Double or single mastectomy and DIEP reconstruction?
Hi there, I wonder if anyone has any guidance for a decision that I realize is mine alone but is nevertheless a difficult one. I was diagnosed with invasive lobular carcinoma in August last year after discovering a lump in my left breast. I had a clear mammogram less than 12 months prior. Ultrasound showed it 4.5cm but subsequent MRI showed it 6 cm.I had very large breasts .At the first meeting with the surgeon (when we thought it was 4.5 cm) he discussed options of either breast conserving surgery or mastectomy on the affected breast.I was leaning toward BCS until we found it was 6 cm and he explained that there was a greater likelihood of not getting clear margins where it was lobular and given the size of the tumour I might need a mastectomy in the end anyway.I opted for a mastectomy and it turned out it was 5.5 cm .Also it extended right up the top of the breast so mastectomy was the right choice.I was lucky there was nothing in the lymph nodes.I opted to go DIEP flap surgery with the plastic surgeon inserting a tissue expander at the same time as the mastectomy and also doing a reduction on the right breast. I have since had radiotherapy and started on letrazole as the cancer is ER positive. It all happened so quickly and I had no one else in my family or even a friend who had ever had breast cancer so I was not that well educated at that time. I have since realized how many women have a double mastectomy,/reconstruction even where they don't have any family history of breast cancer or other high risk factors. I am planning to have the second stage of the reconstruction in June where the tissue expander is removed and replaced with my tummy fat .I didn't want to get an implant as I hate the idea of something foreign in my body and also the potential to have further surgery down the track to replace the implant.I realize that decision is very personal for every woman and also understand the DIEP surgery is much bigger surgery . When I saw my breast cancer surgeon last week he asked had I considered having the other breast removed and reconstruction in the same operation as the DIEP could only be done once and many of his patients opted for a double for that reason and also the peace of mind of not worrying about having cancer treatment again if it came back in the other breast. He wasn't necessarily recommending it but said it was something I needed to decide as it would be too late after the operation in June. I have got over the fact that it would have been nice to have this conversation before the first operation, and just want to make the right decision. I do have quite a bit of anxiety which has been heightened by all of this, and am leaning towards the double (I am 62, never considered myself as defined by my breasts, have an amazingly supportive husband who says "I just want you alive and will support whatever decision you make " and already will have one "foob" so why not two).On the other hand, it will add to the length of the surgery, have extra potential complications and recovery time and may not be necessary. Does anyone have any advice?
DIEP recon and Zoladex
Has anyone been on Zoladex injections before there DIEP surgery... where did you continue the injections in the month before and after surgery? Were you able to use Lupron instead? I am not a candidate for oopherectomy at my age, but my team can’t give me an answer yet about Zoladex injections. Surely I’m not the only young hormone positive BC patients on zoladex who has gone through DIEP....
Mastectomy with immediate DIEP reconstruction
Posted my moderator for @Bb1andBb2 Hi, I’m 54 and had a mastectomy and immediate DIEP reconstruction almost 4 weeks ago Before the surgery I was not really skinny but certainly didn’t have a lot of tummy to work with My surgeon said he took as much as he could from my abdomen in order to build my new breast After the surgery I was excruciatingly tight and suffered terrible back and neck pain due to the tension After the first week I could stand straight again but since then my tummy has remained extremely tight and has hardly loosened at all I’m terrified that my skin will never stretch back to give me the movement and flexibility that I once had (I’ve always been active and prior to surgery walked an hour every day up and down hills, over the years have been a frequent gym user and used to play sport regularly in earlier days) Will my skin stretch again? I can’t find any information about this This has been the most distressing part of my whole experience I can live with the scars and never looking the same again, but I can’t bear the thought of never feeling or being able to be active again
DIEP flap reconstruction
I was wondering of others experiences of DIEP flap reconstruction. From my research it seems to be the most natural way to reconstruct a breast. My surgeon did not seem confident that he would be able to create symmetry using this method. When I look at google images it seems that it is very possible to achieve a really excellent result this way. What are the experiences of others? What does one do if in the public system without private health insurance? Is there a way to request a particular surgeon? What are the options? Can one simply pay for the plastic surgeon and do the rest on public? Thank you for your comments and experiences.