Mastectomy and breast reconstruction pros and cons?

Posted by kruzin @kruzin, Jul 8, 2018

Being treated for breast cancer, having a mastectomy and was wondering what people did for reconstruction?

Interested in more discussions like this? Go to the Breast Cancer Support Group.

Newly diagnosed invasive cell carcinoma grade 3. My tumor is 5 mm. I am trying to decide if I should go with implants or the flap procedure. Any help on recovery times for both as I’m so scared about pain control and healing times. Leaning toward a double mastectomy.

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@colleenyoung

@jdh65, As you probably already know, fat grafting (or autologous fat transfer) is a new breast reconstruction technique. Because fat grafting is so new, no large clinical studies have been done on the procedure. The studies that have been done involve fewer than 100 women and the average follow-up time is less than 4 years.

I believe @boathouse @kwyskiel @jboisjolie @celica have had fat grafting reconstruction done or considered it.

JDH, what factors are you considering as you make your decision?

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@colleenyoung1
I’m noticing that the latest entries available are mostly from January of this year? That’s ALOT of months with no recent activity…? Is this normal? Am I in a currently active group? Please advise, and thank you. ☺️

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@cowgirl0713

@colleenyoung1
I’m noticing that the latest entries available are mostly from January of this year? That’s ALOT of months with no recent activity…? Is this normal? Am I in a currently active group? Please advise, and thank you. ☺️

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@cowgirl0713, I hope you also saw the recent posts over the last 3 days offering your tips and support. Start reading here: https://connect.mayoclinic.org/comment/958845/

There are hundreds of posts made daily to Mayo Clinic Connect, many of them in the Breast Cancer support group. You are most definitely in the current active group. See here: https://connect.mayoclinic.org/group/breast-cancer/

One of the things I also like about this site is the good advice remains good advice. Sometimes the tips, information and support members shared months and years ago still ring true today, including facing tough choices in reconstruction with breast cancer.

You might also appreciate these videos from Mayo Clinic experts.
- Videos about Breast Cancer Surgery from Mayo Experts
https://connect.mayoclinic.org/discussion/videos-about-breast-cancer-surgery-from-mayo-experts/

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@tborengasser

Newly diagnosed invasive cell carcinoma grade 3. My tumor is 5 mm. I am trying to decide if I should go with implants or the flap procedure. Any help on recovery times for both as I’m so scared about pain control and healing times. Leaning toward a double mastectomy.

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@tborengasser, welcome. Fellow new member @cowgirl0713 is weighing the same options. You may wish to join others talking about implants vs flap here:
– Mastectomy and breast reconstruction pros and cons? https://connect.mayoclinic.org/comment/957172/

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@cowgirl0713 I am new to this too and navigating my way. I have an appointment with the surgeon today. This thread is very helpful to hear from others who are in the same journey.

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I am a breast cancer survivor x2 twenty years apart. After the first mastectomy I elected to have my surgeon to leave a flap so I can have more time to think about an implant and more surgeries to follow. I wore a prosthesis for 16 years and though it was a bit heavy at that time, years passed and they got lighter. By means I am not saying they wear comfortable not a constant reminder of my cancer experience everyday when I took off my bra or showered. After my divorce I decided it was time to get the implant and they also reconstructed my good breast so in my mid 50’s I looked and felt pretty good. The doctor was talented and did a tattoo for me of my Ariola and nipple area. I was in heaven with both breast looking and feeling comfortable. He had enough flap so the implant fit perfectly and there was no need for an expander to stretch the skin before an implant could be inserted. A few years later I developed stage 3 breast cancer in the good redesigned breast. At that time I designed to go ahead and have then implant the expander at the same time as the mastectomy was being done. The theory.is that they expand the expander slowly every few weeks until they have enough skin to do the final implant. Unfortunately I had gotten mastitis in the breast cavity with the expander and was in the hospital fifth iv antibiotics for a few weeks trying to get the infection under control or I would lose the expander and any chance of having reconstruction. I guess I was lucky and I healed from the infection and about 7 months later I had the implant surgery. I can’t tell you enough about complications and so because there was no bottom ledge after the mastectomy my new implant failed and slipped down. After waiting months we did the surgery again using a mesh to hold the implant in place. Well the mesh stretch out and once again the breast dropped. I waited u til I found a different doctor in Palm Beach who had experience with this problem and reassured me it would not happen again. And so several years after several surgeries I took my last chance now in my early 60’s and had the implant done once again. What ever this doctor did worked! His name is Dr Lickstein. And although I did not get this breast tattooed I can now wear a normal bra and look in the mirror and see my warrior spirit. It takes strength, and it takes support so when you make this decision please hear my story and know that getting an implant can be complicated. Don’t let anyone tell you it’s easy because it is not physically nor emotionally easy to undergo surgeries. I also had 6 months of Chemotherapy while having the expander in. I pray every day that this cancer will not return. I am grateful one day at a time. Good luck sisters and brothers out there reading my story. I hope it helps someone. Tina

