Reconstruction and Radiation WAS Re: Finally Cancer Free

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mrs.katz katz wrote:

> I'd like to ask you why rads in the picture as well as chemo if bilateral

mastectomy and not lumpectomy was performed.

> Also, how does it effect the success of reconstructive surgery if there is

radiaion involved?

> It was my understanding that once they do mastectomy, chemo is sufficient

and no radiation is necessary.

I had neoadjuvant (before surgery) chemo to try to shrink my huge

tumor. I did NOT have a complete response; the living tumor had shrunk

just 50%. Because of the size of the tumor I'll be getting rads even

though I had a bilateral mastectomy. With large tumors the recurrence

more often is in the breast area, whether there is a real breast there

or not (or so the doctors tell me).

Now, rads and reconstruction are a bit touchy. It would take a

while to type it all out. However, rads and recon do not mix very well.

It is best to get recon out of the way prior to rads, but there is

always the chance that the cosmetic result will not be the greatest

(higher chance for capsular contracture, or something like that). I'll

probably be getting rads after expansion of the tissue expanders and

BEFORE the real implants. Not very pleased with this because expanders

are so darned uncomfortable. I'll have to wait at LEAST six months

after rads are finished before the implant swaps can be done because

rads messes up the skin and blood supply below it. If one has rads

withOUT reconstruction, THEN decides to have it done, the skin must be

grafted from somewhere else because irradiated skin canNOT stretch.

All my docs consult with each other, and the cosmetic surgeon has

lots of experience doing recons around rads. Since he has worked with

my breast surgeon and rad oncologist a LOT, I am placing my trust in him

that the job will be done as good as it can be, given the

less-than-perfect circumstances. I'll have to wait and see how it all

pans out. Ask me in October and I'll be happy to give a report, whether

good or bad.

-Frances

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