Recurrence in recon - what to do next?

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Hello

I would be grateful for your experiences and advice. My background - BRCA1, age 37, diagnosed with BC Grade 2 Stage 1 in October 2010, bilateral mx with expander recon December 2010. Very happy with recon so far BUT -

June 2011 a lump at the front of the implant (same side as last time), very quickly diagnosed as new stage 1 grade 1. Will need rads almost certainly, chemo poss.

And I just don’t know what to do next. Options: 1) take out implant on cancer side and go flat, have largest possible amount of skin taken away, have implant exchanged on good side. 2) deflate but keep implant on cancer side, excise the lump but keep some skin to hold implant, rads run risk of damaging implant but still have 2 breast shapes - this is higher risk since I keep more skin. Surgeon 1 less happy about this option, surgeon 2 says it is ok. 3) take out both implants and go breast free, wearing prosthetics as and when I feel like it. Delayed recon possible with own tissue.

Every day I come to a different conclusion. Yesterday I thought it would be very hard for me only to have one breast shape and I felt that committed me to another recon later on so I was convinced I would go flat. Today I think I am underestimating the impact of being flat and that I will regret taking out the shape on the good side and possibly even regret taking out the shape on the bad side.

Have any of you gone flat on both sides? Do you wear prosthetics? Have you had a bilateral delayed recon? Grateful for your experiences. Do you have a similar experience? Thank you.

Claire2010

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Hi Claire

Similar situation as you, I had recurrence in reconstructed breast last September, managed to have it removed with clear margins without loosing reconstruction. No rads as already had it on that side.

Have yet another recurrence on same side also on opposite side. When I went to see my consultant/surgeon she said I needed a double mx with skin graph, also chemo which I have never had before, my choice which to have first. I decided on chemo as I have had plenty of surgery previously. When I got home I felt terrible wished I could go to sleep and not wake up, would’nt have to have either then.

I had an appointment with oncologist the following week to sort out the chemo and she said she was very much against me having the surgery and had voiced this strongly with surgeon. She said of course surgeons want to operate and she was as much against it as they were for it.

I started chemo, its an oral one Capecitabine, at least I feel I am doing something.

I know we have to be given choices but its hard knowing whether we have made the right one. Know what you mean about coming to a different decision every day I am much the same, what seems a good idea one day does’nt the next.

Take care.

Jan