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@lambchoptina2

I am a breast cancer survivor x2 twenty years apart. After the first mastectomy I elected to have my surgeon to leave a flap so I can have more time to think about an implant and more surgeries to follow. I wore a prosthesis for 16 years and though it was a bit heavy at that time, years passed and they got lighter. By means I am not saying they wear comfortable not a constant reminder of my cancer experience everyday when I took off my bra or showered. After my divorce I decided it was time to get the implant and they also reconstructed my good breast so in my mid 50’s I looked and felt pretty good. The doctor was talented and did a tattoo for me of my Ariola and nipple area. I was in heaven with both breast looking and feeling comfortable. He had enough flap so the implant fit perfectly and there was no need for an expander to stretch the skin before an implant could be inserted. A few years later I developed stage 3 breast cancer in the good redesigned breast. At that time I designed to go ahead and have then implant the expander at the same time as the mastectomy was being done. The theory.is that they expand the expander slowly every few weeks until they have enough skin to do the final implant. Unfortunately I had gotten mastitis in the breast cavity with the expander and was in the hospital fifth iv antibiotics for a few weeks trying to get the infection under control or I would lose the expander and any chance of having reconstruction. I guess I was lucky and I healed from the infection and about 7 months later I had the implant surgery. I can’t tell you enough about complications and so because there was no bottom ledge after the mastectomy my new implant failed and slipped down. After waiting months we did the surgery again using a mesh to hold the implant in place. Well the mesh stretch out and once again the breast dropped. I waited u til I found a different doctor in Palm Beach who had experience with this problem and reassured me it would not happen again. And so several years after several surgeries I took my last chance now in my early 60’s and had the implant done once again. What ever this doctor did worked! His name is Dr Lickstein. And although I did not get this breast tattooed I can now wear a normal bra and look in the mirror and see my warrior spirit. It takes strength, and it takes support so when you make this decision please hear my story and know that getting an implant can be complicated. Don’t let anyone tell you it’s easy because it is not physically nor emotionally easy to undergo surgeries. I also had 6 months of Chemotherapy while having the expander in. I pray every day that this cancer will not return. I am grateful one day at a time. Good luck sisters and brothers out there reading my story. I hope it helps someone. Tina

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Hello was the second cancer in the original breast that had cancer or on in the unaffected one

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I wanted to add I had a 5cm tumor that turned out to be Her2+. I went with implants, my same size. The surgery? I am honestly telling you that the pain blocker they used gave me little to no pain at all. I had Norco for 3 days and then took Tylenol. I had my fallopian tubes and ovaries out at the first surgery. My middle hurt. Not by breast. I had the tumor side removed then the left side 11 months later.
Research. I have met a number of women who went flat and are very happy. I have barbie boobs as the BRCA2 I carry meant any breast tissue could be dangerous if left behind.
kayonson- My younger sister removed her ovaries and fallopian tubes 2 months after me. She has Brca2. Our older sister did not want the genetic test and still has not had it nearly 2.5 years since i was diagnosed. Last July, Ovarian Cancer stage 2. She is a vaccine and drug denier. To me she almost agrees to the 3 additional rounds of chemo and a pill they want her to take. She talked to my younger sister and did not say that. It is a person choice for sure. I do not know what your older sister said when it came back, but a 3rd time would have been tough.

