Mastectomy with immediate implant reconstruction or re-excision and possible radiotherapy

Hi

I had a skin sparing mastectomy with immediate implant reconstruction in November 2018.  I had two areas of concern, widespread DCIS and a small invasive tumour so little choice but to have a mastectomy despite exploring options to avoid. As it turned out my tumour was much bigger than originally seen on the scans so definitely the right decision for me. At the time of diagnosis I knew I would likely need chemotherapy but was told that I wouldn't need radiotherapy, however due to size of tumour and micro mets in lymph nodes I needed to have chemo followed by radio. I was concerned that I would run into problems due to the implant with the radiotherapy, but so far I haven't experienced anything other than a slight pink tinge to my skin and a little bit of tightness or firming up of my breast. I am really pleased with how my implant looks and both my surgeon and oncologist have commented on how good it is in terms of shape and similarity to other breast. I may have been lucky to have a good onco-plastic surgeon. I had a few issues with my wound healing following surgery and chemotherapy slowed this whole process down so that I needed additional stitches putting in around February to help with the healing. I was terrified of this but didn't even need any anaesthetic to have this done and it wasn't painful at all.

I was very worried pre-mastectomy about how I would look and feel but I can honestly say its not anywhere near as bad as I had imagined although it does take some getting used to. In clothes you would not be able to tell that there was any difference between my boobs.

Happy to answer any more questions.

Take care

x

Hi Leonie, 

don’t forget you are a statistic of one; you! So whatever we say your decision has to be yours, and yours alone but with the advice and guidance of your team and your family too. But, my experience follows.....

I had a mastectomy as a matter of choice by my surgeon, as it worked out she fitted my permanent implant, there was no node involvement but she suggested if there was, she would use a temporary implant so rads, if needed, would not impact on the permanent one which could be done in a later op. 

Its not perfect, a bit on the small side and has a flattish area which can be helped if need be, but I’ve a decent cleavage, and woke from the op with two ‘boobs’, which was what I wanted right from the start.

it felt very odd at the start but I’ve got used to it and it’s drooped a wee bit and in a bra looks absolutely fine. There’s more squishy lumpy tissue around it, which the surgeon said could be my body reacting to it as a foreign body, so we are keeping a careful eye in case it may be rejection. 

Hugs xxx

Hi Horsing Around,

Thanks so much for sharing your experience.  It's exactly what I was looking for....yes there are difficulties but you get through them and get used to how the implants feel even though they are different.  It's just that in trying to make a decision last time I seemed to come across mainly negative accounts which although equally valid had the effect that I questioned if anyone was ok with them and as I had a choice it made me go for lumpectomy.  But it was a finely balanced thing after reading about 'unseen' tumours etc being found after mastectomies but also about 'no more cancer found so lumpectomy would have been fine and I could have kept my breast' scenarios.  It seemed an absolute gamble either way and I like things black and white.  The pathology results may sway me the other way or I may have no choice.  Hence although I would rather stick my head in the ground and wait for it to all go away I am back trawling the forum and talking to info lines to get reassurance that whatever the results and future treatments and obstacles it will be doable as I want to go into whatever it is as positive and prepared as possible.

Hi Moomie,

Thanks for replying and yes it is a personal decision and not one I am asking anyone to decide for me but for which I sorely needed some positive accounts of mastectomy and implant reconstruction as a doable thing and which you can get used to.  I may need to make a decision again, it may be taken out of my hands.  Either way I want to be as positive about it as possible.  One consultant said one way and the other stayed on the fence but once I told him my choice said 'I think you made the right choice, why harm yourself more than you need to do when medically the outcome is the same'. I asked why he hadn't said so two weeks ago and saved me a lot of angst. 'because it had to be your choice' he said. True but tough all the same weighing up the pros and cons of both without knowing the full facts and needing to make a decision before you do.  If it was either treatment without choice I would have just got on with it as I am quite pragmatic.....it's the choice part that has messed with my head and emotions the most.

Thank you again for taking the time to share and help me.  I sincerely hope the lumpy tissue doesn't turn out to be rejection.  Even though it can be remedied it's one more thing you can do without.

Take care x