Question for those with breast reconstruction. Long, but I am so confused!

I was diagnosed with breast cancer in late November of 2006.  I had a lumpectomy at the end of December and didn't get clear margins on the pre-cancer (DCIS).  I had a re-excision lumpectomy in January and still no clear margins.  I had told my husband that 2 was my limit.  I then decided on a mastectomy.  After thinking for a couple of days, I decided I wanted to do bilateral mastectomies.  My sister was diagnosed with breast cancer earlier the same year as I was but neither of us had the genetic mutation.  She also had bilateral mastectomies and had 4 months of chemo and takes hormone therapy.

After the stress of the diagnosis and 2 surgeries (lumpectomies)... I decided that I didn't want to go through this anymore.  In March of 2007, I had bilateral mastectomies with expander implants (to stretch skin).  In June of 2007, I had the expanders swapped for silicone implants.

Luckily, the invasive part of my cancer was very small so I didn't require any radiation or chemotherapy.  Also because I had both breasts removed and only have trace amounts of breast tissue left... no hormone therapy either.  The side effects don't outweight any benefit to me. 

I have no regrets at all on my decision.   I wouldn't change one thing.

Kathy

Thank you Kathy for your candid reply. I appreciate you taking the time to answer me. I did find out Friday that I don't have the gene mutation, so Hurray for that! I still have not made a decison, but am thinging long and hard about all the options.. My biopsy is scheduled for Nov. 7

I have known all these fears.Diagnosed with invasive ductal carcinoma in 1999.
My anxiety initially centered around recurrence. I had chemo no radiation and mod radical mastectomy. Several years ago one of my cousins diagnosis with breast cancer. I was advised to get genetic testing. Took a while for insurance to approve testing and since there was no other breast cancer in family. There was a history of other cancers in family,vulva,bladder and lung. I am BRCA2 positive. I had hysterectomy and oophprectomy to reduce risk but have not had second mastectomy as a prophylaxis.

I asked my oncologist which is more important mastectomy or gastric bypass. I always worried about recurrence because extra weight and cancers like breast, endometrial, colon and.
What she said to me was that it was best to do the surgery that did the most for my health.
The prophylactic surgery would deal with recurrence of breast cancer and mental health. A gastric bypass could improve prediabetes, hypertension, elevated cholesterol and sleep apnea.

I have not yet decided on a surgeon but I have decided to have gastric bypass. So the journey continues. I figure that I can have tummy tuck along with tram.I have been told that reconstruction of bilateral breasts is better for symmetry.

I understand that the feelings about loss of breast. I elected mastectomy over lumpectomy before I knew I was BRCA. Found out later. And they can do 6 month surveillance once every 6 months I have a mammogram and other 6 months I have breast MRI.

Fear of something can be paralyzing but if you just stay with the moment you may find out that none of this worrying is necessary in negative biopsy and negative screening of genes.
Best of luck.

Michele

Thank you Michelle for your reply. I did get a clear bill of health from my biopsies and my genectic testing was also clear. I will always be closely watched from now on.

Right now I am dealing with fluid collecting in the left breast, where the cancer was, and I had another one of the biopsies this time. It has had to be drained once already. I also have a rather large hematoma in the right breast that is uncomfortable. I went back Friday to have them both looked at again. I opted not to drain the left and the right can only be watched for infection.

It is the seemingly endless procedures that make mastectomy look more and more interesting. A TRAM flap is what I would like to have after my weight loss is finished.

I appreciate your input and I wish you well as you continue your weight loss journey and continuing breast care.

Best wishes.

Mary

Hi there.  I am DS pre-op right now. 

I had Stage 1 breast cancer in 2005.  I also had a lumpectomy and radiation.  I would definitely like to get a bilateral mastectomy with (hopefully) immediate reconstruction. 

Someone on the DS board who has also had breast cancer was saying that she's going to wait until she loses all her weight and then go and do her breast surgeries since, as she says and I concur, why operate on boobs now that are going to be totally droopy anyways?! 

I know that because have a genetic variant of unknown significance on BRCA2, I am pursuing getting my breasts removed.  I too am looking to a flap (not sure TRAM or DIEP), and I've learned that they can add on an implant for balance and size of those are issues.

I know that scarring is an issue for you, but with the great reduction statistically of a recurrence after a mastectomy, I certainly think it's worth seriously considering it for your peace of mind.  All those tests and all that waiting for results is downright nerve-wracking to say the least.

Thank you for your reply. I completely agree about the droopys. I could definitely use a tuneup.  And getting rid of the tummy at the same time would be a bonus. I will be waiting until after my weight has stabilized and then make a decision. I may not have a tummy left by then.

I wish the best for you as you begin your weight loss journey and good health in the future.

