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Mastectomy or Lumpectomy and Breast Implants for ADH?

asked 2 years ago by melindacheryl in Newport Beach
Latest answer by Adam D. Schaffner, MD
Question viewed 1,309 times
Tags: breasts, female

I have ADH and thinking of getting a Nipple Sparing Mastectomy (NSM), but my doctor wants to do a Lattisimus Dorsi Flap (LDF) with tissue expanders and then have a second surgery for silicone breast implants. I have breast implants that are over the muscle right now and my lesion is right against my chest wall. I don't know if I should do a lumpectomy and new breast implants, or NSM with Alloderm instead of the LDF because I really don't want my back muscle removed. Any suggestions would be greatly appreciated.

7 answers to Mastectomy or Lumpectomy and Breast Implants for ADH?

+2

Best Options for Breast Reconstruction

The decision of what type of surgery to perform to remove the breast cancer is best answered by a surgeon who specializes in removing breast cancer and has examined your breast, imaging studies, and pathology results.  Sometimes, internal rearrangement of breast tissue (oncoplastic surgery) can be performed following a lumpectomy.  If you undergo a mastectomy, then the plastic surgeon will reconstruct the breast.  Most of the time, this is done immediately following the... more
Adam D. Schaffner, MD

New York Facial Plastic Surgeon
+1

Alloderm a better option than muscle flap for breast reconstruction

In my view, the Alloderm option is preferable for circumstances like yours, as it can give good long term results without the major recovery involved with the latissimus flap. Lumpectomy can leave a deformity so that has issues as well. Your own surgical team is in the best position to advise however.
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Breast reconstruction

You should express your concerns with your physician. If you indeed have ADH and not a carcinoma you should discuss the options of lumpectomy with a surgical oncologist.  I have found that often the cosmetic result of lumpectomy is often very good.  Should you require radiation therapy then you should consider removing the implants and having Fat Grafting.
Delio Ortegon, MD

San Antonio Plastic Surgeon
+1

Hard decision

Hello Melinda, You present a difficult question for anyone even a surgeon who can examine you. There are advantages to both your options here: Expander/Alloderm - This is lesser surgery and does not involve operating your back. Latissimus Dorsi Flap - This is more reliable and provides more tissue for reconstruction. You could always opt for the lesser surgery and use the Lat flap to fix things if they did not work out properly. I hope you do well with your surgery.
John P. Di Saia, MD

Orange Plastic Surgeon
+1

Breast reconstruction

Although your treatment options for the ADH is predominantly determined by your oncological surgeon and oncologist, the final decision should be predominantly determined by what you desire your endpoint to be. That is where your reconstructive surgeon is the key. If the mastectomy with nipple sparing is equivalent to a lumpectomy in terms of cure rate for your risk category and you need rediiation with the lumpectomy, you should look a year down the road as to what you want to look like and... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

Lumpectomy and new implants vs nipple sparing mastectomy with Alloderm

Dear Melinda, I agree with Dr. Pfeifer's post and would like to elaborate. As our dealings with breast cancer have changed over the years - so have our breast reconstruction. Fortunately and unfortunately, depending on your philosophy, this remains a complex topic where no one solution is always applicable to everyone. In the "old"days, a properly done "breast cancer operation" meant removing the entire breast, its skin, its axillary tail and all the lymph nodes in the... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Lumpetomy or mastectomy for atypical ductal hyperplasia

Hi Melinda Cheryl. The decision about how to treat atypical ductal hyperplasia must be undertaken with your breast oncologic surgeon. You could manage it either way, lumpectomy or mastectomy, and the decision is usually driven by your other risk factors for the development of breast cancer in the future. For example, you have a greater chance of developing breast cancer if you have a strong family history or are BRCA gene postive. It is good that you are considering your reconstruction... more
Tracy Pfeifer, MD

Manhattan Plastic Surgeon

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