I'm Joanc, a long-time supporter of BC Support and a long time lurker! I've been free of any evidence of cancer for 10 years after having had a lumpectomy in the left breast, rads and 5 years of Tamoxifen and Zoladex. Meds finished in 2006 and since then life has been pretty damned good, although I am getting older and I don't like it!
But now I'm back with some questions because, you guessed it, the cancer is back.
My new diagnosis is much the same as the last, still in the left breast so rads and lumpectomy are out of the question. I'm due for total mastectomy and I have told the surgical team that I want immediate reconstruction. Thank goodness they say I'm a candidate. They will also repeat a sentinel node biopsy of the lymph glands, although the risk that there will be technical problems getting the dye through the scar tissue is high.
There are a number of decisions I have to make in the next few days but 2 have to do with reconstruction:
1) What kind of reconstruction to do – they talked mostly about DIEP flap (skin and fat from the tummy but no muscle, so a tummy tuck, 8-10 hour surgery, 6-8 weeks recovery time, lots of pain)
a latimus dorsi flap (skin, fat and muscle from the back, inclusion of an implant, loss of muscle tone in the back but not usually a big impact on quality of life, shorter surgery, shorter recovery time, less pain)
2) My biggest decision is about what to do about the right breast. It shows no signs of cancer and I know that statistically removing it would not have any effect on my risk or survival. But I also know that in the last 10 years I have been recalled for a second look at “something suspicious” after 3-4 of my mammograms; the second look was always on my right breast and always showed many cysts. Removing Righty would certainly reduce my anxiety over this whole routine. It would also allow me to reconstruct it using the same DIEP flap (a DIEP flap can only be taken once) and end up with breasts that actually look like they are a pair (far from the case right now and I'm very frustrated by it).
I would like opinions from those who've been down this road how accurate these descriptions are and I would like to ask a couple of questions that I didn't think to ask the plastic surgeon when I was with her.
For those who've had the DIEP procedure with a reduction and lift on the other side, are you happy with the symmetry? Were they actually able to give you breasts that look like they belong on the same body?
For those who've had DIEP, are you happy with your new tummy? Is there a problem(s)/criticism(s) that you can prepare me for?
I am considering having a prophylactic mastectomy on the right for reasons of anxiety above, but also because I really, really, really want breasts that are somewhat similar. But I just don’t know about the realities of living with no sensation in either breast. That's very scary to me. My breasts are a big part of my sexual response and my husband and I have a very healthy sex life. I don’t want to make a decision that would impact that without really knowing what I’m getting in to. Has anyone had difficulty coping with this?
But if I leave the right alone (with adjustments to match it) and if I later get cancer in the right breast I could not have another DIEP. I would have to have the lat dorsi flap with the implant and I don't know if they could ever match the left with the right at that point. Can you put an implant into a previously DIEP'd breast???
I know with the last question I'm looking far down the road only at possibilities, but I am a thinker and a planner. I need information to feel comfortable in my decision. Any anwers anyone can give would be appreciated.