I’m so confused. I have invasive ER, PR and HER-2 positive breast cancer in my left breast with 4 lymph node involvement.
I also have LCIS in my right breast.
Surgeon says it’s my choice to remove one or both as the LCIS means I have a slight elevated risk (can’t find numbers on this ‘slight’), but if I ever did develop cancer in the right it would be caught early and would most likely be lumpectomy and possibly radiotherapy.
My first instinct is get them both off - I never want to go through this ever again if I can possibly help it, and I don’t want it in the back of my mind for years to come.
However there are knock on reconstruction issues as follows;
I only have enough belly fat for one breast if I want DIEP unless I use thighs, and I really don't want visible scars on both my thighs as you can't hide that in a swimsuit!
If I take both breasts and go down an implant route I'd have to have expander implant first due to radiotherapy, then that means another op down the line and more visits to hospital top top up the expander. However it is a less major op!
Does anyone have experience of implants after mastectomy? I am worried that because there will be no tissue left that the implant will not look nice? I feel like I’d like to at least put a silver lining to all this that I’ll have nice perky Hollywood breasts after this!
also if I decide to leave the LCIS breast and do a DIEP, I’m firstly worried in general about the size of the op and what my tummy will look and feel like long term after this, and secondly worried that if down the line I have to also lose the LCIS breast then the DIEP will have been wasted as I’l then have to have two implants to make them match!
I’m so confused. I have invasive ER, PR and HER-2 positive breast cancer in my left breast with 4 lymph node involvement.
I also have LCIS in my right breast.
Surgeon says it’s my choice to remove one or both as the LCIS means I have a slight elevated risk (can’t find numbers on this ‘slight’), but if I ever did develop cancer in the right it would be caught early and would most likely be lumpectomy and possibly radiotherapy.
My first instinct is get them both off - I never want to go through this ever again if I can possibly help it, and I don’t want it in the back of my mind for years to come.
However there are knock on reconstruction issues as follows;
I only have enough belly fat for one breast if I want DIEP unless I use thighs, and I really don’t want visible scars on both my thighs as you can’t hide that in a swimsuit!
If I take both breasts and go down an implant route I’d have to have expander implant first due to radiotherapy, then that means another op down the line and more visits to hospital top top up the expander. However it is a less major op!
Does anyone have experience of implants after mastectomy? I am worried that because there will be no tissue left that the implant will not look nice? I feel like I’d like to at least put a silver lining to all this that I’ll have nice perky Hollywood breasts after this!
also if I decide to leave the LCIS breast and do a DIEP, I’m firstly worried in general about the size of the op and what my tummy will look and feel like long term after this, and secondly worried that if down the line I have to also lose the LCIS breast then the DIEP will have been wasted as I’l then have to have two implants to make them match!
I have the same dilemma. I had a breast reduction which I am surprisingly happy with but pathology results now mean a double mastectomy. I am thinking implants with some tissue covering… think I want immediate reconstruction with nipple sparing surgery but not sure they will survive again!!
Like you, recovery time is off-putting to me. I cannot get my head around the flap surgery but now doing chemo and my consultant says I must concentrate on that for now.
Hi Rosie I just wanted to share that I had left breast removed and implant - I didn’t have any tissue I could use from anywhere - I’d lost two stone so was down to 7! They balanced me up after restoring my d cup boobs - i can see and feel the implant on the left - there’s nothing else that side but it’s not unbearable and i am getting used to it - they do look good in a bra! I had my bra fitting last week and my breast nurse was saying in time we could look at fat transfer to even out the edges of the implant but to be honest I don’t think I will bother it means scarring elsewhere and whilst my other boob is now slightly bigger as I’ve put weight on I am hoping I can slim down a little once I’ve finished treatment and balance them out again myself x
Hi @jojey, thanks for sharing. Gosh you must have been through such an ordeal to lose that much weight - I’m so sorry! It’s just a horror show all round isn’t it!
I have now come to the decision to have a double mastectomy as I don’t want to live with
any more cancer anxiety after this than I have to - even if the risk is small and they would catch it early. I also think that being ‘even’, even if that is implants that don’t look and feel natural, is a small plus.
I also think it helped me to call the Breast Cancer Now help line to discuss it as she pointed out that all methods of reconstruction are a bit of a journey and can often mean several procedures whichever route you take - I hadn’t looked at it that way before. The surgeons made it sound like the DIEP was amazing as you only have one op! But she said that there can be many ‘adjustments’ to the DIEP also.
It will mean expander implants immediately and then permanent implants down the line as I am having radiotherapy after I finish Chemo.
@nomoreptosis I am about to do my 7th of 8 cycles of chemo so suddenly these decisions are upon me! It does feel very intense and stressful! Your consultant is right - keep your head down and focus on getting through chemo. I have found it pretty grim to be honest. Many seem to sail through with a few minor side effects but I have been floored by it all the way through! It’s all consuming.
I spoke to a friend today who had a DIEP back in 2018 and she said she had four surgeries in the end to make adjustments and tweaks. That was really helpful to hear first hand, especially as I felt the surgeons were selling it as a ‘one and done’ compared to expander implant then permanent implant.
Hi, here’s my experience, if it helps any. I had ILC, double mastectomy because of high lateral risk, HR+ Her2- nine years ago, chemo, + AI (Aromatase Inhibitor/hormone suppressant) for 9 years. Recurrence as soon as AI was stopped. (Hindsight: Never go off your AI therapy if you’re HR+). Restarted AI therapy now with Letrozole and a CDK4-6 inhibitor Kisqali and it cleared up on PET scans and MRIs. In my cancer center they’d taken the breasts and put in the expanders in the same surgery, then I got ‘fills’ at intervals until ready for implant. I didn’t do nipple reconstruction because it can recur in nipples if left. Tattoed nipples look realistic so not shocked getting out of shower. You never really recover the nerve damage/sensation you had before in the breasts, the scarring gets old and ugly, and the implants – as best as they make them-- still feel fake and hard because they put them behind the muscle. Overall, I like not having to wear a bra, and I wanted them both off. It would be odd to have one pert breast and a saggy second one, IMHO. There’s nothing Hollywood about them though.
Really useful Rosie, thanks. I took a look at some reconstructions on Macmillan and it is shaping my thinking. I think I am leaning to the same choices as you for the same reasons.
I am so sorry you have had a bad experience, make sure your team know as even now they can adjust for you. You are nearly there, I wish you luck.
I have a meeting to discuss surgery in detail in a couple of weeks and surgery likely to be Jul/Aug so may give the nurses a call before then.
@nomoreptosis@rfg you are both strong women and I haven’t any advice on the surgery you are facing as I only had a lumpectomy . All the equally strong ladies who have replied here have come through what you are facing and understand the decisions you have to make. All I can say is that I am thinking of you, mentally giving your assuring hugs and praying for good results, straight forward surgery and easy recovery for you both. Lots of love xx