why nobody will respond? Help please?

I had radiation , after lumpectomy-no expanders

They knew I'd have to have radiation before my surgery as my tumor was approx 6cm and told me that I could not have reconstruction done at the time of surgery, since I had to have radiation.I had no lymph node involvement proven by a sentinel node biopsy although they thought I did as the lymph node was hard.  Biopsy of the sentinel node was negative.

I would have to have DIEP Flap reconstruction.  They removed fat and veins from my abdomen and reconstructed breasts out of that material.  It was pretty painful and over 15 hours in surgery.  That gave me a small B cup.  Later I had implants put in and nipples constructed out of some tissue left at the sides of my abdomen. I was told this was the only way I could have reconstruction since I had to have radiation.

I'm not saying they didn't do right by you but you can see from one of the answers you received that the radiation may have ruined her expanders.  Others do fine.  It's a very good question, BUT, not every case is the same.  We all have very different cancers.  What is not right for someone may be right for others.  You should ask your surgeon for a definitive answer.  I don't know how they know they can put in expanders before testing the lymph nodes but they do.

Sorry if this didn't help but I wanted you to know that you must speak with your doctors.  Only they can answer your question.  We can speak from our individual experiences but there doesn't seem to be any set rule as a general answer.

Wishing you the very best!  At least the worst is behind you!  

Sharon

If you have expanders you cannot have an MRI.  I am glad cause I have had enough radiation from CTs and treatments

HI.  I am new here.  My name is Lisa and I am a 43 y/o Physician Assistant that was newly diagnosed w/Invasive ductal carcinoma in Aug 2015.  I am hoping to help with your concern from a medical prospective as well as to give some suppport.

First of all, from a radiation oncologist standpoint, they will almost always recommend radiation for positive lymph nodes to decrease your risk of local regional recurrence and generally, your breast surgeon will also recommend radiation for the same reason.  However, radiation should be considered dependent upon your overall risk and how many lymph nodes were involved. Also, if you proceed w/radiation, it should be started no later than 7 weeks after mastectomy. If you are having chemo, then radiation is typically done after chemo.

This should also be discussed with your medical oncologist as radiation may not be recommended if you had bilateral mastectomies, and again, dependent upon how many lymph nodes were involved as well as micromets versus macromets.

Now, from the standpoint of the reconstruction surgeon, they understand the importance of radiation, but they simply do not like radiation and try to avoid it because of the possible complications to the reconstruction process.  Radiation can cause changes to the overlying skin of the radiated side (tightening and hyperpigmentation).  It can also cause internal changes, in particular, "capsular contracture" can occur which may result in loss of the expander of the radiation side.  Scar tissue can build up around the expander, asymmetry can result, however, these can be corrected with additional corrective surgeries.

It is a tough decision and I hope you find peace in your final decision to proceed with radiation or not.  I consulted with three radiation oncologists and two medical oncologists before I made my decision.  Personally for me, since I already had bilateral mastecomies and now undergoing chemo, I chose to not do radiation to save my reconstruction.

I hope this helps !!  Big bear hugs!!