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Medical Forum / Diseases and Disorders / Breast Cancer / September 2006Breast Implants
I have had grade 2 bilateral bc, negative lymph node involvement, chemo which consisted of FEC x 3 and Taxotere x 3. Have just finished treatment and would like advice or help regarding breast implants and surgery. I didn't have radiation and considered this to be the best option for me as I am quite lean and implants seem to be the best alternative. I would like to hear from anyone who has had the procedure and would like feedback on this. I went for my 6 month check up last Thursday and the Registrar mentioned that I should wait 2 years, also implants rupturing, and cancers recurring whereby implants then had to be removed. I feel a little lost on the whole idea. > Have just finished treatment and would like advice or help regarding > breast implants and surgery. I didn't have radiation and considered this [quoted text clipped - 4 lines] > implants rupturing, and cancers recurring whereby implants then had to be > removed. I feel a little lost on the whole idea. It sounds like you may've already decided that you do want some type of reconstruction, and if so I wish you well in sorting through the decisions about what route to go. If, on the other hand, you haven't totally made up your mind to do reconstruction, I did want to say that I've found skipping it to be a viable, even happy, decision for me. (I, too, had bilateral mastectomies.) Skipping reconstruction has obvious cosmetic disadvantages, and for some that may have a major effect on self-image. On the other hand, for those who -- like me -- don't have that reaction to the appearance issue, the pluses of skipping reconstruction are easier/sooner detection of any local recurrences and avoidance of additional surgery (some forms of which can have both short and long term effects on physical (athletic) abilities,which *does* matter to me) . While I use prostheses for dress-up occasions (women's clothes fit better!), I go without most of the time, and find that -- surprisingly -- most people don't even seem to notice. Having had the bilateral makes it easier to go without prostheses -- no risk of weight imbalances that can cause back problems, for example. It seems to me that sometimes doctors assume that women "must" have reconstruction after mastectomy, and I don't think that's necessarily true. I don't want to pressure you in the "skip reconstruction" direction -- that would be equally inappropriate -- but do want to give you feedback from the perspective of someone who's gone that route & found it a positive decision. I'm 6 years post-surgery in October, 50 years old now, and single (widow), if that matters. Good luck to you in sorting out what you want to do! Ann T. Remove 'dontsendspam' from address to reply by email >> Have just finished treatment and would like advice or help regarding >> breast implants and surgery. I didn't have radiation and considered this [quoted text clipped - 39 lines] > > Ann T. I agree with everything Ann says, as I usually do. Have a look at women's chests, there's such a variety of shapes that being flat chested really isn't noticeable. Think about it very carefully before you make any decision. Mary >I agree with everything Ann says, as I usually do. Have a look at women's >chests, When I do this I usually get hit - either by Deborah or by the recipient of the increased attention. ;-)  Signatureallan we don't see things as they are, we see them as we are. -- Anais Nin >>I agree with everything Ann says, as I usually do. Have a look at women's >>chests, [quoted text clipped - 3 lines] > > ;-) Nothing to see *here* -- move along, move along . . . . P.S. Re-read your .sig in context of this thread, Allan. Hmmmm . . . . Ann T. Remove 'dontsendspam' from address to reply by email > we don't see things as they are, we see them as we are. > -- Anais Nin >P.S. Re-read your .sig in context of this thread, Allan. Hmmmm . . . . ;-) Signatureallan we don't see things as they are, we see them as we are. -- Anais Nin Btw curly is my husband's name. My name is Mary E. Thanks for your comments and thank you also to everyone who wrote to me. There are advantages and disadvantages in going ahead. I will probably have to do more research and talk to other women who have had the silicone implants. I've got time to think about it as I am on the public hospital waiting list. I haven't had feedback from anyone who has actually had the silicone implants done. Mary E. >>> Have just finished treatment and would like advice or help regarding >>> breast implants and surgery. I didn't have radiation and considered [quoted text clipped - 47 lines] > > Mary > I've got time to think about it as I am on the public hospital waiting > list. I haven't had feedback from anyone who has actually had the silicone > implants done. I have a couple of friends who've had the saline - one is mid-way, has the expanders still in place & will get the implants over the winter (after rowing season <grin>), one had them a couple of years back. I'd be happy to relay questions to them if you have questions about