Mastectomy decision - implant or DIEP flap

Hello everyone

First post, I hope I'm in the right place. 

I was diagnosed with a 2cm breast cancer (tumour?) and extensive DCIS in my left breast 5 weeks ago. No symptoms, routine mammo, no history of cancer in the family so biggest shock of my life. I feel extremely lucky that it's been caught early and is treatable however it's still an awful lot to process and I'm really struggling.  I've been told I need a mastectomy and the breast surgeon thought I'd be a good candidate for a DIEP flap reconstruction. I'm quite slim and have large boobs for my frame (E cup) and so the plastic surgeon has told me that I don't have enough body fat to make a new breast of the same size and therefore I'd need a reduction on the other side if I wanted symmetry. I really dont want a breast reduction - I can cope with scars, loss of nipple, pain but a change in size was my biggest fear. My boobs are my favourite part of my body - I love them and while I understand and accept that I need to lose one and am so incredibly grateful this disease isn't going to kill me Im still devastated at the place I find myself. Ive explored the possibility of an implant in the hope that perhaps I could have one close to my natural size but that's been poo-poo'd by my breast surgeon and she's told me that if I insisted on that route she'd only implant roughly a B cup anyway.

Both surgeons and the nurses I've spoken to seem to not understand why I'm so upset at a) losing a breast and b) having to go considerably smaller to create any symmetry. In my first appointment with the plastic surgeon, a week after I was told I'd lose my breast, I became upset. I was asked why I was so upset and was then told I'd be referred to a psychologist. Today I was told by a nurse that I needed to 'reasses my priorities'. I feel like everyone thinks I'm massively over reacting and I should just be grateful I'm alive. Am I not allowed to be upset about this? 
 

I guess I'm really struggling and feel completely unsupported and without answers. I wondered if there was anyone in my position who had to have a sizeable reduction and how they came to terms with that. I'm reluctant to attend the meeting with the psychologist as I'm afraid l'll again be made to feel like I'm making a fuss. 
 

Sorry this is so long - if anyone has any advice I'd be so grateful x

  • [@Flamingo46]‍ , Hi lovely, You are definitely in the right place - welcome! Well Flamingo, I am 5 weeks post surgery with implant recon, after being diagnosed with IDC cancer which was her2 positive - double downer! I chose the implant, and I too am an E cup but was told I would end up with a healthy C cup, I’m happy with that as I’m not as happy with large boobs as you - different strokes and all that. I didn’t have the choice of the diep flap as I had extensive surgery on my stomach 20 years ago, so the skin is already compromised. I couldn’t face flesh being taken from my thighs or back, at the end of the day there would be more than just the one painful site healing, with more possible complications if unlucky. Thighs or back seemed intrusive, whereas a stomach you are not sitting or leaning on it. I could have coped with that. Diep flap for me would always feel like ‘you’ because it is you - an implant can feel like a foreign body, that’s what it is after all. Age would be an important factor for me, had I been 30, not late fifties I woukd have gone with the diep.

    Why not click on the magnifier search above and put in diep - it may likely bring some previous posts up or mastectomy reconstruction, the fewer the words the more success you should have, if you see something that relates to you, you can message the poster by putting in the @ icon followed by their name, they will get an email to alert them.

    I am so sorry you have been diagnosed with cancer, it is a bummer for all of us for sure, so much to absorb and digest, decisions to be made, it’s not easy. BUT I have found the interaction with the lovely posters on here - lovely ladies, and not forgetting the men has been totally inspiring, what a great bunch of caring, sharing individuals. I do get the way you feel absolutely, I was totally devastated,  but I just want to live, a few scars won’t define who I am, or who anyone else is.

    As the weeks and months pass,  an acceptance does occurr - be kind to yourself, give yourself that time to mourn your poorly breast and accept things, your health professionals want only the best for you, though maybe you don’t feel it at the moment - you’ve had a horrendous life jolt. Good luck moving forward Flamingo. Anything else just holler. Lyn. X 

  • Hi Lyn

    Thank you so much for your reply. I'll have a look around and see what I can find regards other people's experiences. I'm so glad I found this place, it seems really lovely. 

  • [@Flamingo46]‍ , you are very welcome! Lyn. X

  • Hi Guys, think I'm in a similar situation.  Had a DCIS diagnosis about 5 weeks ago.  Head still reeling.  Had a lumpectomy, which I was feeling fairly confident with the 80-20% result.  Unfortunately I was in the 20%.  Am only an A cup, so don't think the surgeon wants to do another lumpectomy as feels that in order to get the clear margins, will have to take out so much, might as well do a mastectomy.

    So then I have the issue with silicon v flap - like you, probably not enough body fat & had 2 emergency C-sections, so the area not in good shape anyway.  The other flaps sound more complicated & longer recovery etc.  A friend who had silicon implants & then changed to flap (after putting on enough weight), says they're so much better - warm, move, etc.  She hated silicon.  The other friend has one silicon & pretty relaxed with it, although says its fairly obviously in certain places due to lack of body fat.

    So much to think about.  Pretty freaked out.  Also have to have the node dye thing done, which is worrying me.

    Sorry to offload. xx

  • Hi [@LaraH]‍ 

     

    I think this is the perfect place to offload and I'm sorry to read of your diagnosis. It's just completely over whelming isn't it? I too have had 2 sections but they didn't seem to think that would be an issue.I guess each person is different. 
     

    I think I have no choice but to go for the flap. I received a letter today which confirmed they estimate they can reconstruct to a C cup (although the nurse said B cup at best when I spoke to her). I have a further meeting tmrw and I think I'll need to decide after that. I too need further biopsies (nipple and lymph nodes). I also m ie someone who has a silicone reconstruction and she says that 4 years on it looks very different to her other breast. 
     

    I hope you have lots of support around you xx

  • I do thank you & hope you do too!  I think the Diep flap is a good route to go down, so a positive outcome I'm sure.  My friend says its great compared to silicon, as is part of her body & not an alien object!  Best of luck with your surgery. xx

  • [@LaraH]‍ Hi Lara, Welcome to you too. I am so sorry you have been diagnosed with cancer. You are so right, so much for us all to take in, and so little time to reach decisions. The blue dye will fade in time, you will have a blue tinged boob for a wee while, but nothing too serious, it wasn’t painful to have the isotope injected, you’ll be totally fine. There are absolutely upsides and downsides to both types of recon. I couldn’t face the more intrusive fat removal from back or thighs, I’m a size 16 so had the flesh to spare, but the stomach was a no go, so went with the implant route. If you message Flamingo46 too, she is in a similar position as you, though she could have a B Or possibly C cup, I absolutely get that she loves her E size breasts. it may be good for you both to chat together? If you search on cancer chat like I advised Flamingo in my message to her, there are postings from other ladies that have gone the diep route, if you search the word diep, I checked earlier. It may give you more insight? I hope whichever way you decide to go you have a smooth journey. Take care, Lyn. X

  • Thanks so much Lyn.  You take care too x

     

  • Hi [@LaraH]‍ and [@Flamingo46]‍ 

    If you want some wider opinion on the good/bad/ugly of implants, DIEPs and other recons you may find social media useful...not sure if I can give you details here but send me a private message if you want further details of a really useful group.

    Sam

  • Hi would you be able to let me have details of where to find more info on good/bad/ugly DIEP.  Thank you x D