Delayed reconstruction

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Hi all.

Can anyone help with their experiences please? I had a full right side mastectomy at the end of August. My surgeon recommended that I didn’t go for immediate reconstruction as it was likely that I needed radiotherapy (I had neo adjuvant chemotherapy and still have another 8 rounds of Trastuzumab to go). I was advised that the radiotherapy would likely damage any reconstruction, so I opted to “go flat” on the understanding that I would be able to have reconstruction at a later date. I completed radiotherapy in October, and today had a follow up call with my consultant. I was quite upset that she seemed almost taken aback that I was still keen to pursue reconstruction. It was almost as if we’d never even discussed it. I’ve been told that the waiting list is extremely long, and that I now go to the bottom of the list as it is now classed as elective surgery. I understand that my cancer has been removed (I had a HER2 positive Grade 3 35mm invasive DCC), but I don’t understand why this isn’t still classed as cancer treatment? I am obviously absolutely indebted to my surgical team, and more than grateful to have been lucky enough to be told that the cancer has gone….but I almost feel like I’ve been abandoned. It’s like emerging from a battlefield minus a body part, my hair, and any sense of who I actually am anymore. I thought I’d been quite stoic, but this has kind of knocked me! I’m 51, I appreciate I’m not young, but is it wrong to just want to look normal(ish) again? 

  • Surgery is in my future, so no experience to share.

    Does your hospital have a PALS, who can look into this for you, and maybe advocate on your behalf to reassess your place in the queue?

  • Good morning and thank you for replying Relaxed️ Sorry to hear that you’re on this same horrid journey. I’m not entirely sure to be honest. They are unable to carry out reconstruction of the type I need at my local hospital, so I have been referred. Looking at the current wait times, it would appear it’s 4 months to initial consultation. I’m not sure if that’s a countrywide timescale or just where I live.

    I completely understand that a wait will be involved. I cannot fault the amazing treatment I have received on the NHS. I think I was just so taken aback by the fact that once the initial phase of treatment to tackle the life threatening part of this disease is over, you feel kind of dropped like a stone. Her actual words were “So, all back to normal now then?” Err no, funnily enough I’m really not!  I really wish I’d looked into the pros and cons of immediate reconstruction in more depth, but you are led by what your consultant tells you. I am really lucky to have an amazing Macmillan Centre at my hospital so I willl speak to them when I have my Oncology appointment tomorrow. I think maybe this has all affected me more than I first thought. You don’t have time to take stock whilst you’re in the throes of treatment, and it’s only when you get to the final phase that you realise the toll that it’s taken on your body and mind.

    Wishing you all the very best for your treatment. 

  • I had two lumps so had to have a mastectomy at 51, the same age and had to have radiotherapy so said I would have delayed reconstruction. That was 7 years ago now as Covid hit and I was advised not to go into hospital to have reconstruction then managed to tear my acl and break my leg and wrist since. I’ve fortunately got private health so am hoping to have reconstruction next year. Diep surgery so it is natural and when I put on and lose weight they will both look the same. It’s a big surgery though so am going to have to syc myself up for it. Nicola Jane catalogue have kept me going with swim wear and my local bra shop have sent the bras off to have pouches inserted. With clothes on you cannot tell so I really feel there is no rush to have treatment so just get yourself on the list. 

  • I'd definitely highlight in your meeting that this sounds like they've made a scheduling mistake by not recording that you would still have the reconstructive.

    I'm due surgery March / April and am being told now to make a decision, as getting the plastics team involved would take months to get sorted? (Not the exact wording, but gist).

    Sounds like they didn't listen / record your choice properly, their mistake, and I would hope it would be at their discretion to fix that mistake by not recording your need as "elective" and get your place in the queue back?

    I wish you luck for tomorrow and hope you get a good answer xx

  • Oh my goodness you’ve had a real rough time of it! Thank goodness you have private insurance and will be able to proceed in the near future. I wish you all the very best. X

  • She explained that because I chose to delay reconstruction (because that’s what I was advised was the best option), it’s considered elective as those “with” cancer will go to the top of the list, just didn’t really understand that (and maybe should’ve asked). Just wish I’d done a bit more research and maybe just gone with an implant and taken the risk with radiotherapy. 

  • Hi, I got quite emotional reading what you are experiencing. I had the same cancer as you only left side and same treatment including radiotherapy and was told I’d have to have a delayed reconstruction as the radiotherapy would damage any reconstruction also. I had my treatment in 2022. It doesn’t make any sense to me that your consultant would  assume that you would not want a delayed reconstruction after being told you were unable to have an immediate one. When I went to see my advanced nurse practitioner at the hospital it was she that asked if I’d considered my reconstruction and she immediately referred me to see my surgeon to talk about it. I’ve just had my reconstruction after 3 years. My hospital wasn’t able to perform the reconstruction I chose but was referred to one that was. They did tell me I’d be on a waiting list for 2 years, it turned out it was 1 year. They didn’t say anything about going to the bottom of a list because I’d waited so long,  they just said the waiting list is 2 years unfortunately, but turns out I only waited 1 year. I turned 60 in November and had my op 5 weeks ago, age has nothing to do with it, we just want to feel more like ourselves that’s all. My advice would be don’t give up and speak to someone else about this. Good luck.

  • Hi Purplepower. Thank you so much for your reply. I’m sorry not to have responded sooner. I think I’m just about back to some sort of reality when it comes to which day of the week it is! I’m so happy that you’ve now had your reconstruction (although after 5 weeks I would imagine you’re still feeling a little delicate). I received the best present of all which was to return home to an appointment letter for an initial consultation! I was absolutely gobsmacked and feel a little guilty at “flying off the handle” after the conversation with my surgeon. Yet again our amazing NHS have come up trumps. I would be really grateful if you were happy to share your experience? I’m hoping to have an autologous DIEP flap reconstruction. I’m unable to have an implant because I obviously don’t have the skin to stretch. Now that I have a date for a consultation I want to research as much as possible. 
    Thank you again for your reply and I wish you a very happy and healthy new year. Xx

  • Hi Anij, that’s brilliant news! I’m so happy for you. Hopefully you won’t be waiting for too long after your consultation. For me it seemed to fly by and I was quite shocked when I got the call to give me my operation date as I was told the waiting list was 2 years so I wasn’t expecting it at all, I went into panic mode mixed with excitement. The reconstruction your hoping for is the one I’ve just had and I also did lots of research, it just so happened that the program on tv ‘inside the operating theatre’ were showing the exact same procedure that I was going to be having so I watched that as well, so I was very prepared and made me realise how amazing the surgeons are at what they do. My operation took 8 hours on a Thursday, my drains were taken out on the Saturday and I was back home on the Sunday which was a bit scary knowing there wouldn’t be any nurses checking on me every half hour but I’m getting through it day by day.  I would be happy to answer any questions you might have about my experience and I’m sorry if I’ve gone on a bit too long. I wish you all the best for the new year x