Urgent Surgery advice
Hi everyone. I’m in need of some urgent advice about breast surgery options. I have been given two different opinions by two different surgeons and I need to decide ASAP, which to go with (surgery April 16th).
I’m 36, with grade 2 & grade 1 invasive ductal carcinoma 2-3 lumps in a line at 10 O’clock(in line with underarm), ranging over a 5cm area, no children/Small C cup.
Dr Cindy Mak initially recommended a nipple sparing right mastectomy, with immediate implant and radiation. I was afraid of capsular contracture because I heal poorly/radiation.
She now wants to try removal of the cancer in one large lumpectomy (scar from under arm, along side of breast).
Then a second surgery to perform a LICAP flap reconstruction (I think they take a flap of fat from under the arm to fill the void?). I’ve lost weight over the last few weeks so I don’t have a huge amount of fat. She said I’ll be at least one cup size smaller and my nipple may be off centre. She could try fat transfer to help at a later date.
Dr Elisabeth Rippy suggested that in trying to keep my breast, I may end up with a less desirable shape/aesthetic result. She recommended a full nipple sparing mastectomy (scar hidden under breast fold) with an expander. Then radiation, followed by a second surgery for implant placement and fat transfer.
I was wondering if, given your decision again, you’d try to keep your breast tissue at all costs? And if unhappy with the size and shape, have a breast implant/augmentation at a later date? Is it even possible to have a breast implant after LICAP and breast radiation? Does radiation change the texture of a natural breast so much that an implant is impossible afterwards?
Or because the cancer is so large, is a mastectomy safer?
I’ve read that your initial surgery & shaping is very important in relation to future aesthetic outcomes. I really don’t know how to make a decision this important with so little information.
I would really love any advice (or even other surgeon suggestions in Sydney, for a final opinion). X