Negative impact of radiation on Flap (autologous) reconstruction??
Hi all, will have mastectomy in a couple of months time, am considering to have an immediate breast reconstruction (IBC) using my own tissues/ flap (autologous). Unfortunately, I will have a series of radiation after the IBC. I am worried the radiotherapy will kill/destroy/ causing complications on the flaps. I did some research at my end. However the comments were conflicting. Therefore would appreciate your advice. Please..no advice is too silly. Thanks heaps!
Surgical options when you need radiation post surgery ???
Hi All I am seeking advice/information about what options you were given for surgery when you needed to have radiation post surgery. A bit about me, I am 52 single mum to adult sons (one still at home). I was diagnosed with IDC Grade 3 Triple Negative BC in early May. I have been undergoing neoadjuvant chemo and have just completed my last AC treatment, but still have 6 months of immunotherapy to continue. I've lost 10kg as a result of AC treatment. I struggle with being able to eat much so the weight loss may continue which won't be ideal. I get fatigued extremely easily with shakes and feeling like I'm going to faint after simple activities like doing dishes and food shopping. So I'm pretty house bound with minimal family support available. Back to my main question, what surgical options were you given and what warnings about negative side effects of radiation? My initial thought was to have a DMX with immediate implant reconstruction but the Oncoplastics team feel i should go for a SMX with DIEP reconstruction due to the radiation requirement. Due to my weight loss I probably only have just enough tissue for the single DIEP procedure and I'll likely need fairly extensive node removal also as I had 3 active nodes at diagnosis. My concerns are the length of the surgery needed, the scarring from the DIEP procedure and the recovery time as I have my first grandchild due to arrive around Christmas time. Any advice, stories, photos, anything would be much appreciated. Thank you for reading this and I hope your journey is going well. Sandi
Newbie - not the 2024 I was hoping for!
I was diagnosed just before Christmas 2023 with invasive lobular cancer - a journey that just keeps unfolding. Initial diagnosis scans showed the ILC was 3.3 cm, then MRI 6 cm and the pathology results ended up at 7 cm and another 1 cm LCIS spot in a totally different area. I had two surgeries- a mastectomy and a positive sentinel node, followed with an axilla clearance. I have some cording post surgery which physio is working on. Next week, I start chemo (AC and then Pacilitaxel) followed by radiation and then endocrine treatment. Not what I was hoping for the year I turn the big 5-0. I really appreciate reading other’s experiences, and the Q&As available here.
Breast Cancer Risk in Survivors of Hodgkin's Lymphoma
I discovered this resource from Hodgkin's International titled "Breast Cancer Risks For Hodgkin's Lymphoma Survivors" https://youtu.be/YRp4NLcS4Os?si=QwtFipIn5q4LGrNW At 15:22 on the video, the surgeon discusses The National Comprehensive Cancer Network clinical guideline on breast cancer screening for people who have undergone chest irradiation. This has important guidelines on when to start screening for breast cancer as well as methods of screening for breast cancer. At 17:51 on the video, the surgeon talks about The Childhood Cancer Survivor Study breast cancer risk calculator. Unlike mainstream breast cancer risk calculators, The CCSS risk calculator includes questions on previous radiotherapy treatment. I love that the surgeon provides strategies that survivors can use to advocate for themselves should they receive "push back" from medical providers.Flat chest scars - restrict movement or very tight? And did you have radio before going flat?
