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Newbie with a surgical dilemma


Re: Newbie with a surgical dilemma

Hi Joozie

Dec.5th I had a masectomy and reconstruction, taken from my back, I was afraid, and being 67 years old and never having an operation was very apprehensive. I did put on a brave face, but I kept thinking positvally all the way through. The op was ten hours, but my recovery was good,I was back home within nine days, was given alot of support from family, surgeons, consultants,breast care support, and always kept in the picture of what was going on. After seven weeks I am driving again, having a automatic car I am sure has helped, my only discomfort at the beginning was reaching for my safety belt, and looking back over my shoulder. I am still a bit uncomfortable if I carry anything with my right arm, and have to remember to keep using my left arm, if reaching for anything. At the end of all this I was given the all clear on the 13th Dec. and havn't had to have chemo,rad, nor Tamoxifen. My last visit to see my Plastic Surgeron he only wants to see me now in six months time, to discuss my "boob" job, (on my what I call my old boob) and a nipple on my new reconstructed breast. This being fantastic, I have only dropped 2 cup sizes, was a 38DD and am told I should be 38B.


Re: Newbie with a surgical dilemma

Hi Juliet

Sounds like your a very brave and strong person good luck with all of it

thinking of you

Liz x


Re: Newbie with a surgical dilemma

Hi Juliet

So sorry that you have joined us here and wishing you well for your decision on surgery.

I was dx Oct 2007 with high grade DCIS, thought to be invasive and it looked like 5cm tumour. I had sentinel node op on 21 November which showed lymphs were clear so then on Dec 1st I had mastectomy with immediate ld flap recon and they found slightly smaller tumour of 4.4cm, smaller than the imaging showed but with margin 1mm to chest wall a lot closer than the imaging indicated, also had 2 areas of micro invasion. Overall, the imaging for me was pretty close but they can never be certain on that. A wee bit closer to the chest wall and I would have been having rads which would have caused problems with the implant that I had to have with the recon.

Your surgeon will know what he/she is doing and I guess we all just have to trust their judgement, this is after all their area of expertise. I am 34C and was not told that the ld flap can move, mine has unfortunately which means another op to replace the implant with a larger implant and secure the ld flap muscle. I was gutted last Tuesday to hear I had to go back into hospital but am ok with it now (liar liar pants on fire) hmm pretty much ok just hacked off that I had not known this might happen really and relieved that the op is more cosmetic and to ease the pain I have from the muscle moving rather than it being a return of cancer.

Also I asked after the op what the odds are on it coming back and in the recon it is only 2% so no worries there and on the other side with mine being high grade they tell me it is 7 out of 8 dont have a recurrence which I think is enough to say no to a prophylactic mastectomy on the unaffected site. I was not offered that even tho my Nana had bilateral breast cancer as I am the first in the family after her to be unfortunate to be dx with this awful monster, sadly my Nana passed away and had cancer in her brain, stomach and both breasts, she was not diagnosed until she went into hospital aged 83 following a couple of strokes so there is no pathology from my Nana to start off genetic testing for me or my sisters.

The way I look at is, if and for me I believe it is a big IF, it comes in the other breast then I will address that then as I am being monitored for the next 5 years annually and will by then be 52 so onto the 3 yearly mammos anyway. I feel safe enought to just get on with recovering from my ops on the poorly boob and get on with my life.

Write a list of questions down and leave space for the answers, press them to tell you all the cons as well as the pros for the type of recon that you are considering as in my case I was only told the pros and had to have the surgery fairly urgently as the cancer was growing so fast. I was dx on 23 Oct, sentinel on 21 Nov and mast and recon 1 December.

All the best for Thursday Juliet, and I do know what you mean about the just wanting to get on with it now, I had that feeling too but mixed with a sense of dread of the operation and recuperation and still some days I simply wake up and remember that all this has happened to me, I dont know when that will stop but I am sure that one day it will.



Re: Newbie with a surgical dilemma

Hi kmans

Thank you so much for replying. It's interesting to know that they can do a reduction at the same time as the recon, and also how they both healed differently. It sounds like one hell of an operation! Are you happy with the reduction?

My plastic surgeon said that they do reductions further down the line because they need to wait for the recon breast to settle and "grow" to the desired size. With the expander implants the cup size will initially be small and as they inject it with saline over a period of months the tissue will stretch to accomodate the growing implant. Once it's reached the desired size then they would know what size they were matching the reduction to.

Nevertheless, thanks for the tip - I shall be quizzing him on Thurs & see what he has to say.

Juliet x


Re: Newbie with a surgical dilemma

Hi Bunnymum

Thank you for sharing your experience - it's really helpful to know how you felt physically after your mastectomy.

Until the dx I had absolutely no idea of how complex BC is - I just thought there was one type! You're so right about everybody being different and there being a million decisions to make - with so much going on in my head I just want to make sure that it's the right one!

