Reconstruction after Radiation?

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