the saline. The one who's mid-way is very happy with her decision, so far. I think I know one woman who's had silicone, but (a) she's moved several states away, and (b) she may not be the one to ask -- I understand (secondhand) that she's very upset right now because her implant has migrated, and maybe ruptured. Ann T. Remove 'dontsendspam' from address to reply by email > I haven't had feedback from anyone who has actually had the silicone > implants done. ---------------- I have a silicone implant, but I just got it on July 31. So far so good. In my case, the risk of the cancer coming back and killing me is much greater than the risk of being harmed by the implant. Eva > It sounds like you may've already decided that you do want some type of > reconstruction, and if so I wish you well in sorting through the decisions [quoted text clipped - 29 lines] > > Ann T. This is such sensible advice. I also found that doctors seemed to assume that all women wanted reconstruction. However, when I resisted one doctor explained that a woman's self image was a large part of the decision. Thus for some, it didn't matter and for others it was critical. For me, the extensive procedure just wasn't worth the result. MM > > It sounds like you may've already decided that you do want some type of > > reconstruction, and if so I wish you well in sorting through the decisions [quoted text clipped - 36 lines] > critical. For me, the extensive procedure just wasn't worth the > result. ---------------- It was for me. I actually gained range of motion after the reconstruction (latissimus flap) was done. I feel more comfortable, less tightness and soreness in my chest than after the mastectomy. It is as you say, though, an extensive procedure and should not be undertaken lightly. Eva > > This is such sensible advice. I also found that doctors seemed to > > assume that all women wanted reconstruction. However, when I resisted [quoted text clipped - 9 lines] > > Eva I'm glad to hear that your reconstruction had a corrective effect. I always thought it was only cosmetic. Actually I do have some stiffness in the area and I am always aware of it. I wonder if there is something short of reconstruction to address this - massage, some sort of excercise? MM >> > . . . reconstruction. . . . >> >For me, the extensive procedure just wasn't worth the [quoted text clipped - 3 lines] >> reconstruction >> (latissimus flap) was done. <snipage> > I'm glad to hear that your reconstruction had a corrective effect. I > always thought it was only cosmetic. Actually I do have some stiffness > in the area and I am always aware of it. I wonder if there is > something short of reconstruction to address this - massage, some sort > of excercise? Yes, in my experience. This has been important to me, given my late-blooming flights of athletic fancy. Four possible things to try, three of which I've tried, and the fourth of which has been praised highly by others I trust: 1. Stretching and/or yoga, focusing on things in the stiff/tight area. I have a couple of stretches I can describe, if you like. This needs to be done consistently (daily, or even twice a day) for a while, before you'll see results. You also should warm up the area (some motions to get the blood flowing) beforehand. Worked well for me. 2. Massage. A therapist trained in therapeutic massage can break up scar tissue via massage. Talk to your doctor (surgeon or radiation oncologist, by preference, if you had one), think about whether deep massage in the surgery area will be scary for you in terms of lymphedema risk, and expect it to be very "intense" (some would say "painful", but I won't go that far) when it's being done. I've done this, and it's also helped. (No lymphedema caused, despite 9 nodes removed, but others' mileage may vary.) Last visit to my radiation oncologist, they remarked about how soft the tissue in my surgical/radiation area was. (I had bilateral mastectomies *and* radiation because I did such a good job of getting breast cancer - locally advanced.) Bonus: The massage therapist taught me stretches to reinforce what she was doing via the massage. 3. Self-massage. Gentler, but still firm, self-massage of the area. Some cocoa butter or the like helps. Press firmly and just kind of press and knead the tissue with your fingers. My surgeon recommended this, but I didn't do it consistently enough to be of help. I think it *would* help, over time, done consistently. 