My First Post

Thanks Mona, I have just read that article. Very interesting, think i might take this with me to my next appointment.

Wow what a small world...might even run into you at some stage in the Breast Clinic waiting room:)  Do you have same surgeons?  I have Cid_Fernandez for Breast and Anna Goodwin-Walters for PS.

Well you have given me more questions to ask - i am writing them all down.

I am going public through Royal Perth as well - its very reassuring to know the calibre of the surgeons - i didn't know about the Bali victims. I have an appointment to see the Breast Gallery at RPH but not until the 15th Jan - I could have my surgery date by then.

I am in a state of disbelief as well and know it won't hit me until i am on the trolley being wheeled into theatre - hopefully by then i will have been given lots of sedatives.

When I saw the Breast Care Nurse on Monday she was to show me photo's for diep reconstruction but she didn't actally have any that used their own nipples.  When she read the notes and the breast surgeon noted that he was going to use the nipples...it suprised her.  She said that it is not very commonly done.   My understanding from the meeting with him that he was going to put them on ice if they were cleared of cancer and they would go on later but she no he stated that that they are staying as long as the sample they send of during the operation is cleared?

The PS did mention that she would be performing the operation through the hole where my nipples would have been.  But when I told the BC nurse she said that, she said she won't be able to do that if the nipples are there.  So she will have to cut on either side of the nipples and half under the nipple to create a window to work in.  Also she said that when they complete the operaton for 48 hours they monitor the flap to make sure blood flow and you need a window for that.   

I felt like the Plastic and Breast surgeon are on different pages at the moment.    I see the PS tomorrow and then I see the Breast surgeon on Tuesday to discuss what happened with the Plastic surgeon and then he does a plan up as well.  Apparently he works with the Plastic surgeon not the other way around, so whether that will still include the nipples I'm not sure.

I'm lucky actually.  I'm going public through Royal Perth and both are meant to be excellent surgeons.  I know the Plastic Surgeon worked with the Bali bombing victims and is meant to be one of the best micro surgeons.  So I feel safe with whatever she decides to do.

I think a lot of about what could happen...but I don't think it will hit home until I walk in to the hospital on the day of the operation.   I stress having a needle so god help me:)

Hi again, Thanks for all your info. The only surgeon i have seen told me i had enought stomach fat to reconstruct both my breasts (i knew that) my husband was surprised the surgeon didn't get a black eye :) I am waiting to see the PS on the 8th Jan so i will talk to her about the DIEP and free Tram Flap. I really don't want the TRAM Flap if they are going to use my 6 pack ( i don't have a 6 pack but maybe one day..............)

That was another question i wanted to ask - about using the existing breast tissue - i was under the assumption that the breast is reconstucted through the nipple. I know i was told that they couldn't use the nipples because they are attached to the ducts.

Chemo hasn't been mentioned to me at all - i suppose that would be considered if they find anything in my lymph nodes but they said they are not expecting to.

Let us know how you get on tomorrow.

Sue.

Well this is what i know so far.    When I saw the breast surgeon and I told him I want both off he suggested in that case that I have immediate as he didn't think it wise to go home with no breasts as it will be a big shock.  So then went and saw Plastic Surgeon and I told her I wish to have diep reconstruction as my first option.

I don't have enough stomach fat (which I couldn't believe) to match my current B cup. I said thats fine this is about having natural looking breasts not the size.  So looks like she will try for a A+/-B?

Because I want bilateral she wasn't too happy with this , as its  a huge operaton she would need 2 teams to work on each side.  the Breast surgeon comes in and does the Sentinal Node Biopsy and removes both breasts (keeping my skin and hopefully nipples).  While he is doing that her and another off sider start opening up my stomach to see what my vessels look like.  If I was only getting one done and they had complications in not being able to get blood supply, they can usually pinch from the other side, but because I'm having both they won't have that option.  So therefore she may have to use some of the muscle if there is a problem.    I will have to sign a waiver which states if they need to use muscle they will do, thats okay if thats the path they have to go down.

She classes the "diep" as the "rollsroyce of all restructions" so alot risker but better outcome than the implants or back strap otpion (can't remember what thats called).   

Also I have been on blood pressure tables for the past 2 years.  She adivsed that people with hypertension their arteries tend to age quicker than those who don't have it.  So another reason why she might have to use muscle to get better blood flow.

I was sent off then to have CT scan on the blood vessels.  One to see what they look like and apparently it also shows the mapping so they know where they are working.    I haven't spoken to her about this scan yet, so hoping it all looks good.

So tomorrow after I have seen her and she gives me more info.  I wlll keep you up to date.    

Have you been told if you need Chemo yet?   I get over one hurdle then I start dwelling on another.   The BC nurse said that despite what my results come back at I may still need to chemo due to my age?     Its funny because I class 48 as getting old but in the BC world we are referred to as being young...which I find entertaining.

Talk you soon:)

Hi Karon, I can't believe our stories are the same - i only have the DCIS in my right breast - it is 65mm. You are right about the surgeons not being keen to remove the left breast, i was under that impression as well.

Some of the questions i have for the surgeon are about the pros and cons of TRAM flap surgery and DIEP surgery. I have read on the net that TRAM flap surgery is no longer used in the States because of risks of hernia or abdominal bulge. And DIEP surgery is the better option because they dont use your stomach muscles. Was this discussed wit you? They have only discussed TRAM Flap with me.

I have to have the Sentinal Node Biopsy in the same op as well. 

If you find out anymore information tomorrow that might be helpful - i would love to hear.

Best Wishes,

Sue.

I am the same as you. Work offered mamogrammes in work time so thought I would go as everyone else was going.  I haveonly just turned 48 in December, so didn't see the urgency to go...but glad I did.  They found micro calcification in both my breasts and I had biospsy on both.  My left was benighn but I ended up with Invasivie Ductucal carcimina and DCIS in my right breast.   At this stage they are saying 20mm but won't know actual size until they go in.

I have decided, thanks to this site, to have a double mastecomy with immediate diep reconstruction.   I am seeing surgeon again tomorrow to confirm my surgery date.  Looking at 16/1 or 20/1 at this stage.   They will be doing the Sentinal Node Biopsy either prior to the operation or on the same day. That also has to be confimed as the operation is going to be upto 14 hours.

I had no hesitation in wanting both breasts off but its the surgeons who try and sway your decision.   I was disagonosed on the 24/11 and it is only this last week that I finally come to accept my decision as being the right decision and no one is going to change my mind now.    I don't want to watch and wait to see if the left breast develops into cancer.   

Good luck:)

Karon