Surgery decisions to make

Well I kind of insisted on
Well I kind of insisted on reconstruction at the same time. I just thought it would help phychologically and for me it has helped.I had an expander put in at the time of the surgery. It was expanded during chemo. Then I had rads with it fully expanded. Now I am ready to have the expander removed and the implant put in. Then they will reduce my other breast so that they match.So even though reconstrucrion was started at the time of the mastectomy, it is still a lng slow process. If you have flap reconstruction they may do it all at the time of the mastectomy. I certainly would have chosen that option if it had been offered to me just to have it all done with....If you feel more comfortable waiting awhile, I'm sure you wont get much argument from your ONCS.I think they prefer to wait.But if you intend to have reconnstruction eventually, I can't see any advantage to waiting.

Shelby
First I want to welcome you to the boards...this is a great place for support and information. Lots of women (unfortunately) have already been where you are right now and can help you w/their thoughts.

I can't help w/discussions of mastectomy/reconstruction as I opted for lumpectomy and rads. Finished active treatment in Jan and am currently on tamoxifen.

Just wanted to encourage you and let you know to come back often...Good luck w/your decision...God Bless...
Julie

sanmb said:

On the same boat..
I also have to make the same decision.. I thought instead of writing new subject I will write on your thread.. On first thought I had decided to not go for reconstruction now (my surgery is scheduled for next week).. When I talked to another person who had reconstruction at the time of mastectomy, I am not sure now.. Main questions for me are - how long the healing takes? do people feel any complications afterwards? any suggestions/guidance will be highly appreciated....

Hi Shelby and Sanmb
I have recently had to make my decisions regarding mastectomy and reconstruction. On 2/9/10 I had a right mastectomy and expander placed for ICD and DCIS. There are so many variables in each person's case, lifestyle and overall feeling of "peace of mind", so there is no one answer that fits all.

You have started your journey in a great place on this board. My decision came down to: my age and lifestyle. (I am 49 and still want to travel, work and look normal in a tee shirt). My MD did not want to do bilateral because I had to have a tissue transfer and alloderm placement. (Nothing showed in the left, but I have very dense breasts). There are no guarantees, but I would highly recommend you see a plastic surgeon just to see what he or she might do. Also ask for pictures of their work that specifically relate to your case. They should also have information and pictures of TRAM and Latissimus Dorsi Flap procedures. They should also have an expander and implants (silicone and saline) that they can show you. There is also a website called Breastfree.com were women have decided not to do reconstruction, their stories are posted there and can give another perspective.

Reconstruction can take a very long time, with my MD's depending on chemo, radiation, how you heal, nipple reconstruction and tattoing, it may take up to a year. You can have chemo and radiation with expanders in. The expander is uncomfortable, I do have occasional muscle spasms, but it is totally managable, and nothing you can not handle. So far I have not had any complications, they will prescribe antibiotics and pain meds if you need them. I only need tylenol and ibuprofen. My process is still begining, so I will keep my fingers crossed.

This is a very personal choice. You must be able to "feel you made the best decision you could with the information you had at the time you."

Hugs to both of you, and good luck at this difficult time.

-Carrie

All I can do is relate my
All I can do is relate my story. Only you can decide what is best for you. After a biopsy and lumpectomy, I still didn't have clean margins for DCIS in my right breast. I researched and talked to many women about all the options, their decisions, etc. I decided that I wanted a bilateral mastectomy with immediate reconstruction even though the oncologist told me that wasn't normally recommended for DCIS in one breast. I felt that, for peace of mind, I needed to be as aggressive as I could be. Well, after the MAJOR surgery, my pathology showed that there was a 0.5cm Stage 1A tumor, grade 2, ER+, HER-. Because I had the bilateral mastectomy, the clean margins were very wide, there was no node involvement (I had the sentinel node biopsy done at the same time), and the tumor was found so early, I need no further treatment, not even hormonal therapy. How that tumor wasn't seen on the mammogram I'll never know, but I am so grateful that I followed my gut on this one. And you will have to follow your gut....that little voice inside of you that says, "This is what is best for me." Get all the information and input you can but, in the end, make the decision that is right for you. Good luck.

shelbyhome said:

Well thank you all for your
Well thank you all for your comments, Sparky it sounds like we have alot in common so far. It sounds like this is going to be a great place to speak to people like myself! Thank you all again.

Just another comment....I
Just another comment....I had the TRAM reconstruction at the same time as the bilateral mastectomy and I am very glad that I did. The surgeon did a wonderful job but it was easier for him because he didn't have to "match" to the breast that might have been left.

shelbyhome said:

Sparky, Is the TRAM where
Sparky, Is the TRAM where they use your tummy? If so was it as bad as I hear it is?

Yes, it is the tummy tuck
Yes, it is the tummy tuck one. It is a huge surgery....the scar is big and you will need help for about two weeks afterwards. Everyone is different but I was off pain meds in 4 days. You have to be careful about how you move and you would have lifting restrictions for several months, but I have worked around all the limitations and I am thrilled with the results. I was off work for four full weeks, going back part time for two weeks. I am back full time now and am doing well. A lot of it has to do with what kind of shape you were in before the surgery. If you are otherwise healthy, obviously, you'll do better. I do know of one woman who was off work for 9 weeks but she didn't take care of herself very well and had complications. But........make no mistake about it, it is not an easy surgery. If you've had abdominal surgery, that helps to let you know what to expect, although it was bigger than my C-sections. If you have any specific questions, just let me know. I'd be happy to help.

shelbyhome said:

I am going from the TRAM to
I am going from the TRAM to Expanders and the time frame it takes to heal. We are wintering in Fllorida and live in Michigan and we usually go home in April and I really want to get home as soon as I can but do the right decision for health. I know that the expanders take weeks to fill and then another surgery and then another for the nipple if thats what I decide.I meet with the plastic surgeon tomorrow so we will see what he has to say. I don't work and I am in good health, just hate this whole thing. I am so glad there are people out there like you to give your stories and let me hear decisionss that you have made and not my friends that say what they think they would do, it makes a difference when you are faced with it. I always said if it came to this what I would do and I still feel the same way but it is still different. I can't thank you enough for your words of information and they do encourage me to know that I can too do this and make it.Thank you again and I will talk to you soon.

Just wishing you good luck
Just wishing you good luck Shelby! Keep us updated!