WWYD, mastectomy only or reconstruction

[mycatislickingherpaw]

WARNING: potentially upsetting post for women having gone through breast cancer.

I found a lump in my breast 2 weeks ago and was diagnosed with breast cancer a week ago. I passed a week thinking about death or, in the best of cases, painful, painful treatments and possible slow recovery. I have young children and I am their main carer, so you can imagine...

I just saw my surgeon, who told me that I’ve caught it so early that I will be fine. Hopefully further testing will confirm that.
I should be operated shortly, and I have been given the option of full mastectomy or full mastectomy with breast reconstruction (implants, a boob job basically).

When I was told that I will live I thought nothing better could happen to me. I told the surgeon, with other words, that I couldn’t give a fuck about having no breasts, they could even chop off my arm if necessary.
The nurse I spoke to at length afterwards understood where I was coming from with my thinking, but also said that I should consider the breast implants seriously. She gave me other options (grafting my own skin or doing the implants after the operation) but I don’t want to consider them as I have a decent phobia of operations/needles/IVs, so the least medical interventions I have the better.

I don’t know what to do. Can you help me?

1- i can take being alive over breasts any second of the rest of my life.
2- i want to have the least possible medical interventions because of my phobia. Implants, AFAIU, need to be changed every decade or so, might rupture, might have to be changed because of skin adhesions.
3- I will have perfect breasts when older (if I manage to live that long), which will look very strange to me (I could say will cause me psychological problems but obviously I don’t know for sure)
4- maybe I could use a mastectomy bra to suggest breasts and avoid all these issues?
5- will they feel strange to me? Will I be remembered daily of my cancer when showering etc, as much as a mastectomy? Is there a point getting them in that case?
6- they can cause a type of lymphoma in a very small percentage of women. My husband remarked that the percentage is absolute minute. Equally, I ticked all the boxes for this not to be cancer, and yet it is. I’m also in the small percentage of women who gets cancer despite everything.
7- my husband isn’t pushing me to get new breasts.

Equally:

1- I’m young, I don’t have to suffer psychologically or punish myself for the rest of my life when medicine has developed so much that I can have breasts, even if not the ones I was born with.
2- they probably will make me feel better about myself and my image.
3- I might regret not having the implants done straight away and having them done at a later stage would be more difficult, though not impossible.

I’m not really asking you WWYD, but if you have an opinion, would you share it with me? I don’t know what to do and I don’t have so many women to ask to.

Thank you.

I would have the surgery to remove then think about it later down the line like I am, I had equal pros and cons for the recinstruction, my latest is that I am still in a fuck load of pain 3 months post surgery so I fear how it would be if I did opt for reconstruction

I dont think you want "new" boobs. That is all I can really gather from your post. But i've never been in this situ and dont feel qualified to help- hopefully someone else will be along soon.

for your bravery and love of life. I wish you well xx

Sorry to read this. I know from friends’ experiences how tough this is to go through. I have 2 close friends who have had breast cancer and both opted for double mastectomy and reconstructions. If you want me to intro you to one of them, she is much better placed than me to give advice. Just dm me your email if you do and I’ll sort it out.
I think both are pleased they went for reconstructions but the process isn’t as straightforward as for a normal boob job so it has been a few ops for both of them. One has just had fat removal from her legs to improve the look of the reconstructed breast. Good luck with it, whatever you decide, and please do pm me if you’d like an intro xx

I am sorry you are going through this.
I would have the reconstruction. My reasons are totally vanity based, but I love my boobs and they are quite big, so I would miss them. Whatever you decide, I hope everything goes well for you.

A close family member went without reconstruction and was then too nervous to get it done later. She regretted it, but couldn't bring herself to get it done.
If it were me, I'd prefer to get all the major surgery out of the way in as few operations as possible.

Google Diep Flap reconstruction, I had a mastectomy two years ago and they took fat from my stomach and made a new breast. It was not fun but I was back at work in 6 weeks. I had my other breast altered to match, did not want a nipple reconstruction. I look and feel fairly normal, I could not have coped with a silicon breast but I know people do.
I will not need any other surgery, I am happy to provide more details if you want them.