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Hi Kruzin
Hope you are doing well !
I had a double mastectomy in October and two lymph nodes removed.
Dcisi in the right breast. I am 75.
I could have had a lumpectomy and then radiation.
My family history as with my Mother
at 75 had the same exact cancer right breast removed and 16 lymph nodes.
No radiation or chemo.
5 years later at 80 she had cancer in the left breast so the left breast was removed!
I did not have any reconstruction.

I knew I had no intention of looking over my shoulder for the rest of my life. I wanted to live life in peace!

I found flat was beautiful and life was to be lived and enjoyed!!

I am cancer free and hope for everyone on this site they will be at peace with the journey !

We are here for each other and pray everyday for all and the new people who come on the journey!!
God Speed !!
Hopeful@2024

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@casualobserver

Hi @kruzin - I don't know if I'm too late to post my experience as you may have already gone ahead and done your surgery. But, if not,
I wanted to share my information with you, if it might help you.

I just had my bilateral mastectomy with reconstruction less than a month ago. I had biopsies in both breasts. I learned one breast had cancer the other tested out benign. The diseased breast had several large masses that all tested malignant and a lumpectomy was not deemed 'ideal' due to the amount of tissue removal involved so a full mastectomy was indicated for that one breast.

I am a research nut and did copious research on the subject and also had 2 consults with the breast surgeon and 2 with the plastic surgeon before deciding. I also spoke with my spouse, 2 children and daughter-in-law who's a nurse. During my weeks of contemplation and research, I subscribed to MedScape and read many of their published medical studies on mastectomy and breast cancer, including survival rates, surgery options, decisions made by patients who chose a particular option and comments from nurses and surgeons. I also searched every article I could on the internet and read many patients' comments.

In the end, I decided to remove both breasts and do immediate implant placement in both. I knew I wanted reconstruction as I would be too depressed otherwise. Mental health is equally as important as physical health and should be weighed as carefully, in my opinion.

My reasoning for doing a bilateral mastectomy and immediate reconstruction rather than just doing one breast is as follows:
* If both were done at once, the plastic surgeon would be able to make both breasts match closely, utilizing the new Alloderm artificial skin and identical silicone breast implants.
* I currently have excellent insurance and who knows what I may have years from now if the healthy, remaining breast were to develop something.
* I will never be younger than I am now, and my chance of a good recovery should be better now than years down the road (if cancer were to develop again).
* I would have one time off from work, one (longer) procedure day, one hospitalization, one anesthesia, and one recovery.
* Both breast gone = no further mammos, MRI's, no chemo, no radiation, (hopefully??) and no further worry about the other shoe dropping with the remaining 'healthy' breast developing something down the road. I have read how women who have cancer in one breast must go in and have any remaining breast tissue looked at and poked and prodded yearly for the rest of their lives. I wanted to avoid that if I could. Who needs more stress and worry?
* In addition, my healthy breast had been banged up pretty good with a stereotactic biopsy and had developed a large, hard lump and depression at the point of entry. I felt that it was now injured and may be more susceptible to getting cancer (gut feeling) which further directed me to going forward with both mastectomies.
All-in-all, I am currently glad I chose as I did, however I am still in recovery and may come to a different conclusion later, but I'm hoping for the best!

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I hope you still get back on this page occasionally to check messages. I am have the same issue as you. One breast cancer, the other has some calcium spots which could turn into cancer. I was going to go the lumpectomy route, but after reading all of the side effect from the estrogen blocking drugs and radiation I am wondering if a double mastectomy is the route to go? Did you have to call your insurance company to see if they would cover having both of them done?
just starting to research all of this, as I met with my surgeon 4 days ago and it is finally sinking in that this is way more than just a surgery... the after care is the hardest! Any follow up you can give would be wonderful

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