4. Lebed method exercise. It was developed by a dancer & her two physician brothers to help their mother regain arm movement after mastectomy. This is the one I haven't tried myself, but there's a Lebed group locally for BC survivors, and I've heard raves about improvement in range of motion, including from some very level-headed women. One woman greatly improved her frozen shoulder - formerly couldn't lift her arm above her shoulder, and now has much of her range of motion back. There's a book, " Thriving After Breast Cancer: Essential Healing Exercises for Body and Mind" by Sherry Lebed Davis & Stephanie Gunning (ISBN 0767908465), and a DVD, " The Lebed Method, Focus on Healing Through Therapeutic Exercise and Movement". Amazon (U.S.) has both, if you want to check on descriptions. The friend cited above learned this method & got her results via the book -- then was instrumental in getting the local class started, since she'd found it so helpful. If you swim, some regular backstroke practice might help, too, if you have sufficient range of motion to do it without risking injury. Hope you find something that works! Ann T. Remove 'dontsendspam' from address to reply by email > > I'm glad to hear that your reconstruction had a corrective effect. I > > always thought it was only cosmetic. Actually I do have some stiffness [quoted text clipped - 53 lines] > > Ann T. Thanks for these comprehensive suggestions. I've just ordered the book and I'm going to try and consistently massage the area. I read somewhere that lavender oil is helpful for scars. Think I'll try that also. I would appreciate a description of the yoga stretches that you found useful, if it isn't too much trouble. So kind of you to take the time for this. MM ... So kind of you to take the > time for this. That's Ann. She is very thoughtful, as well as intelligent, pretty, witty and all the things I'd like to be :-) Mary > ... So kind of you to take the >> time for this. > > That's Ann. She is very thoughtful, as well as intelligent, pretty, witty > and all the things I'd like to be :-) <snort> I'd like to point out that Mary has never met me. I think doing so might shatter some of her preconceptions <G>. But thanks for the kind sentiments, anyway, Mary! Ann T. Remove 'dontsendspam' from address to reply by email > <snort> > > I'd like to point out that Mary has never met me. I think doing so might > shatter some of her preconceptions <G>. I *have* met Ann. IM frequently less than HO Mary's preconceptions are spot on. ;-) >> ... So kind of you to take the >>> time for this. [quoted text clipped - 6 lines] > I'd like to point out that Mary has never met me. I think doing so might > shatter some of her preconceptions <G>. I'm looking forward to it. > But thanks for the kind sentiments, anyway, Mary! I'm rarely kind - just brutally honest, as a Tyke I speak as I find :-) And I've seen your photograph! Mary >>> That's Ann. She is very thoughtful, as well as intelligent, pretty, >>> witty and all the things I'd like to be :-) [quoted text clipped - 11 lines] >> > And I've seen your photograph! Kind, and severely near-sighted, too -- like Allan, I guess <G>. Ann T. Remove 'dontsendspam' from address to reply by email >> I'm looking forward to it. >>> [quoted text clipped - 5 lines] > > Kind, and severely near-sighted, too -- like Allan, I guess <G>. Not at all. I don't know much about beauty but I know what I like :-) Mary > I would appreciate a description of the yoga stretches that you > found useful, if it isn't too much trouble. The stretches I've found helpful that I can easily describe are not from yoga, though I *have* found yoga useful. I'll suggest some free yoga references later in the message, though. Some specific stretches that helped me (I hope this is clear enough!): #1 Doorway stretch Stand in a doorway and hold onto the door frame with your fingers. Gently lean forward through the door opening, putting enough weight into it that you feel a comfortable stretch in your shoulder area. Keep your spine straight (do not let it bow). Hold the stretch for (say) 3-5 deep, slow breaths. Do multiple times, varying the arm height (in any increments from overhead to below the waist) to stretch different areas that are tight. #2 Arm circles Lie on the floor on your side, with your knees slightly bent. Bend the arm that's beneath you to a comfortable position, such as with your hand under your head. Extend the arm that's on top out from the shoulder so the hand is on the floor in front of you. With that extended hand, make a big circle rotating your arm from the shoulder, keeping your hand on or as close as you can to the floor, going over your head, behind your back, and all the way around to the starting position. As your arm is going behind you, try to be stretching mostly your shoulder & chest rather than twisting the whole torso to the back. Circle both clockwise & counterclockwise. Repeat 2-3 times on each side. #3 Chest stretch Stand in a doorway or near an "outie" wall corner so that you can put your hand on the wall at approximately shoulder height, with your arm extended horizontally from your shoulder. Turn your body further away from the arm (arm is then more behind than beside you), maintaining stretch in the shoulder for 3-5 slow, deep breaths. Do on both sides. #4 Shoulder stretch Raise your arm straight up from the shoulder (fingers toward ceiling), then bend your elbow so your hand is behind your shoulder (your elbow now points at the ceiling). (If you can't get your arm straight overhead, go as far as you can comfortable -- feeling a slight stretch -- and put the hand on your shoulder so the elbow is pointing upward in front of you at whatever angle you can achieve. Take the opposite hand, put it on your up-pointing elbow, and gently push the elbow just a little bit further in the overhead direction (or past overhead toward