Agree with PP, it doesn't sound as if you want a reconstruction.

Is it an option to leave it for now (no reconstruction), then opt to have it later on if you change your mind?

I’m so glad you have a good prognosis OP. I think you will always be reminded whatever option you go for - just choose to be reminded that you fought and beat this
If you have phobias I would go for the implants over any other reconstruction. I know someone who had reconstruction at the same time as mastectomy using fat from her stomach and her body rejected it (or the blood vessels weren’t lined up properly) and she had to have emergency surgery to remove it. So two surgery sites and nothing to show for it. Implants are a shorter surgery and less risk.
If you think you can live with it then have the mastectomy and reconstruction at a later date. My Nan had a single mastectomy 20 odd years ago and by the time they offered reconstruction she was quite happy to live with her body as it is (she was late fifties at the time).

My mum didn't have reconstruction at the time and never wanted further surgery. She can't wear the fake boob bras because of lymphodema and it rubbing her scars. So she has clothing issues.

I do think implants are much more likely to lead to further surgery in the future.

Can they do own body reconstruction or not? It might have to be in a second op though because you already have cancer. With own body recon you are less likely to need future surgery

Also, ask your nurses for some pointers, there are a ton of resources available where people have made these decisions in the past, which can help you think it through.

Yes get in touch with the Macmillan nurse and see if she can put you in touch with people or point you in the right direction.

When I had bc i looked into this thoroughly.

I decided that silicon implants weren't for me.

They can put in some inflatable ones which stretches the skin ready for delayed recon.

Diep flap is the one to have. Your fat becomes your boob so is warm, goes up and down like normal with weight gain and loss.

Your bc nurses should give you a dvd to watch on pptions.

Diep flap takes a longer operation and also longer recovery time - it's the stomach op that takes it out of you.

You can have this done later but will probs need the skin expanders.

Most hospitals have show me tell me type sessions with women who have had all types of recon.

Needles, etc, don't worry about - you will be asleep! I think you will have drains though.

If you do the arm excercises lymphodema is unlikely. Hurty thing is lymph node removal. Under my arm is still odd two years later.

Scars fade. I have a three inch 'smile'. I don't really notice it now.

As you are young, I would really think about the recon.

I work at the breast clinic. Lots of women don’t get a reconstruction and just stay flat. Are you having radiotherapy? They suggest a delayed reconstuction in that case.

Another thing to be aware of is if you decide on a reconstruction a year or so down the line, the waiting list is very very long! It isn’t an immediate thing (although I believe it should be!). You are no longer in danger so you go to the back of the queue.

Did the surgeon mention a DIEP? 3D nipple tattooing is fantastic and looks very realistic although you may not want this as you don’t like needles

I thought there were more likely to be complications if done at the same time, certainly if they need to do more surgery (ie. no clear margin) it would be more difficult.

A dear friend had the double mastectomy, then opted for reconstruction about a year later. Biggest mistake, she has taken 18months (and counting) to get over the reconstruction, the actual mastecomies (she had them done separately) was a breeze in comparison.

She massively regrets the reconstruction, but to undo it would set her healing back again.

Do the necessary surgery, heal and then decide what you want for the future.

It’s a hard call. I’d ask the surgeon if you have to also have radiotherapy after surgery? That can sometimes delay healing of wounds so it may be better to wait to have a reconstruction until that’s done. Also are you a reactive/allergic type person? I know I don’t react at all well to any type of foreign body within my system. Mirena, implant, earrings, my body rejected them.

Thank you so much, you are all really kind and I appreciate it.

I won’t go for the ‘use my own skin’ op. I know it has great results and I would like a flat belly but it seriously freaks me out. The nurse told me it’s totally safe (as safe as it can be) but also that it would take 10 hours in the OR and another scar on my belly, and I just can’t deal with it.