The hospital can't give me a date for surgery without a decision cos they don't know how much theatre time to book. It's almost 6 weeks since dx which seems like a lifetime as the whole thing is so intense. I think the strain is really getting to me now and so I am keen to get on with the treatment, even though 6 weeks ago I felt like running out of the door!

I have spoken to the lovely ladies on the helpline and they are trying to find a "match" to talk to. I have got an ever-increasing list of questions for my consultant, so I shall definitely be putting him through his paces and hopefully I can make the right decision for me.

Juliet x


Re: Newbie with a surgical dilemma

Hi Juliet

If you don't need a prophylactic mastectomy, I would think very carefully before going down that route.

I would recommend asking your surgeon why you can't have reduction at the same time as reconstruction. I was diagnosed in April 2005 and in June 2005 I had mastectomy + tram flap reconstruction + reduction in the other boob. It was a very long operation (10 hours) but I was out of hospital in under a week and haven't looked back since!

If the surgeon insists on two ops my comment on the reduction would be that it recovered very quickly and was far less traumatic than the recon!

With very best wishes on your decision

K x


Re: Newbie with a surgical dilemma

Hi Juliet,

Wow! Sounds like you have an awful lot on your plate at the moment -- no wonder you're confused!!

My situation wasn't like yours, I'm afraid, but I do remember the initial feelings at my first diagnosis (exactly a year ago). I went from someone who didn't even know anyone with bc, and refused to read anything in the papers about it cos it was too scary and only happened to other people, to being diagnosed and having a million decisions to make!

I was dx with invasive lobular cancer in one breast and extensive LCIS in both. Since we weren't sure if I needed chemo, it was decided to just removed the cancerous breast and hold off on the LCIS one. As it happended, I didn't need chemo. I never wanted recon even though I'm only 46. However I have felt very lop-sided with just one breast (a 'c' cup) and haven't been able to wear my prosthesis much due to a large keloid scar which is sore and sensitive.

To reduce my risk of getting cancer in the remaining breast and for sake of balance and cosmetic reasons, I am having another mastectomy in April.

I didn't find having a mastectomy painful but it was tiring, and I'd imagine having both done at the same time would be hard on the body. But many women find it difficult to go through one surgery only to face another one later on. Everyone is so different.

Can you sit down with your consultant and work out the options you have - sort of 'If I have this then I'll need this done at that time....' so you can work out the best path for you to take? Don't be afraid to ask a million questions - there's a lot to take in! Is there a desperate rush to make a decision?

Whatever you choose, make sure it is YOUR decision cos it's your body and you have to live with that decision.

Hopefully other women will give you lots of advice too, or at least share their experiences with you. Might I suggest you call the wonderful ladies on the helpline?

Whatever you choose, I wish you all the best.

Jacki x


Newbie with a surgical dilemma

Good afternoon, ladies

My apologies in advance as this is a long post. I’ve been reading the forums since I was dx with high grade 5cm DCIS on Jan 17th. mx with immediate reconstructive surgery proposed. 39 at the time of diagnosis (Happy 40th, not!) and I struggled to understand why I needed such drastic surgery for non-invasive cancer. I thought I was going mad with the whirlwind of conflicting thoughts, so it’s been a revelation and a huge comfort to discover so many women on this forum experiencing similar thoughts, emotions and fears.

I haven’t had surgery yet as I’ve been waiting for results of genetics testing for the BRCA1/2 Ashkenazi mutation. Suddenly, I was having to consider prophylactic surgery on the other boob as well as the mx. However, I found out on Friday that the test was negative. Now, I don't know whether to go ahead with prophylactic surgery anyway.

I am seeing the plastic surgeon again this Thursday and these are the factors that come into play:

- I’m a 32G and I don’t have enough of my own tissue to use (tell that to three pairs of jeans I can't fit into!). As we don’t know if I need to have rads yet, he is proposing expander implants which could later be changed to silicone.

- Surgeon recommends a reduction of the other boob to get a better cosmetic result, but that won’t be done at the same time as the reconstruction of the other boob.

- MRI has shown necrotic cells which my breast surgeon says are “suggestive” of invasion, but can't confirm until after the mx. She thinks the area affected is larger than what is showing on the imaging.

I’m fine with reducing the size of my boobs all round, but the way I see it, if I have a reduction this will involve two operations, being majorly lopsided for quite a while (summer’s round the corner and I can’t wear ponchos), plus I don’t know what the final results of the pathology will show.

On the otherhand, is it too extreme to consider prophylactic instead of a reduction? If I have a double mx then I imagine that's double the pain, healing time etc. I'm worried that I am being frivolous. When I was first dx I was desperate to hang on to my boob. I can’t believe that in the space of 5 weeks I am thinking of a double.

Has anybody else had a similar experience?