your back, if you started with your elbow all the way overhead). Hold for 3-5 slow, deep breaths. As with all of these, it's good to do both sides for balance, even if only one side is really tight. To get results, I've found it *really* important to do stretches daily and consistently. It only takes a few minutes, and feels good (as long as you don't over-stretch to the point where it hurts). It will take a period of time (maybe 2-4 weeks??) to see results, but you *will* see results. If you'd like some specifically yoga things to do, check out http://www.hathayogalesson.com/ . This site has really nice little line-drawing animations for each pose, and a clear description. Click on "yoga postures" (middle of the page), then explore the postures. "21 Side Bend Pose" is pretty good, for example. There's also a good site at http://www.yogajournal.com/poses/ . You can select "shoulders" under "anatomical focus". This has nice clear descriptions & photos, but not the handy animations. Personally, I've also found some weight training exercises good for my shoulder range of motion (say, dumbbell pullovers, even though that's a chest exercise), but that's getting into territory some consider risky from a lymphedema perspective. > So kind of you to take the > time for this. Gotta hang together, don't we? I'm more than happy to help, if I can. I hope you have some success restoring your range of motion -- let us know, OK? I'd be particularly interested in your review of the Lebed book, since I haven't done that myself. Ann T. Remove 'dontsendspam' from address to reply by email > > I would appreciate a description of the yoga stretches that you > > found useful, if it isn't too much trouble. [quoted text clipped - 89 lines] > > Ann T. Thank you so much. Actually the first excercise is one of my favorites that I had completely forgotten. It was great for stretching the back after sitting hunched over at a desk for a long period. When I tried it last night, it really helped in extending my reach further than I had been able to manage since the operation. It really is a great excercise. I will certainly report back on the book after I have read it. Again, many thanks and I think Mary has it just right! MM MM Hi Mary Sorry for the mix-up. Moz is a nickname so I thought the same for you! You asked what age I am, I'm 37. I can understand a bit about the chest wall, I'm always paranoid about there too but what the heck. There's as much chance of it coming back anywhere else. Size wise I'm a US/Canadian 8. I'm not sure how that translates into Aussie sizes. I'm going back to my original B's...no upgrades here! And I've been told to ease up on the exercise and not worry about food (yippee) until after the surgery. I'm doing a 1/2 marathon on Sunday so I'll back off on the exercise then. Tamara, I think you asked where I'm having it. I live in Toronto so I'm having it in St Michael's hospital up here. I feel lucky in that the plastic sugeon is fairly new to the hospital and I believe is one of only 2 surgeons who can perform this surgery in Toronto. I had my previous surgery and chemo there also so I'm comfortable there. I have all my pre-op stuff tomorrow and as I said I can't wait to do this :) Moz > Again, many thanks and I think Mary has it just right! My family knows that I'm always right. They daren't say anything else :-) Mary >I have had grade 2 bilateral bc, negative lymph node involvement, chemo > which consisted of FEC x 3 and Taxotere x 3. Have just finished treatment [quoted text clipped - 6 lines] > whereby implants then had to be removed. I feel a little lost on the whole > idea. I can't speak from personal experience (being a male), but my late wife had bilateral mastectomies followed by immediate reconstruction. I don't understand the suggestion that you wait two years. Also, I think the chance of cancer returning to the breast area is pretty slim for patients having had mastectomies. SignatureJohn Richards > > I went for my 6 month check up last Thursday and the Registrar mentioned > > that I should wait 2 years, also implants rupturing, and cancers recurring [quoted text clipped - 3 lines] > Also, I think the chance of cancer returning to the breast area is pretty > slim for patients having had mastectomies. ------------------ Perhaps they were referring to recurrences on the chest wall. I don't understand the need to wait 2 years either. I had to wait a year, but that was because I had had radiation. Eva > I have had grade 2 bilateral bc, negative lymph node involvement, chemo > which consisted of FEC x 3 and Taxotere x 3. Have just finished treatment [quoted text clipped - 6 lines] > whereby implants then had to be removed. I feel a little lost on the whole > idea. Hi Curly Your story sounds exactly like mine, I too had stage 2, N0. I also took FECX3 and TaxotereX3. I also had a bilateral mastectomy with no radiation and am in the process of sorting out my reconstruction. Unlike you though I wouldn't be described as lean...although I 'm not overweight either I have enough of a tummy to go for the free DIEP. My surgery is scheduled for Oct 13th and no I'm not superstitious! I can't wait