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How long after chemo/rads until reconstruction?

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Bonnie View Drop Down
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    Posted: Nov 05 2009 at 7:31am
Just wanted to check with some of you to find out how long you waited after your chemo and radiation treatments were over to have reconstruction?  We just found out recently that Ashley will need to wait 4 to 6 months after treatment ends to have her final mastectomy and reconstruction.  We didn't realize it would be that long, but I know the body needs time to heal and prepare for the upcoming surgery.  Also, what type of reconstruction did you have and would you do it all again or choose a different route?
Bonnie - Daughter Ashley dx TN 8/09 @ 22; St3, BRCA1/2-; AC&Ixempra done 2/10; mets to lung 3/10; G/C 3/10; PARP 6/10; sternum mets 9/10; NK012 failed; mets to liver, spine, kidney; Avastin/Xeloda
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 05 2009 at 8:07am
Bonnie,

I had a bilateral mastectomy with tissue expanders on 6/30/09 and finished chemo on 9/24/09.  I did not have radiation.  I waited 5 weeks for my exchange surgery - 11/2/09.  The ps removed the tissue expanders and replaced them with silicone implants.  I am so happy to have the expanders out as they weren't very comfortable.   While I'm still recovering from the surgery, the new implants feel so much better and I'm glad I went ahead with the procedure.  I agree that you need to make sure your body is healthy enough for surgery.   The ps ran some blood tests to make sure the results were in the normal range.  I also had a check up with my primary doctor to make sure I was in good shape for the surgery.  I ended up getting bronchitis a few weeks after my last chemo and they wanted to check my lungs to make sure they were clear.   The exchange surgery is nothing like the original mastectomy and the recovery is easier. 

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote adaniel Quote  Post ReplyReply Direct Link To This Post Posted: Nov 06 2009 at 9:27am
Thanks, Donna.  I hope you recover quickly and fully from surgery!  Ashley plans to start researching the various options for reconstruction surgeries available.  She'll be done with chemo in March 2010, the wait a few weeks, then 6 weeks of radiation.  Then her surgeon says he'd like for her to heal for four to six months.  Seems like forever, but I know it will go quickly.  Have a great weekend and rest as much as you can.
Bonnie
dx TN 8/09 Age 22; St4, Gr3, 4/18 nodes, BRCA 1/2-; AC & Ixempra x4, finished 2/10; 3/11/10 mets to lung & nodes; G/C began 3/15/10; Iniparib began on 6/8/10
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 06 2009 at 10:21am
Bonnie,

Is a unilateral mastectomy the same as a bilateral?  Did they place tissue expanders in Ashley when she had her surgery or will they do this procedure later?  It sounds like excellent advice to make sure that Ashley's body is healed before reconstruction.  Chemo and radiation takes its toll and its best to get your health back up before another surgery.  I know it seems like such a long wait for reconstruction, but she'll be glad she waited until she's stronger and healthier.  I think I wanted the reconstruction mentally because it means you're closer to being back to "normal".   Feel free to ask me any questions as you're doing your research. 

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Bonnie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Bonnie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 07 2009 at 10:59am
Donna:  A uni-lateral is when only one breast is removed.  The did not place tissue expanders in Ashley at time of surgery.  Was not discussed as an option.  Thanks for your help.
Bonnie
Bonnie - Daughter Ashley dx TN 8/09 @ 22; St3, BRCA1/2-; AC&Ixempra done 2/10; mets to lung 3/10; G/C 3/10; PARP 6/10; sternum mets 9/10; NK012 failed; mets to liver, spine, kidney; Avastin/Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 07 2009 at 11:09am
Bonnie,

After I asked that question I realized uni-lateral probably meant only one.  I think they can place the tissue expanders in at a later date when she's ready and recovered from chemo and radiation. She may also have other options for reconstruction surgery that her plastic surgeon can discuss with her.  How's Ashley doing?

