Immediate Reconstruction

Hi there, Has anybody with DCIS had Mastectomy and Immediate Reconstruction? I’m so unsure about what to do. So many people have different opinions as to what is best. I was thinking I’d go for immediate reconstruction with DIEP flap but what if the Histology report shows something other than DCIS? I’m having an MRI next week so that should eliminate that risk, I suppose. Also has anybody waited a long time between told diagnosis of DCIS and having surgery? I was told on March 11th and due to my Consultant offering me a 2nd opinion and that taking a long while to organise, the 2nd opinion suggesting MRI and that needing to be organised here I am 7 weeks later and not seeing my Consultant to discuss surgery for another 3 weeks!!! 10 weeks seems ages to me.

Hi,

I was diagnosed with DCIS on 13th March and due to it being fairly widespread was advised to have a mastectomy. I was offered an LD flap reconstruction which I had at the same time (2nd April). So I’m now 4 weeks in to recovery while you are still waiting - so, to me, it does seem like a long time but your surgeon may have good reasons for waiting. I really feel for you with the waiting - I think that is one of the worst things as so many of us find that our imaginations go into overtime! Whereas, for me, my feet barely touched the ground - I just about had time to clear my desk and hand on my work!

While having my surgery they discovered that the DCIS had developed further in quite a number of areas and one in particular was quite large. Although, thankfully, my lymph nodes remained unaffected. However, my consultant wants me to have chemo followed by radiotherapy as a precaution. I think she would have recommended this even if I’d not had the reconstruction. To begin with I wasn’t bothered about having reconstruction but once my bcn had shown me the prothesis and photos of reconstructions I decided I would go for it. The surgeons recommended immediate as it meant they could use more of my own skin and I couldn’t see myself opting to take time off work again in a year or so - although I will now be off for longer because of needing further treatment! However, I’m really pleased with the surgery - it’s really neat and tidy - so would make the same decision again.

Wishing you all the best as you make your decision.
Zoe

Hi There
my situation is slightly different from yours in that I have IBC but my lumpectomy showed DCIS to the margins and I was advised to have a mastectomy. I had DIEP immediate reconstruction in March and have now just started chemo. My B surgeon described DCIS as a pre-malignant condition but high risk of becoming malignant hence the recommendation for mastectomy. However he also said that it can take a very long time for DCIS to become malignant sometimes months and years. Although I am pleased with the outcome of my DIEP recon it was a huge procedure and I count myself as realtively young (38) and fit (just ran 5K this morning) it still knocked the stuffing out of me for a while. I would def recommend it in terms of outcome but it’s something you must be absolutley sure is right for you and I think you are right to get a second opinion. I don’t think 10 weeks is too long to wait in the grand scheme of things. I think is more important that you get the procedure that you can go into with total coonfidence that it’s right for you.
Best of luck with everything

Hi, I had LCIS 2 years ago and have been having 6 monthly mammograms since. In July last year my mammogram was clear but only 6 months later the DCIS had appeared. I think that worries my Consultant. She said that she considers it to be a very “at risk” breast.

Hello thetrumumshow ,

I had a longish gap between being diagnosed with high grade DCIS and the actual operation. I was diagnosed end of January 2007 but I postponed the operation until the second week of May 2007, because I needed to find someone to look after my disabled husband. I don’t think that the cancer cells had spread in those 15 weeks. I believe that your 10-week wait will not worsen your condition.

Evening ttms!

I was diagnosed with DCIS March 20th, confirmed by core biopsy 10 days later, at that point needle biopsy of lymph nodes clear (and still is as far as I know - nothing more on MRI in lymph nodes). Mri 2 weeks ago picked up another ‘suspicious’ area (don’t u just love that word!) so had core biopsy last week and today told I have IBC grade 3 in that area. This changed the surgery plans a bit - I was then given the choice of mx with expander to keep skin stretched with LD flap and implant at later date (ie after chemo & rads) or LD flap only, no implant with view to equalizing them after adjunctive treatments by either using an implant or reducing other breast. So, the fact that I have waited and the surgeon has managed to get a very clear picture of what’s going on in there mans that I’m not going to risk buggering up my recon as there will be no implant to mess up during rads. My surgeon isn’t a plastics one so LD flap was my only choice, although I could’ve gone with Diepp had I chosen to.
I’ve chosen LD flap with later equalization because I don’t want another big op next year and I do want to be able to get on with the chemo asap - you need good healing for that. Not fussed about lopsidedness at this point…
I’m having my op on 12th May - 9 weeks from first finding it. I think the chemo will get any stray cells and rads will be belt & braces…
Hope that helps. But it is quite complicated…!