to have this done. While I have managed with the prosthetics and when I exercise I go without and it's true generally people don't notice I'm still excited to get my body back. For me it's less about appearance as it's saying a big 'so there' to bc. And somehow a conclusion to this part of the story. Are you sure you can't do the trans? They can take fat from the tummy, back or bum. I had my mastectomy on Oct 3rd 2005 and will be having reconstruction on Oct 13th so there's no 2 year wait...which to be honest I don't understand either. Good luck with your decision Moz Hi Moz, You have to let us know how it goes! We will be 'rooting' for you. I too am stage 2, N0 and had a bilateral. I met with a plastics dr before surgery ( wanted to have immediate but wasn't in the cards as I had to have rads) but have been reading up on the free DIEP and am very excited but will have to wait at least 6 months. Can I ask where you will have your surgery? The breast center here does them but patients have a 1 week ICU stay. I was looking at a place in New Orleans called the Center for Microsurgical Breast Reconstruction and read info written by patients where they were discharged in 4 days! Big difference. Best of luck to you. Tamara >> I have had grade 2 bilateral bc, negative lymph node involvement, chemo >> which consisted of FEC x 3 and Taxotere x 3. Have just finished [quoted text clipped - 33 lines] > Good luck with your decision > Moz > Hi Moz, > > You have to let us know how it goes! We will be 'rooting' for you. I too > am stage 2, N0 and had a bilateral. ---------------- What does "N0" mean? Eva >>Hi Moz, >> [quoted text clipped - 5 lines] > > Eva N0 ( N-zero) means no lymph nodes involved. It is part of the commonly used TNM system of describing cancers, where the T number is the stage, and the M number indicates the presence of metastases, so in Tamara's case the designation would be T2 N0 M0. Tim Hi Moz Btw, Curly is my husbands name. My name is Mary E. Forgot to say that I am 51 years young and feel 21. The 2 year wait mentioned, (which a few people questioned), was the period that the Registrar told me that cancer could recur within that period if it was to return. The area he said, could be the chest wall! Other opinions as well mentioned, that the longer the wait, the less complications with silicone implants. As far as taking fat from the back or butt, same thing, not that much fat to take! sounds like I look anorexic, no I'm not, just a Size 10 (Australian size). How old are you? Good luck with the op. I hope all goes well for you. Mary E >> I have had grade 2 bilateral bc, negative lymph node involvement, chemo >> which consisted of FEC x 3 and Taxotere x 3. Have just finished [quoted text clipped - 33 lines] > Good luck with your decision > Moz >"Curly" wrote : >I have had grade 2 bilateral bc, negative lymph node involvement, chemo [quoted text clipped - 7 lines] >recurring whereby implants then had to be removed. I feel a little lost on >the whole idea. Curly, Regarding any concerns regarding saline implants. Saline implants are not without serious risks despite some plastic surgeons' insistence that it is a "safe alternative" to silicone gel implants. Keep in mind that while the filler is saline vs. silicone gel, the saline liquid is encased in a silicone case. Perhaps the cases are less rare than the number of cases with the silicone get implants. The point is, some patients are not told that they can have very serious side-effects therefore the patient makes an ill-informed decision. If you'd like to read about it further, try entering the following in a search engine: "saline breast implants" complications Mckenzie I include the name Mckenzie because she is the daughter of a work associate of mine who has struggled with the results of her silicone implants. Her site is www.poisonedbeauty.com. A local news article that is quite informative is at: memphisflyer.com/memphis/Content?oid=oid%3A5637 Again, I'm not trying to scare you off from any decision but I think you'd agree that you want to make your best informed decision. If anything, if I were shopping a plastic surgeon, I'd probably base my decision of the surgeon on whether or not he/she informed me of this risk. HTH, Marsha > >"Curly" wrote : >>I have had grade 2 bilateral bc, negative lymph node involvement, chemo [quoted text clipped - 38 lines] > HTH, > Marsha Hi Marsha Thanx for the info! It's made me think twice about implants - though I am very disappointed as I had my heart set on having silicone implants done. I've decided to see my GP and also another surgeon to see what they may comment on with reconstruction options. I was horrified to see photos of disfigured breasts due to implants and health problems presented down the track. Thanks again, Mary E. "Mizz Marcia Ryder" wrote : > >"Curly" wrote : <Snip> > I include the name Mckenzie because she is the daughter of a > work associate of mine who has struggled with the results of > her silicone implants. Her site is www.poisonedbeauty.com. er, that should read saline implants (i/o silicone implants). Sorry. Marsha |
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