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Bonnie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Bonnie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 07 2009 at 8:13pm

Donna:  Ashley's doing really good.  Just had her 3rd AC treatment on Thursday and it has been kinder to her this go round.  That makes me happy!  One more AC to go then she starts the Ixempra. 

Bonnie
Bonnie - Daughter Ashley dx TN 8/09 @ 22; St3, BRCA1/2-; AC&Ixempra done 2/10; mets to lung 3/10; G/C 3/10; PARP 6/10; sternum mets 9/10; NK012 failed; mets to liver, spine, kidney; Avastin/Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote thenewme Quote  Post ReplyReply Direct Link To This Post Posted: Nov 14 2009 at 5:37pm
Hi Bonnie,
Wow - 22 years old? Ugh, that's just sooo young!  I'm so sorry you have to be here.  I haven't seen - is she scheduled to do rads after chemo, or has that been decided yet?  I had bilateral mastectomy with tissue expanders last December 30.  Then chemo, then rads, which I finished around the 4th of July.  My plastic surgeon wants me to wait a full YEAR after completion of rads before she does the exchange from tissue expanders to the silicone implants. 

Rads can sometimes cause tissue changes, scarring, and capsular contracture, so by waiting a year, all my changes should be pretty much stable.  That way, my PS expects to have better results and less chance of complications with my reconstruction.  The tissue expanders are pretty uncomfortable, but in the scheme of things I'd say it's not so bad.  I can't wait until I get the silicone, though!

Has Ashley seen a plastic surgeon yet?  If not, maybe she could get in to see one and get their opinion before she starts rads (if she's doing that).  Her options for reconstruction may be different, depending on the order they do things, so it's best if you get all the docs on the same page early in treatment. 

Best of luck to both of you!  AC is tough, but it's so good to be moving forward!  HUGS!!
DX: IDC/TNBC 11/08 5-cm Stage IIb Grade 3. Age 39. Double Mast 12/08 (prophy right) with tissue expanders . ACx4-Tx3. Suspicious IM node. 25 Rads. BRCA NEG.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklez Quote  Post ReplyReply Direct Link To This Post Posted: Nov 15 2009 at 12:41am
Hi Bonnie,
I think a year's wait is likely to make the long term results fantastic. Ashley may or  may not want to wait but the wait will almost certainly make a lot more options feasible and more likely to succeed. God bless.



Edited by unklez - Nov 15 2009 at 1:20am
Wife Dx: Jul/09. Age: 37. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. E5103. DD ACB-> DD Abraxane (Taxol reaction). Zometa (S0307). Canadian Fraction Rads.
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Bonnie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Bonnie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 16 2009 at 11:07am
thenewme:  Yes, Ashley will be having radiation - 30 treatments (5 per week for 6 weeks).  We have not seen a plastic surgeon yet.  I think right after the first of the year, when Ashley's AC treatments are over and she has moved to the Ixempra phase, we will start searching for a plastic surgeon and get an appointment to discuss the next steps.  Rads should not start until March.  Thanks for the advice and hugs,
Bonnie
Bonnie - Daughter Ashley dx TN 8/09 @ 22; St3, BRCA1/2-; AC&Ixempra done 2/10; mets to lung 3/10; G/C 3/10; PARP 6/10; sternum mets 9/10; NK012 failed; mets to liver, spine, kidney; Avastin/Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Bonnie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 16 2009 at 11:14am
unklez:  Thanks for your note.  I guess, in the grand scheme of things, a year is not too long to wait.  Especially if the results will be that much better.  Ashley is so young - she has a long life to live and deserves the best shot at good reconstruction.
Bonnie
Bonnie - Daughter Ashley dx TN 8/09 @ 22; St3, BRCA1/2-; AC&Ixempra done 2/10; mets to lung 3/10; G/C 3/10; PARP 6/10; sternum mets 9/10; NK012 failed; mets to liver, spine, kidney; Avastin/Xeloda
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