I could do it afterwards, but it would be another medical intervention, and the more I will stay away from hospitals the better.

I am probably happier with mastectomy only at the moment, I just fear that I won’t be after the operation. Maybe.

I most likely won’t need chemotherapy and possibly no radiotherapy. AFAIU it was caught so early on one side and the other side is preventative. I’ve been very lucky.

I had a mastectomy last year. Couldn't have reconstruction due to diabetes. I hate how I look - lob sided without my prosthetic and just odd with it. They won't take off my healthy boob to even me out ( which I'd love) and now I have about a year to wait before I can have the reconstruction. If they offer it now, then I'd take it.
They will alter your natural boob to match over the years and implants only last about 15 years so there will be regular chances for them to do this.
Perhaps some counselling alongside to help with the fears? If you have chemo then there will be lots of needles I'm afraid.
But nevertheless, I'm glad you've caught is early, and come on over to the cancer support thread, you will be most welcome ❤️

You’re so brave!
I have no personal experience, but I have been toying with the idea of implants for 15+ years (vanity) the thing that stops me is the risks, of body rejecting, leaking, implant illness, it going wrong, repeat surgery. The thought of not spotting lumps. Also with the fat transfer it can “lump” calcify I think they called it, so also making spotting cancer difficult.
But in your situation is not just vanity, so it’s totally different.
Could you not have the surgery, wait 5 years for the all clear and see how you feel about reconstruction? There could be a totally new “boobjob” by then

Sorry, cross posted about chemo. Glad that's not on the cards!

I was facing a similar dilemma and in the end chose to have just the mastectomy. Long story short I didn’t need it- thankfully- but I had pretty much decided that yes I’d miss my boobs BUT I’d prefer no HDU bed not constant appts to follow up the implants etc
In fact as a large chested woman I was sort of intrigued as to how much life would be easier with no boobs or indeed options of boob sizes in post mastectomy bras- small boobs for straps dresses, no boobs for exercise, larger ones for nice outfits that suit a bigger boobage. I knew it would remind me daily of my cancer/post cancer BUT I figured it would also remind me daily to appreciate being alive.
Best wishes to you

Cancer Support #70. Please post on this thread, not #69, If you have cancer or are undergoing tes... www.mumsnet.com/Talk/general_health/3541493-Cancer-Support-70-Please-post-on-this-thread-not-69-If-you-have-cancer-or-are-undergoing-tests-for-cancer-Rant-rave-scream-cry-whatever-helps-Supportive-lurkers-for-Leslie-welcome-on-69

I had a mastectomy in November, left side, no reconstruction. Waiting to go back and have the other breast off. I'm happy flat despite being an H cup - in fact it's quite freeing but I am 45 and have no need of them any more! It is a very individual choice but of course the difficulty is that cancer is forcing you to make it and it can all feel very overwhelming. Please do come and join us on cancer thread #70 as linked above; lots of support and advice available xx

Thank you for the cancer thread, I will definitely join in.

I had breast cancer 7 years ago. Had a mastectomy with no reconstruction. So I have one breast and one side of my chest concave with a big scar. I wear a prostetic breast in a mastectomy bra.

My thoughts:

1. If you don’t know what you want to do at this point, them don’t have a reconstruction immediately. They can be done later.
2. The ‘glad to be alive, don’t care what I look like’ thing will last a good while. For me it was about 5 years. But at some point you will care.
3. Mastectomy bras and prostetic breasts are hugely expensive. Bras (in Australia) $80 each, prostetic breast $400 each.
4. With no reconstruction, your clothing choices will be limited. No deep v necks, strapless very tricky, anything low cut around the armpits very difficult. Bathing suits a nightmare, you need mastectomy ones, my last cost me $140.
5. I would suggest therapy to work on your fear of medical procedures.
6. If I had my time again, would I have a reconstruction? Honestly, most days I would say probably not, but on days where I just want to swim without my fake tit floating out of the top of my togs, I would say, yes maybe.

Good luck, there are no easy or simple decisions. #fuckcancer