I'm in discussions with two surgeons (initial and then second opinion) about removing my 10-year-old textured and radiated implants and either going flat or replacing implants. I posed a similar question on the 'Flat Chat' group - I'm hoping this main chat has some more people who can share their experience on flat scars and radio. I was first diagnosed with BC in 2011 and had a loco-regional recurrence in 2014. I had a mastectomy with immediate reconstruction in 2011 (39 years old), and the other side was prophylactically done a year later. Due to the recurrence, I had radiation to the implant reconstructed site (10 years ago). The implants are the textured variety. The radiated side has some contracture (firm/tight), but specialists have told me it's not too bad (but it feels average to me). I also have a fair amount of tight scar tissue under my arm due to the recurrence and radiation. One of the surgeons has suggested that due to the radiated skin and existing scar tissue, I may find the 'going flat' scars across my chest may restrict movement/be very tight for some activities (I do medium weights for bone health, walking, hiking, some swimming, gardening and lots of remote camping etc). Has anyone found their flat chest scars restrict movement/very tight? And did you have previous radiation (or even a reconstruction) before going flat? What has been your experience, scars, issues and advice for going flat?Have you replaced implants after radio? What's your experience/issues/advice +capsule (kept /rem'd)?
I'm in discussions with two surgeons (initial and then second opinion) about removing my 10-year-old textured and radiated implants and either going flat or replacing implants. I posed a similar question on the reconstruction group - I'm hoping this main chat has some people who have faced re-reconstruction. I was first diagnosed with BC in 2011 and had a loco-regional recurrence in 2014. I had a mastectomy with immediate reconstruction in 2011 (39 years old), and the other side was prophylactically done a year later. Due to the recurrence, I had radiation to the implant reconstructed site (10 years ago). The implants are the textured variety. The radiated side has some contracture (firm/tight), but specialists have told me it's not too bad (but it feels average to me). I also have a fair amount of tight scar tissue under my arm due to the recurrence and radiation. I'm so confused because two surgeons have advised different processes for removing the current implants. One of the surgeons has suggested that due to the radiated skin and existing scar tissue, I have up to 50% chance of failure of replacing implants, resulting in needing a flap reconstruction or going flat. This has frightened the life out of me because I thought the replacement surgery would be relatively minor (a simple grease and oil change LOL) This surgeon suggests removing as much of the scar tissue capsule around the implant as possible before inserting the new implant (but not because of breast Implant Illness concerns - neither surgeon is on the en bloc/ BII train). Removing the radiated capsule could remove the current hardness and minor deformity. This surgeon also advises I may need up to 3 fat sculpting surgeries to smooth out the breast (thin) skin (but that’s more general anaesthetics and recovery and $s!). The other surgeon suggests leaving the capsule as is and placing the new implant inside the existing capsule. As my skin is very thin from the mastectomy, removing the capsule could hinder healing and create more scar tissue/infection/concaving. The fact that this area is radiated means the newly created scar tissue capsule could be worse than the one removed. I guess this approach means the existing firmness stays – but hopefully, it shouldn’t get worse if it heals without infection (better the devil, you know?). If you replaced your implants after radiation, what has been your experience, scars, issues and advice? Did your surgeon remove or keep your existing capsule?
New DCIS diagnosis in Brisbane
Hi all, I've had two lumpectomies now for DCIS, which was caught in a routine mammogram/ultrasound. I'm waiting for the final pathology results from the last op and will then move on to radiation therapy. I'm wondering what the wait times are like in the public system (probably RBH). My mum is worried I'll be waiting too long but the cost from the private surgeries/pathology/screening/anaesthetics etc. was around $5K before rebates. Does anyone have an idea of how long I'll wait and if that wait will be okay?
GenesisCare filed for bankruptcy on 01 June
I was diagnosed last month with early BC and live in Sydney. I was offered radiation at a public hospital (free treatment, with a waitlist) or immediate access to a private GenesisCare facility. Now I've learnt that GenesisCare filed for bankruptcy on 01 June and has had financial problems for at least a year. I was a bit uneasy with the cost and upfront payment anyway with GenesisCare so have decided to go on the public hospital waitlist. https://www.afr.com/companies/financial-services/genesiscare-s-undoing-leaves-more-questions-than-answers-20230602-p5ddgy It's incredibly demoralising and discouraging to have to consider a private provider's stability when making decisions in the throes of a surprise cancer diagnosis. Ugh.