I'd like to thank you all for your remarks and especially you corky1057. Sounds like we have been sailing along in the same boat. I was diagnoised with bilateral invasive ductal carsonoma in June of 2007. I was over weight then and proceeded to gain more thru chemo and radiation. I opted for lumpectomies and my plastic surgeon did a reduction before radiation because my breasts were so large it would have been diffucult to do both at that size. The raduction showed some DCIS that they didn't know was there so even though I've had the radiation there is still no guarentees so the wait and see feeling is nawing. There was one plus side though, my plastic surgeon said that I was a good candidate for WLS because of so many other problems that he would recommend going for that then when I lost the weight come back and have the mastectomies and he could take care of the whole ball of wax at one time. I'm looking forward to going for my first visit to my surgeon and get on with getting the weight loss taken care of. I was wondering if there are any problems that come up with having WLS after the whole cancer treatment stuff? 

Hi Corky-Blessings to you and yours for a Healthy  '09!
I too am a bc survivor.  I was initially diagnosed in Nov. 06 with IDC on the left breast.  I also opted for a lumpectomy-we initially thought it was not node positive as my first sentinal node turned up negative in the O.R. HOWEVER, (and this is the first time my surgeon OR pathologist had seen this) the remaining two nodes later turned up positive in later testing.  My surgeon told me that the other tests were still being ran but all looked good-just my kind of luck!!  He calls me two days later and gives me the good news (NOT) and that I will need the rest of the nodes removed from that side.  Turned out I had 9 pos. out of 17...long story short, I was EST/PROG. pos., as well as HER2 pos. so I was looking forward to 6 months chemo and as well as a year of Herceptin. Oh and 7 1/2 weeks rads!!
I also had the gen. testing and asked for an onco. type (they usually don't order onco typing if it's a sure thing you'll need chemo) my score was 74-which pretty much guaranteed a recurrence.  BUT NO mutation-your thinking YAY-so was I-but my geneticist went on to say that because I was so young (40 then) and it was so aggressive- that she will definitely be keeping my name in the hat at their weekly meetings as if a new test ever came along that she thought I would benefit from-she would add me to the list.
I finally started becoming comfy with my breasts at the end of my Herceptin treatments-Jan 08.  Well between the end of Jan and middle of March-I had 3 biopsies!!  By April, I had been so anxious and tried of cancer and worried to death-I opted for a bi-lateral mast. which turned out that I had a recurrence on the left side.
I never had recon. and because of the rads, I was told implants are out for my poor skin couldn't handle it.  I seriously need a panni but if I do have one and one day would like the tram...I'm "poop" out of luck!!!  The extra skin on my belly causes me serious back pain already and I've only lost 54 lbs. so far!! 
Sorry for the book but wanted to respond to your initial concern....and to find out what you chose to do.
For me, I don't want anything to do with breasts right now and can't see recon in the future.  However if I had to do it again and weren't so scared and wanting to get those things off me, I guess I'd opt for recon immediately.  Sorry I didn't see your post sooner and offered my opinion.
Blessings!

Holy Cow Ronda! It sounds like we have been riding the same wave with the biopsies. It can make you crazy can't it? All the not knowing all the time. Waiting for the other shoe to drop. So far, for me, I have been given the all clear after each one.

I have chosen to wait on the mastectomy until...well I don't know when. If I need another biopsy, then that will probably make it a done deal for me. I will see how things are in 2009. Right now I just want to take a break from thinking about it everyday so I have put it out of my mind for now.

I wish you the best and a very healthy 2009!

PS: Congrats on your awesome weight loss!

Hi,
Well, I just found this wonderful site and this particular board is so timely to me.  I was diagnosed with breast cancer 2 years and 4 months ago (ya know we count those months)...I did not have reconstruction.  I had a total masectomy with 10 of 10 lymph nodes involved. I decided to wait to do recontruction and last year decided to really look into it. 

Because my skin was so radiated I was not a canidate for tram (no skin to stretch)  and alot of scares from an infection I had in the incesion....so I was told that the DIEP would be the best thing for me.  Now, for the good\ bad news and why I am now pre approved for WLS---I have to get my BMI down to have the surgery performed--I have tried just about everything (like all of us) but now  with the aromsin, hysterectory and stress....have not been able to loose no matter how hard....so my gp reommended the surgery.

Anyway, once I have reached the bmi required I will get the DIEP surgery.....and I WILL get the other breast removed.  It is one less place that those little cancer cells can go....so for me....not only will I get to identical breast (with sensation back in most cases) I get a tummy tuck too....soooo---that is my two cents.....

Now, I have a question....I have been preapproved for surgery.....now they want me to write my history.....not sure where to start....do they want pictures????  What seem to cause the weight gain????  Does being preapproved by the insurance company mean I can get the surgery?????
Teresa in Texas

So, for me.....