Hi, new to this online group and after some advice please. I was diagnosed with stage 2 IDC HER 2 positive. End of March this year. Have just finished 4 th round of AC dense chemo and start paclitaxel and hercepin in 2 weeks then mastectomy and radiotherapy . When I asked the surgeon about how long do I have to wait for reconstruction she said 2 years. I was really shocked it seems so long. What is other people’s experience?? Thanks

hi halzai've had neoadjuvant chemo (finished in march) followed by a skin sparing mastectomy with exapander of the right breast in april. i will have 5 weeks of radiotherapy starting in june. i will be having a DIEP recon (using tummy fat). my plastic surgeon's preference is that recon takes place 3/6 months after radio as it gives the skin and underlying tissue time to settle down so that he knows what he's working with, so to speak. i understand this is particularly important in relation to the blood vessel in the chest area that the transplanted tissue from the abdominal area will be connected to. i believe that some plastic surgeons do immediate DIEP recon after radiotherapy (reverse sequence), but my surgeon preferred not to and i'm happy to go with his recommendation. at first i wanted to get it all done in one op, but i actually feel a bit better that i have them spaced out as i felt things were moving rather quickly (even though my treatment path has been over the last 6 months!). this is just my experience and understanding, but i hope it helps answer your question somewhat :) lvlwxxx

Hi Halza and welcome. I'm sorry that you find yourself here but hope that you find it as helpful and supportive as I have.Are you referring to your specific medical advice, or the waiting list in the public system? If it's the latter it very much depends on what state you live in. Where are you?The medical advice seems to be that you get the best reconstructive outcomes with immediate reconstruction, ie done at the same time as the mastectomy. This does not always suit everyone as mastectomies can happen early and fast, just after diagnosis when we are in shock and at the beginning of a vertical learning curve.The type of reconstruction can affect timing too. A DIEP is a more arduous procedure than implants, but often is the one preferred if you've had radiotherapy.Breast size can impact your choices and so the timing as well. I'd suggest asking your breast surgeon to detail for you her decision on the timing next time you see her. Unless it's a waiting list issue.I had a double mastectomy with immediate DIEP reconstruction. This took place after chemotherapy and was to some degree prophylactic. I avoided radiotherapy because I had the mastectomy.Good luck and let us know how you get on. Big hug, Kate xox

I believe the 2 years may be the waiting list. But because you need radiotherapy it does need time to heal completely. The tissue changes after treatment. You may be able to discuss if you are a candidate for immediate tissue expander at time of mastectomy. What type of reconstruction are you considering?

Hi @Halza, I'm not sure why your surgeon would necessarily suggest 2yrs before you can have reconstruction, unless, as the others have suggested, it is due to the waiting list if you are in the public system. I did have a delayed DIEP (where they use stomach fat to make a breast) reconstruction, and as it turned out it was a 2yr break between my mastectomy and reconstruction, but that was my choice. The reason I waited was that I wanted to get through all the treatments (chemo, Herceptin and radiation), feel confident that things were stable in relation to the cancer and to fully heal before undergoing reconstruction as the chemo and radiation were pretty hard going. I could, however, have chosen to proceed with the reconstruction a bit earlier as I went through the private health system. I did have my name on the public hospital waiting list (at Prince of Wales in Sydney) but it was at least a 2-3yr wait and I couldn't be sure that I would have the surgeon of my choice.There are some options to talk to your surgeon about, including the possibility as @primek suggested, of an "immediate delayed" reconstruction where the breast surgeon places a tissue expander at the same time as your mastectomy. The tissue expander can help prepare the area for later reconstruction (including DIEP). DIEP is usually the reconstruction option many surgeons recommend if you are having radiation as there is a higher possibility of complications and failures with implants after radiation, although it does largely depend on how well your skin and the underlying areas are affected. You might find this page useful on the Reclaim Your Curves website which talks about immediate vs delayed reconstruction: https://www.reclaimyourcurves.org.au/timing-of-breast-reconstruction.html. There is further information on that website about most of the reconstruction options available in Australia and hopefully you will join us in the Choosing Breast Reconstruction group on this site as there are a wealth of photo stories and wonderful members who are able to share their experiences around reconstruction with you.Hope this helps. Jane xx

My mastectomy & DIEP took place six weeks after the end of my last cycle of chemo. It's made recovery a bit slower but has not caused any other problems. I was a private patient.

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