I know that every woman's situation is different, here is what has happened with me.
I had a lumpectomy and radiation 2 years ago. DCIS returned in the same area. Last Friday, I had a mastectomy with sentinel node biopsy. Tissue expanders were placed at that time. My biggest worry was that if cancer does recur, would it be detectable after the reconstruction? In my case, the plastic surgeon assured my that it would be easier to detect because the inserts push my natural tissue closer to the skin.
I also need to let you know that I only had a Mammosite for radiation, not radiation of the full breast. You may a completely different situation. If my radiation area had been larger, the plastic surgeon said she would have moved some muscle and tissue from my back to aid in reconstruction.
This is an agonizing time for you. Definitely talk with your MD and maybe 1 or 2 plastic surgeons. Your breast surgeon probably has at least one she works with on a regular basis. If your mammograms are difficult to read at baseline, they will take that into consideration.
By the way, I know there are lots of male MD's out there who do fabulous work, but emotionally I feel extra blessed that both of my MD's are women and really understand what I'm going through.
AJfunstuff, please talk, talk, talk with your doctors and ANYONE who has been there. Even strangers are willing to help out a sister in this situation.
Blessings to you. I will say a prayer for you and hope all goes well!