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Reconstructive Surgery (Expert Forum)
Rt. Breast radiated in 2003 with lumpectomy now has invasive cancer
Questions in the Reconstructive Surgery Forum are being answered by Dr. Archibald Sanford Miller III, MD,FACS, the Associate Professor at the University of Oklahoma School of Medicine.
Rt. Breast radiated in 2003 with lumpectomy now has invasive cancer
by Marly51, Oct 06, 2009 07:33PM
In 2003, I had a DCIS, non-estrogen receptive tumor. I opted for a lumpectomy and radiation. Within the past three weeks, I have learned that I have invasive cancer (Grade II and estrogen receptive) in the same breast and it appears I have limited options for reconstruction. I have been told by my plastic surgeon that I more than likely would not be a good candidate for immediate reconstruction. She recommended that we delay it until I heal and get the results of the sentinel node biopsy. She did say that having had prior radiation on that breast poses a problem due to possible shrinkage and toughness of the tissue and skin. Now I will be having bi-lateral mastectomies and am very concerned that I will not be able to have any reconstruction. Is that true?
To answer this publicly yes you can have reconstruction. Once you've had rads, you really don't want to have an implant or an expander put in. The skin doesn't stretch anymore, the rib cage has been weakened by the rads and an expander could push the rib cage inward rather than the skin outward. And then there is also a large percentage of a chance that you could and would have capsular contraction.
You could have FLAP surgery though. The old methods are Tram and Lattisimus Flap where they move skin, fat and muscle or you could have DIEP, SIEA, GAP, TUG or any of the newer FLAP surgeries where they move skin and fat and blood supply only and leave your muscles in tact, which is preferred. I recommend you research this thoroughly before making any decision. FLAP surgeries can be done at the time of mastectomy and I'd have it done with someone who does them as their primary surgery since they will have a better success rate. My plastic surgeon - micro surgeon has less than 1% failure rate in 10 years of doing DIEP flap.
Best wishes