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Newbie- To reconstruct or not? Implant issues?

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URL: http://forum.tnbcfoundation.org/forum_posts.asp?TID=9345
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Topic: Newbie- To reconstruct or not? Implant issues?
Posted By: Jane825
Subject: Newbie- To reconstruct or not? Implant issues?
Date Posted: Nov 30 2011 at 4:51pm

Hello everyone,

I am so thankful for finding this site! I was dx'd May 2011, at age 31, stage II triple negative, enrolled in a neoadjuvant chemotherapy trial (ISPY-2) where I was randomized to the PARP inhibitor arm. After Taxolx12, along with carboplatin x4 all while taking the oral PARP inhibitor for 12 weeks, followed by AC x4, 11/8 was my last chemo session, with the best post chemo breast MRI result possible (thank goodness) surgery now scheduled for December 15th. BRCA 2 unspecified variant. I'm blessed with a 2 year old daughter and a loving husband.

I have gone back and forth between lumpectomy and radiation and bilateral mastectomy with immediate reconstruction, leaning much more for the latter due to wanting some peace of mind, and my shaky BRCA status but now have also considered not doing immediate reconstruction with implants due to the myriad of problems I've read about with implants (both saline and silicone)- the unexplainable headaches, neck, back pains, seemingly depressed immune system, autoimmune problems and chronic fatigue that some women have attributed to their implants, along with the stories about ruptures. The thought of using autologous tissue is ideal, but I would want to preserve the integrity of other parts of my body used for many types of autologous recons like the DIEP, or TRAM, for after, if I am lucky enough to be able to experience, another pregnancy. Also the extended surgery time for the DIEP concerns me.

I am wondering for the women who have opted for implants saline or silicone, if you love your implants, or have experienced problems with them?

Also I would appreciate hearing from women post mastectomy who opted for either no reconstruction or delayed reconstruction and your thought process with regards to your decision.

Thanks so much,

Jane



Replies:
Posted By: ann u
Date Posted: Nov 30 2011 at 5:23pm
Hi Jane and welcome-
 
This Friday will be the two-year anniversary of my double mastectomy (which was my second occurance of TNBC).  The first diagnosis 5 1/2 years ago, I had a lumpectomy, radiation, then chemo.  I tested positive for the BRCA1 mutation after I finished treatment, but choose to do surveillance on my breasts with semi-annual mammograms and breast MRI's.  It was during a routine mammogram that the radiologist saw a 3mm spot that turned out to be TNBC again. 
 
I choose to have a double mastectomy with reconstruction using expanders then subsequently silicone implants.  I knew I wanted something there - didn't want to deal with prosthetics (or nothing at all).  Are they great?  They do what I intended them to do.  They are not real, and they are not perfect, but I'm OK with that.  You have to remember that you will have no feeling in your "breasts" after the mastectomy.  It's a strange sensation, but I'm used to it now.  I have not had any issues with the silicone implants.
 
I will tell you that a double mastectomy is a doosie of a surgery (at least it was for me).  I hate surgical drains with a passion, and I had four of them - 2 stayed in for almost 3 weeks. 
 
In discussions with my PS, we discussed using my own belly fat - he said I didn't have enough - who knew!  I would probably have had to have inplants anyway to get enough volume.  All-in-all, the expander to implant route is probably the easiest.  I would recommend that you read The Breast Reconstruction Guidebook by Kathy Steligo.  It goes over all the possiblilities.  Most public libraries carry it.  Remember, you can always have a lumpectomy right now (although you will probably have to do some radiation too??), then research your options and maybe have a PBM somewhere down the road.  I will also tell you that if you have radiation, it will sometimes compromise a reconstruction later on.  Again, speak to a plastic surgeon to get their opinion.
 
It's a lot of decisions to make, and it's definitely not easy.  Every one has to weigh all their options and choose one that's right for them.
 
Ann


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8/06: IDC 1cm, 0/9 lymph nodes, lumpectomy, Mammosite radiation, 4 x A/C
5/07: BRCA1+ (5382insC)
11/09: IDC 3mm, double mastectomy w/reconstruction



Posted By: clwille708
Date Posted: Nov 30 2011 at 5:43pm
Hi Jane,

So sorry you are going through all of this.  A young friend of mine (now 38) had a double mast. and she had immediate reconstruction...using her own tissue.  I am not sure of the name, but it was belly fat and muscle channeled up to make breasts.   Some kind of material was used to replace some of the abs muscle.  She has since had a little boy (18 months old now) and is a very happy contented mom.
She is very pleased with her new boobs, and they look terrific.

If you would like to connect with her, send me a private message and an email and I am sure she would be willing to connect.

Best wishes for whatever decision you make.

Hugs, Linda from Wasaga Beach


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Dx Aug/10,age 62, Lump & SNB Sept/10,1.7 cm, grade 3, Triple Neg, Nodes clear. Annual screening due to family history of Ovarian C. BRCA - Chemo DD AC -->Taxol 21 Rads done. Hugs -Linda


Posted By: 123Donna
Date Posted: Nov 30 2011 at 7:27pm
Hi Jane,

Have you met with a plastic surgeon to discuss your options?  I had a bi-mastectomy with tissue expanders.  I had 3 drain tubes on each side (my plastic surgeon's choice).  I didn't have any complications from the surgery or implants.  I thought the drain tubes were a pain in the butt (well not there actually), but they only last a few weeks.  The tissue expanders were uncomfortable and I was glad to have the reconstruction surgery as soon as I could.  The surgery was a breeze.  I had the silicone implants and no problems so far.  I echo what Anne said before me about you won't have any sensation in your breast area, but with clothes on, I look the same as before.  They just don't feel like real breasts, but the real ones tried to kill me. lol

Donna




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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



Posted By: christina1961
Date Posted: Dec 01 2011 at 7:10pm
I can't give any information about silicone implants or reconstruction yet, but I had saline implants for augmentation in 2003 and never had any problems whatsoever from them.  I had a unilateral mastectomy in July followed by radiation and still have the other implant. I am hoping against hope to get reconstruction with expanders next summer even if I have to be smaller in order to avoid using my lat muscle.

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2.5 cm TNBC, BRCA-, diag. 2/11, neoadj chemotherapy, uni MX, y2cm,2/16 nodes, RCBII, tumor retested 5-10%ER+,PR-,Her2-, rads, clin trial eribulin 10/11-2/12, tamox.



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