Combining TT/Breast recon with prophylactic mastectomy

chameleon · October 29, 2006

OK, This will scare the bejeesus outta you....I have been persuing this lapband procedure for about 8 months and am still fulfilling the lastest hoop of fire that my insurance company requires, it looks like I will finally have a surgery date sometime in February. Heres the kicker...I had Breast Cancer in 2001 when I was 37 and then a metastisis to my lung in 2005. I had a lumpectomy and chemo and radiation for the breast and a lobectomy and chemo for the lung. Recently, my PCP and my oncologist are seriously discussing prophylactic mastectomy and a total hysterectomy because I am high risk for reoccurrance due to my history and my testing positive for the BRCA 2 gene mutation. All of my docs have given me the go ahead for the lapband though because I am cancer free and halthy right now. Soooooo I am planning to have the lapband in Feb 2007 and then in July of 2008 I plan to have a bilateral mastectomy with DIEP flap reconstruction... that means that they will remove excess skin and fat from my abdominal area and use some of it to recreate my breasts...they can donate the rest to a soap company for all I care!!! So whattya think...am I crazy? Does anyone else know someone who has had any of this stuff done...I am kinda scared of all the surgery...but I have a 97% chance of getting breast cancer again if I don't do it and I have a very good chance of ovarian cancer without that one too so I guess its a no brainer...but still scarry...I also wanted to know if you think that is a big enough time span to allow for alll or most of my weight to come off with the band...that is 17 months...I need to loose about 140 lbs and I know everyone is different but I'm just wondering because I do have to plan this stuff and also, I'd like to get the mastectomy sooner...like December of 2007 if possible but that would only leave 10 months after the lapband surgery for me to loose weight. I really don't want to jeapordize my health because of vanity and I wont but I just need advice.

Thanks,

Donna

KariK · October 29, 2006

Donna don't they make you wait to heal before they do the reconstruction? Im just thinking maybe you should get the mastectomy first, then the band, then the reconstruction and add in a TT too boot!

Alexandra · October 29, 2006

Donna, I don't have any advice but I wanted to wish you all the best with all of this. What a handful! Sounds like you have a lot to think about and I hope everything works out in all the best possible ways for you.

Good luck!!

chameleon · October 29, 2006

With a DIEP flap and or with a skin sparing mastectomy with implants you don't have to wait, because with DIEP flap reconstruction, even if they remove all of the skin (and sometimes the nipple depending on what you choose to do...leaving the nipple also leaves a 10% chance of a breast cancer reoccurrance), they replace the skin usually during the same procedure with skin and fat from the abdomen. With a skin sparing mastectomy they just use the fat and throw away the skin from the DIEP flap procedure. They also do something called a GAP flap where they use tissue from the gluteal area instead of the abdomen...but I have more fat in the abdominal area and pretty much no butt! Here is a link to some of the newest procedures being done, but some of them are pretty graphic so beware...

http://breastcenter.com/breastrecon/beforeafter-images.html

Anyway, I have considered doing the mastectomy then lapband then TT but if I choose to do the DIEP which is where I am leaning, the TT is part of the deal...I would rather not have these kinds of decisions to make at all but alas...tis life!! Thanks for the words of encouragement...I need all I can get!

Love One Another...

Donna

paula · October 29, 2006

Donna, this is the first time Ive ever heard of using the flap for reconstruction. I was in awe to see the reconstruction job on some of those patients! Totally impressed.

You have a goal/time line for all of this work to take place.. very wise!

Its hard for many of us to give direction on an issue like this - until one goes through it, we're not sure what we would do... but this option looks very logical! And definately one I would consider if I were in your shoes.

Good luck!

the best me · October 30, 2006

I wouldn't hesitate to get a prophylactic mastectomy/hysterectomy, especially with your history. The possibility of breast or ovarian cancer popping up again between mammograms and Paps year after year after year...just get rid of it all! In my thinking, I have a life to live without that hanging over my head. So, yeah, I'm with you on the mastectomy/hysterectomy. Heck, I'm not sure I'd want to wait till 2008, even, but honestly, your plan looks great to me, very reasonable. The only real variable is the 140 pound loss in 17 months. One never really knows how the pounds will shed.

So, you COULD do mastectomy/hysterectomy in Dec 2006, banding in Feb 2007, and TT/breast reconstruction in July 2008? Do that. Cancer sucks (as you know) and weight loss is a back burner when you are fighting breast cancer...AGAIN...so enjoy your banding with lots less cancer concerns. You'll do great on your weight loss, I'm betting. You sould like a smart, fine lady.