i could go home that night as it was 9 pm i decided to stay my 20 yr old daughter stayed night with me. i told them she would be from beginning i needed support. i wished i hadn’t stayed though as i thought i would go about 9 but it was more like two as had to wait for doctors etc. i didn’t understand that as i could have gone the night before. anyway with mastectomy and recon i was told four days and i could go. i did i left with one drain in at the back and i was still using a commode for loo. i knew once i got home i would get to the en suite loo myself its so degrading having to go to order of the nurse etc. i did it first day home i had nurses daily to dress wound and check drain. all OK
go for it. it may depend on what type of recon u have mine was back and implant.
take care.
julie

Hi Miyoko,
There are a lot of things to consider and a lot depends on the surgeon too. My surgeon originally said if I needed radiotherapy I could not have an immediate recon. if I had an implant. I had sentinel node disection which was clear and then opted for recon with LD muscle hoping not to need implant. Success, 8 hour op but well worth it to wake up complete and so little pain. Seven days in hospital, & had to go back twice to have fluid drained from my back. I am still going to have radiotherapy as the tumour was large and close to the chest wall, but recon. should be OK because there is no implant. I refused chemo as it did not offer enough to make me want to suffer the side effects, I am a coward.
Talk to the surgeon and check out your options. Good luck

hi abismum
i m in dilemma as to whether to have chemo or not on what grounds did you refuse i am interested. i has lump sentinel nodes then mastectomy and immediate recon no rad needed chemo offered as slim chance i will benefit do i take risk. that’s y i am interested in your views if you don’t mind. thanks
Julie.

hi miyoko

my treatment plan seems to be different from any of the above, i have just finished 7 months of chemo and am now waiting for my operation. i am having a mastectomy with immediate reconstruction followed by rads,then herceptin for a year and tamoxifen. my surgeon says he has no worries about doing both ops at same time. i think it all depends on were u r being treated. im in scotland and i really trust my surgeon as he has been very open and honest with me.

ps i may also need more chemo, just depends on results from tumour removed.

good luck and take care

maria

Hi Jal777,
The chemo would give 4% increase in survival for 10 years for me and I decided that it was not worth suffering for. I decided on rads because of the small (clear) margins and I am on tamoxifen and weighing up the situation the chemo did not seem worth it. I am a retired pharmacist and I did a lot of research and I hope I have reached a good decision. I also say, that should anything reappear I can have the chemo then. Hope this helps, but you must make up your own mind and be confident with what you do. I should also point out that I am 60, if I was younger I may have thought differently.
Good luck