Breast Reconstruction Options?

I have been diagnosed with intermediate DCSI. My surgeon has performed a lumpectomy and the margins are not clear. Currently, it is considered 3.5 centimeters and was told I would need the 6-week radiation treatment rather than the 1-week because of the size. I would rather not do another lumpectomy at this time and do a mastectomy to be safe. I'm a heavy woman and am currently a DD. What is the best reconstruction option?

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DD cup mastectomy options

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9 Doctor Answers | Asked by Confused in TX in Round Rock, TX

Doctor Answers (9)
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Breast reconstruction

An option not discussed is to do a breast reduction with another lumpectomy followed by radiation. You would also do a reduction on the opposite breast. This does mean watching for development of cancer in both breasts. You may ask your surgeon about getting an MRI if you have not had one to check the extent of any DCIS in both breasts. If abnormalities are found in the opposite breast, then a double mastetcomy is something to consider. If you are going with a mastectomy, the... more

Michael Hueneke, MD

6 reviews

Nashville Plastic Surgeon

Mastectomy avoids the need for radiation.

Hi. 1) Based on the facts you present, a mastectomy is a good choice. You would be spared the possible complications of radiation, and you would not have to worry about a recurrence. 2) You may be a candidate for nipple sparing mastectomy, which psychologically, almost feels like not having a mastectomy. 3) Many women choose bilateral mastectomies, because the symmetry is better, and because you never have to worry about breast cancer again. 4) ... more

Dcis, implants, diep flap

DCIS can be multifocal, as it is the the ducts, and therefore it is not uncommon to convert to a mastectomy after a lumpectomy with positive or close margins. The good news is that you are candidate for several reconstructive options, using your own tissue, implant, or combination.

Mastectomy with sparing of skin and immediate reconstruction

Mastectomy with sparing of skin and immediate reconstruction is a good option as it avoids radiation and recurrance. Whether to spare the nipple, use your own tissue, or implant has much to do with your body habitus and aesthetic desires. DD sized breasts rarely have the nipple in a normal position and likely will require reduction in your breast skin envelope to yield an aesthetic breast reconstruction. It would be best to meet with an experience breast plastic... more

Breast Reconstruction Options

I am sorry that you will require an additional surgery to remove the DCIS. With DD breasts, it may be very feasible to preserve your natural breast shape, size, and contour with a lumpectomy re-excision and radiation. However, If you are committed to a mastectomy, then I would recommend immediate reconstruction. This is where tissue or an implant isplaced during the mastectomy, such that you recover from surgery with a breast mound. This... more

Options for Breast Restoration

With positive margins from your lumpectomy, it sounds like you've decided on a mastectomy. It is likely that you will not require any radiation treatment after your completion mastectomy. The good news is that you have many options to restore yourself after mastectomy especially with the elimination of any radiation therapy.. Furthermore,all aspects of your reconstruction will be covered by your insurance. The two major categories for breast reconstruction are... more

Breast reconstruction options

A DD breast is very large and depending upon yoru body habitus will determine surgical options for reconstruction. Being that you are getting radiation,. some surgeons would opt to delay your reconstruction especially if tissue expanders and implants are being used.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Skin-sparing mastectomy and immediate reconstruction for DCIS breast cancer

The good news is that you do have options. Radiation is not always the best alternative even though it is typically offerred as "breast-conserving" treatment. Further, if you have to be placed on estrogen blocking medication such as tamoxifen (for ER-positive tumor types) these can have significant side-effects. There is a trend to what is called a skin-sparing mastectomy, and with DCIS sometimes a nipple-sparing technique that preserves all of the breast skin so a... more

Breast Reconstruction Options?

Sorry to hear of your predicament. If there was ONE "best" solution in your situation, we would all be doing. Obviously, there are multiple solutions which are dependent on how the local general surgeons and Plastic surgeons work together. Most Plastic surgeons would prefer to do an IMMEDIATE reconstruction at the time of the mastectomy. The TYPE of reconstruction would be - using the Tummy tissue as a pedicle (TRAM flap) - with or without additional hook-up to vessels... more