Love, Td x

Oh yes- meant to say, knowing all the info before surgery means no huge suprises after. The histology of what is taken out takes 10days - 3 weeks to come back. If there’s any chance you may need rads the surgeon will be looking for a recon that won’t fall apart during rads… my surgeon said to me ‘if I’m going to invest 6-8 hours of my time and expertise into making you perfect breasts, I want them to last’ !! Well, My mum put 9 months into giving me the perfect breasts that I already have, and they haven’t lasted, but I see her point!!

Tdx

Hi,

i had my surgery just under 2 wks ago, i went for a recon straight away and iam now so pleased i made that decision. The results are amazing if i don’t say so myself…you would never know i had a breast removed! The op took a couple of hours and i was in hospital 2 nights. The most painful bit for me is the lymph node clearance.

Lisa

I was first biopsied on 3.12.07 because I had 2 solid lumps (one with a shadow behind it) and several clusters of micro calcification in my right boob. They pierced my artery whilst doing the biopsies and I was left black and blue and had a huge haematoma in my breast as a consequence. I had a wide local excision on 25.1.08, when they could only pin point one lump to remove instead of the two. (the other lump with the shadow,I feel, was hidden by the haematoma). I was told on 13.2.08 I had intermediate DCIS in the clusters and other tissue. They said the edges werent clear in 2 places and I needed another smaller op to get clearance and that is all the treatment I needed. They wrote to my doctor twice saying this. I argued that there was still one lump still inside me for weeks and weeks and have never had the egdes cleared . AN MRI showed everything still hidden by haematoma.They said I could consider a mastectomy if I wanted or have the edges cleared and wait 6 -12 months for review when they might be able to see more clearly.

I went for a 2nd opinion and was told without doubt that I needed a mastectomy . Moreover they have picked up from the MRI that I have it in my other boob. I found out on 21.4.08 that I need a double mastectomy.

I have been back and forward to hospitals for 5 months and am desperate to get the cancer out of me. I saw a plastic surgeon yesterday who says they have provisionally booked 17.5.08 for my bilateral mastectomy and recon. I saw him for first time 4 weeks earlier when I possibly only needed one done. We agreed on a DIEP recon then. Now yesterday he suggested an LD with implants as he couldn’t guarantee my size with the DIEP. I mentioned theTRAM ops which use your muscles as well to bulk out. He doesn’t believe in doing those at it compromises your stomach muscles. I was all set on having a tummy tuck as well.

I have been thinking about it overnight and rang the breast nurses today to see if I could speak to someone re TRAM recons especially the free TRAM. They have said I have to have what he does as he is in a team with my breast consultant. To speak to another team and a different plastic surgeon there who does do TRAM recons will delay my op. I have had to wait 4 weeks to see the plastic surgon yesterday and feel he is limiting my choices and I would rather not have implants if possible. I am 10-12 and 4ft 11 in , 9 stone and 36c. Would I get volume with a tram and should I wait to get a second opinion or go for LD and get it out of me after 5 month?

Maxinebev

Hi,

I had a masectomy and immediate tram recon 7 weeks ago, and I am thrilled with everything my ‘new boob’ is fanastic a perfect match although I dont have a nopple yet. I have to control myself because I want to show everyone, and as well as a perfect new boob I have a loverly flat stomach, so Ive had a boob job and a tummy tuck for free!
My main problem is loosing my hair with the chemo, Im more tramatised by that than the op. But all in all Ive been very lucky and would advise the immediate tram reconstruction, it was good to come round after the op and still have a breast.
Good luck
Marie x

Hi

Good to read you positive message Marie - With High grade DCIS and big boobs I am going to have a mastectomy shortly. I originally said I didn’t want a reconstuction “Nah I’ll just stuff a pair of rugby socks in my bra” were my words . I was given a date, but then imagined nothing on one side and a great lolloping bosom on the udder side so asked if I could have a reduction. I met a new surgeon - he was brill - and am now going for immediate recon( expander implant reconstruction- anyone had one of these?) after mastectomy and a reduction. Anyone else had this combination? Howerver he wanted to ascertain that radiotherapy would definitely not be needed so have just had overnight stay in hospital for snb and am awaiting results - surgeon hopes to get me in on 17th if he can hurry results - oooooer! Would love any encouragement advice…anything…please! Chebsy xxxx