Reconstruction after Radiation?

Good to hear you got such sound advice from your radiation oncologist. I had radiation 12 years ago with a lot of skin damage and was advised against implants when I had a recurrence and mastectomy last year. I preferred to go with my own tissue anyway so that was OK. I do know people who have had implants after radiation and are very happy. One had to really push her surgeon to do it, but it worked fine and the surgeon ended up using photos of her results as examples for future women to show that it could be done and look good. Fingers crossed for your genetic testing results and for the job. Viv

So I woke up today feeling like making toast was far too hard...quite bizarre as I haven't had "exhaustion" like that so far! Dragged myself out of bed, had breakfast, then went back to bed and nearly missed the appointment altogether!!  Aaaargh! 

Made it there in the end, had an almost 2 hour consultation with the lovely radiation oncologist, and found out a few things that put my mind at ease. 

She said that in some situations, even if a mastectomy is done, radiation is required due to the cancer being close to the chest wall, or if there is lymph involvement. This does limit the options for reconstruction, but thankfully it doesn't apply to me. So, all going well, I would be able to choose the type of reconstruction I would have. 

Then she said that although radiation can affect the tissue & skin, the opinions of surgeons on the best way to do things swings back and forth, with new techniques & developments, training etc - and currently there is a lean towards implants being ok after radiation (results wise) it just takes a bit more work on the surgeon's part, and may take longer to get there as the expanders need to be filled slowly. 

In a nutshell, she said that a good surgeon will be able to deal with irradiated tissue and skin, and if it comes to that, to shop around til I find one that has multiple examples to show me, that I like the look of. 

So now I'm just waiting til next Tuesday so I can FINALLY get the results of this genetics test...hopefully, all my worry about mastectomy and reconstruction can be forever banished out of my mind, and I can get on with chemo, radiation, and loving my Frankenboob!!

And, on the way home, I had a total stranger on the tram tell me that she thought I looked wonderful, and she had had BC 11 years ago. She wished she had been so brave back then to go without her wig! Made my day :-)  I said how I hate covering it up, and how I have wigs at home that have still not come out of the packaging! We chatted for a bit about how it changes your outlook on life etc etc.  Never ceases to amaze me how we get these little bits of encouragement from strangers more often than people we know! Anyway, I feel better about the whole situation now, waiting for Tuesday to be over and done with!!

 

Hi,

 I had a right-breast mastectomy in July, followed by chemo, then 33 radiation sessions. The rads finished a fortnight ago. I’ve found them more tiring than my chemo. It’s a different tiredness – I’m not tired during the day and it doesn’t affect me mentally, but I found I got tired at around 10pm during radiation (tiredness kicked in after three weeks) and I need about 9-10 hours sleep to feel really refreshed (working full-time through-out). Still tired now, but told this should resolve itself in a fortnight or so once the last of the dying cells regenerate.

 I was given the ‘option’ of radiation. My breast surgeon (a 20-year breast specialist veteran) recommended it, as did the radiation oncologist. My medical oncologist was pretty neutral, and I gather my plastic surgeon would have preferred I didn’t have radiation (but didn’t say this to my face).

 So, given the ‘option’, I chose to proceed with radiation after some research and my diagnosis of a Stage 2B, grade 3 (aggressive) cancer with ‘extensive lymphovascular invasion’.

 I’m being candid about my results because your pathology results will influence your choice. I knew all along that radiation would complicate my reconstruction surgery outcome (I currently have an expander and cannot have final reconstruction until at least August to allow the radiation effects to settle).

 The radiation effects on my skin settled quickly (2 weeks post final rads I’m wearing scoop-necked tops and no one would discern any difference from my ‘normal’ skin unless they looked closely – or saw me naked).

 My plastic surgeon (who I gather has been in a long-time partnership with my lovely breast surgeon) is aware of my choice to have rads and seems very confident that he can achieve a good reconstruction despite this (while acknowledging it is easier for him without having to deal with irradiated tissue).

 So far, we’ve discussed an implant to replace my expander, plus a likely ‘small implant and lift’ to my left breast to achieve balance. We discussed a DIEP flap to overlay the implants, but I doubt I’ve got enough fat to benefit from that, plus I’m reluctant to have the large abdominal surgery unless I really, really need to! He knows that and it’s still undecided.

 So, at this stage, I’m glad I had rads (given my own personal diagnosis), and I trust my plastic surgeon when he says he can work out a good reconstruction solution for me.

 

Fingers crossed for your work outcome!!

Big hug,

Peta

 

I have the same dilemma. I have I chemo left then will begin radiation in April. I did have a mastectomy but due to the cancer being close to the chest wall they believe radiation will decrease my chances of reoccurrence. He said that I could still go the Implant route if I am willing to wait at least a year for my skin to successfully heal. I do want a good result so I am willing to wait. Let me know what yours says. So many different opinions. I am a member of reconstruction group and I think it's best to get expanders after radiation . Just from the pictures I've seen who put expanders in first. Good luck!

I have the same dilemma. I have I chemo left then will begin radiation in April. I did have a mastectomy but due to the cancer being close to the chest wall they believe radiation will decrease my chances of reoccurrence. He said that I could still go the Implant route if I am willing to wait at least a year for my skin to successfully heal. I do want a good result so I am willing to wait. Let me know what yours says. So many different opinions. I am a member of reconstruction group and I think it's best to get expanders after radiation . Just from the pictures I've seen who put expanders in first. Good luck!

I agree with Deanne. It is my understanding that it is tricky if the area has been irradiated as the tissue forms quite hard scars which do not stretch easily for expanding etc. just what I have read from others experiences. Fantastic news about work possibilities. Fingers crossed for you. Julie

I'm wondering if you will need radiation if you end up having the gene and opting for mastectomies? Radiation is always needed after a lumpectomy but not always after a mastectomy. It is my understanding having had radiation myself that implants are more prone to complications if you have had radiation. However some surgeons do do them successfully, so it maybe worth some more research on this, if it becomes relevant for you. Take care. Deanne xxx Ps The reconstruction group is definitely a fantastic source of info if you do end up needing this.

I'm wondering if you will need radiation if you end up having the gene and opting for mastectomies? Radiation is always needed after a lumpectomy but not always after a mastectomy. It is my understanding having had radiation myself that implants are more prone to complications if you have had radiation. However some surgeons do do them successfully, so it maybe worth some more research on this, if it becomes relevant for you. Take care. Deanne xxx Ps The reconstruction group is definitely a fantastic source of info if you do end up needing this.