Cancer has pushed forward onto skin - what will mastectomy look like?!

Hi all.

Surgery is creeping closer and, whilst I’ll ask my surgeon these questions obviously, I’m hoping to get some insight here too.

My tumor was large (9cm pre chemo) and had made it’s way to the skin/nipple. I’m having a mastectomy but can’t picture what it’ll look like. Lots of mastectomy scars are straight across our inverted ‘T’ shapes. With mine needing to remove so much actual skin I can’t work it out. I only have small breasts (B) so it’s going to be everything going I should think.

Any insight from anyone would be greatly appreciated please!

Also, I had an initial MRI at diagnosis but not one since starting chemo. Did most people have another one or do the surgeons just work from where the cancer WAS.

Thanks everyone.

Doris x

Dear Doris

Sorry about your bad news but I found it gets easier once you have your operation. My mastectomy was a skin sparing one as I had a reconstruction which went underneath. If the cancer had gone to my skin I would have had it removed along with my breast and been very glad for it to go. It is best to ask your nurses what happens as they will know much more than anyone else as they get to see so many patients. The treatment is very much tailored to the individual as breasts and breast cancers vary so much. It’s very difficult to advise anyone of anything as a result unless you are a professional breast specialist.

Seagulls

Sorry to hear your cancer has spread to your skin.

I’m in the same predicamet. The skin involvement was picked up on an initial MRI & confirmed by biopsy. Saw reconstruction surgeon today & I asked where exactly the scars would be but he couldn’t tell me. Says I’ve to ask breast surgeon as its up to them how much they take away so I’m going back to them to ask.

They have spoken about end imaging but not sure if that’ll be ultrasound,ct or MRI.

I’d recommend you go back to your surgeon & ask. Hope you get the answers you’re looking for & good luck on your journey

Hi Doris

It was a skin infiltration that saved my life. I’d had a clear mammogram but one morning I noticed 2 small bumps on my areola. I contacted my GP because my mum had had breast cancer twice so it made sense. No one was worried, even the breast consultant said there was nothing to worry about and I had another clear mammogram and a clear ultrasound! The following week I was told the biopsy on the freckles showed breast cancer and I ended up with 5 diagnoses over 5 weeks, with 2 tumours of different types!

I had a mastectomy and full axillary clearance. One tumour was burrowed between my ribs. My scar is a straight white line across my chest, about level with the armpit. There is a nub of flesh in the cleavage area because they do the operation with us lying flat but it does help give the impression of cleavage if wearing a v-neck. The scar goes haywire under my arm. You may find the skin very tight but massage and doing the exercises even when you think you no longer need them will help. If you’re opting for reconstruction, ignore all this.

Hormone therapy meant I gained weight. I went from 34A/B to 36DD in the one breast - most disconcerting to eventually get a womanly boob at 68, and only one! I actually don’t wear a prosthesis. I prefer the comfort of what I now call monoboobery. I’m lop-sided, tough!

The fact that you’ve had chemo first suggests your tumour needed to be shrunk before surgery, which is quite common. This saves more of the breast muscle and tissue and enables the surgeon to secure clear margins - reducing the risk of recurrence further. Unless the skin infiltration was above or below the breast, it shouldn’t present a problem if you are having a mastectomy because all that skin will be removed. Plus, chemo may have resolved it

It takes about a week to begin healing and I would advise you to look at it with curiosity rather than horror. Some people regard it as mutilation. Personally I see it as my life-saver. I didn’t have an MRI or CT scan until after surgery btw - but I did have surgery before chemo, radiotherapy etc.

Good luck with the surgery 

Jan x

By the way I was a 34B when I had my mastectomy last year. It didn’t seem to matter what size I was to the surgeons no doubt they have seen a lot of breasts and nothing fazes them! I wouldn’t like to think of them having any thoughts except to make us look as good and healthy as possible. I had no idea how it would turn out either time I had breast cancer surgery in 2003 and 2022 but I just had to accept the things I cannot change. Not easy but better than trying to do the impossible. 

I know delayed reconstructions are possible for some women.

Good luck

Seagulls