Thanks for your post where you told us that you are undecided whether to have a mastectomy or a “back flap” reconstruction. This is a very personal decision and it’s understandable you want more information to help you decide.
This type of reconstruction uses the latissimus dorsi (LD) muscle that lies in the back just below the shoulder blade to form the new breast. As you say, the blood vessels of the flap remain attached to the body. It’s usually necessary to use an implant under the flap to help create a breast that’s a similar size to the other one and the scar on the back is usually horizontal and hidden along the bra line.
After fully recovering from an LD flap reconstruction, some women will notice weakness in the shoulder during everyday activities. This might be an important consideration if you’re very active, for example if you regularly swim, climb, row, play tennis or golf. Your may want to discuss with your surgeon what effect the surgery is likely to have on your lifestyle and whether it is likely to affect your aching shoulder and left arm lymphoedema.
You’ll find more detailed information in our Breast Reconstruction booklet. You might also find some useful information on the BAPRAS (British Association of Plastic Reconstruction and Aesthetic surgeons) website.
Talking to someone who has had a similar experience can be helpful when you have a difficult decision to make and our Someone Like Me service can arrange for one of our volunteers to talk to you by email or telephone. Our volunteers have had a personal experience of breast cancer and are trained to provide support.
You can ring the Someone Like Me team on 0345 077 1893, or email them email@example.com so they can match you to a volunteer.
Do call our free, confidential Helpline if you would like to talk this through or have any further questions. The number is 0808 800 6000.
Our opening hours are Monday to Friday 9am - 4pm and 9am -1pm on Saturday. Out of hours you can leave a message and we will call you back when we next open.
Breast Cancer Now Nurse
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Thanks for posting your question.
We hope to be able to respond to you on Monday.
In the meantime our Helpline is open until 4pm today.
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With best wishes.
Ask Our Nurses Co-ordinator
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Hi, I was diagnosed with a grade 3 hormonal breast cancer in 1989, I had a lumpectomy to the left breast, chemo and radiation, a little later it was decided that I would benefit from radiation to my ovaries to significantly reduce my oestrogen levels. Now over thirty years on and after a routine mammogram a 1mm cancer found in same breast different area, this has been diagnosed as another primary. I have looked at all the options to hand and after consultation with the surgeon, plastic surgeon and key nurse, it was decided I would not be suitable for the tummy flap as I had not enough elasticity in the skin in that area. I have been offered a back flap instead, this has the advantage of the flesh from the back being moved round to the front to create the breast with the blood vessels intact, unlike the tummy flap where the blood vessels are severed and have to be reattached in the breast area. I am then having a breast reduction approx year later on my good breast. The reason I chose that, rather than a double mastectomy was that I would be able to still have a mammogram on that breast as my risk of a further primary cancer was moderate and the hope is if that happens it will remain in the breast area where it is easier to treat rather than appearing in another major organ. I also have slight lymphedema in my left arm and aching in my left shoulder where the flesh at the back seems to have receded in comparison to my other shoulder. No one seems to offer reasons for this.
I am dithering and wondering if I should consider just having the mastectomy with a prosthetic and leave well alone, although I have become rather unhappy with my partial prosthetic over the years.
I would greatly appreciate the risks of the back flap operation re-affirming if you could and any other information you feel may be useful to me. I have posted on another site in the hope others who have been through similar might also contribute advice. Many thanks.