Tissue expanders and radiation

techgirl

Hello ladies. I met with the PS yesterday who shared with us his ideas about what I can do immediately following my mastectomy. He said that since I will have radiation and reconstruction will be delayed, he can put in an expander. Okay, I feel like that would be a good option. Something will be there when I finish surgery. BUT, I worry that this expander might get in the way of the radiation. Those of you that have gone through this (or considered it) what does your radiation oncologist say? He told us that it's done all of the time and is safe. But, it seems to me that it might alter the way radiation is administered or received. I sure would appreciate your insight on this one. Thanks!!

seof

techgirl,

I am so glad you posted this. I am doing the same thing you are. I had bilateral mastectomy 12/21/07 and had expanders put in at that time. I have had very little trouble with any of it. The drains after surgery were inconvenient, but I had no complications. I did the excersizes Doc. told me and got back normal range of motion within a few weeks. I still have twinges of tightness in the muscles under the arm where lymph nodes were removed, mostly when I am foolish and try to be Wonderwoman (moving furniture, etc). I meet with the radiation Dr. tomorrow to set up that schedule. I expect to do radiation 5 days a week for 6 weeks, then wait up to 12 months for the tissue to "settle" into whatever state it will be in after the effects of radiation are gone. Doc. says it might not be exactly as before, but it will be close. Then I plan to have reconstruction at that time. My Dr. believes the implants do not interfere significantly with the radiation. Modern technology allows for very specific targeting of the radiation, so it can get through to where it needs to with minimal collateral damage. She said the radiation causes the skin to tigten up a lot and may make the expander on that side look smaller than the other for the duration of the radiation, until it heals up. I have done a little reading on the subject, and it seems to be considered as safe to do radiation with implants as without, according to the little research I've done.

I hope this is useful. We will have to compare notes after we get done to see how it is going.

Thanks again for bringing this up, seof

3cbrca

Hi Tech girl

I had an interesting experience with all this that I can share with you. The bottom line of the story is meet with your Radiation Oncologist as well and find out what the RT plan is and share that with the plastic surgeon. I had chemo before surgery and wanted expanders placed at the time of surgery before radiation. Both my Radiation Oncologist and Plastic Surgeon (both very blunt individuals) were opposed to it (but willing to go ahead) because of the amount of RT that was planned. My oncologists thought that they were being overly cautious and I would be fine, so I planned to have the expanders - I could not imagine not having any breasts, much less for a whole year.

My PS developed vision problems and called in sick on the day of my mastectomy - I was devastated and had to make a decision that morning to have a doctor I didn't know or delay my surgery. I was more afraid of cancer than no breasts, so I opted to go ahead without the expanders rather than delay surgery.

Now I am glad I didn't have the expanders. I saw a new plastic surgeon and she said that she would not do simple implants (Lat Flap only) because of the amount of radiation damage. Additionally, I had multiple seromas (which I had never heard of before surgery and most people don't get them so don't worry) which required regular and ultrasound guided draining and had my drains put back in 10 months after my surgery. Had I had the expanders in that would have been an even bigger pain in the rear than it was - (which I can't imagine).

It was 1 year ago Wednesday that I had my surgery and I just made an appointment to see the Plastic Surgeon in 3 weeks. With RT and Seromas and everything else that was going on not having "something" turned out not to be an issue. I feel good about going ahead with surgery now that I am healed physically and mentally. I'm actually glad that it worked out the way it did and after having been thru so panic at the idea of no breasts, I was surprised that I did not miss having my breasts at all.

Remember - I had more radiation than most and most women don't get one seroma, much less multiples so none of that likely applies, but the message is that I was so nervous about walking around without breasts, and it turned out to be kind of a "non -issue" ...
Talk to your radiation oncologist and do what you think is best for you.
She