• After radiation, I thought if a recurrence happened that mastectomy and tissue expander reconstruction at that point was impossible. True?.

    Asked by Ajfunstuff on Monday, December 10, 2012

    After radiation, I thought if a recurrence happened that mastectomy and tissue expander reconstruction at that point was impossible. True?.

    Since radiation scars the internal tissue, how can mammograms be reliable? Mine were never reliable even when I was totally intact before all the surgery and radiation. Seems any mammogram now would be an exercise in futility.

    8 Answers from the Community

    8 answers
    • Mom2's Avatar
      Mom2

      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!

      over 4 years ago
    • Beebop's Avatar
      Beebop

      Every situation is different. Reconstruction is not impossible, but might be a little more difficult after radiation. Get amore than one opinion and make sure to keep that skin well moisturized during and after radiation. My PS suggested cocoa butter. Good luck!

      over 4 years ago
    • Mom2's Avatar
      Mom2

      I suggest you speak with a plastic surgeon about this issue. It sounded to me like my surgeon does it after both local and whole breast radiation, but I may be mistaken. It also seemed to be a "bigger" surgery after whole breast radiation, but she could make it work. She said that after removing the radiated tissue, she would move tissue around from the back.

      Ask your breast surgeon for a referral to whoever does reconstruction on her cases. Then make an appointment and go in for a consultation with your list of questions. There's not any obligation. You can always decide NOT to go through with it. That's the attitude I had when I went in. Luckily, the plastic surgeon was not hard sell at all. If you are a good candidate for reconstruction, you still don't have to do it right away. My MD said (and I also read on the internet) that many women make their decision to do it at a later time. If you are worried, stressed and/or confused by all these decisions coming at you at once (over the holidays, no less), just file the info away for a later time.

      I agree with you about future mammograms and detection. That was my biggest concern for the future. Again, the surgeons you are working with can help you make that decision. And if you don't want reconstruction ever, that is also perfectly OK. I know several friends and aquaintances who have not opted to do it and are healthy, happy and doing well.

      Good luck with all of this. Hope it all goes well.

      over 4 years ago
    • nancyjac's Avatar
      nancyjac

      Actually no, none of that is true. I had radiation after a lumpectomy. I had a new cancer but in the same breast as the previous one. I had a bilateral mastectomy with a flap to cover the wound taken from my abdomen. Not intended as reconstruction but medically necessary to close the wound and to provide new skin for the following radiation. I chose not to have reconstruction, but I know many women who have both implants with expanders and transplants.

      Many women have fibrous breasts, with from previous surgery, radiation or neither. That is the purpose of getting an initial baseline mammogram as a basis of comparison for subsequent ones. Both of my cancers were detected by mammograms. The first one a tiny 0.7 mm tumor in the center of my breast that undetectable by breast exam because it was so deeply embeded, and last year from new calcification that had not been there the year before.

      over 4 years ago
    • Mom2's Avatar
      Mom2

      Please do not believe that "none of that is true" . Check with your MD's as everyone's situation is very different.

      over 4 years ago
    • Nomadicme's Avatar
      Nomadicme

      I believe the issue with reconstruction post radiation is how your skin reacts. It may not heal as well post mastectomy, higher chances of necrosis, compromising the cosmetic outcome (plus its hard enough as is without the extra "fun" of complications). However, Ive read of skin issues being addressed by harvesting the skin from another part of your body.
      Cancer is psychologically tough enough without having the extra burden of feeling mutilated. I can't being to tell you how much it has helped having the fake breasts and nipples. I know they're not real, and that bothers me to some extent. But, I feel sooo much better having humps :)

      over 4 years ago
    • Ydnar2xer's Avatar
      Ydnar2xer

      I had radiation on my right breast 9 years ago and in August went through bilateral mastectomy. I did research and decided on DIEP reconstruction. Before my mastectomy, I consulted a Plastic Surgeon who assured me that a DIEP flap (which conveniently includes a tummy tuck) is the way to go. It uses no muscle (which I like) and will give me both breasts AND a flatter tummy (which I ADORE!). Good luck with your decision.

      over 4 years ago
    • nancyjac's Avatar
      nancyjac

      Mom2, I believe you may have misunderstood my answer. I said "none of that is true", responding to the original post stating that "After radiation, I thought if a recurrence happened that mastectomy and tissue expander reconstruction at that point was impossible. Since radiation scars the internal tissue, how can mammograms be reliable? Mine were never reliable even when I was totally intact before all the surgery and radiation. Seems any mammogram now would be an exercise in futility." and asking if that was true. Since, as you stated, every situation is different, and both you and I had personal experiences to prove that her original statemet was not true, we are in total agreement.

      over 4 years ago

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