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Ask the Doctor: Q&A

March 11, 2019 by

Q: I had a lumpectomy and radiation for breast cancer. I would like to know if I can get reconstruction surgery.

Sincerely,

Ms. Jones

A: Ms. Jones,
Thank you for your question. You can absolutely get reconstruction after lumpectomy and radiation. Some of your options depend on the extent of deformity/radiation damage and asymmetry between breasts, and whether you want to proceed with a complete mastectomy.
If you are looking to just improve the appearance of your radiated breast, different things that can be done to adjust that breast to achieve a better cosmetic result and symmetry. Often modifying the non-cancer breast with a reduction and/or lift can create better symmetry.

With true breast reconstruction, you need a complete mastectomy for an implant or your own tissue to replace the breast mound. Implants are often not recommended for and do not work the best in a radiated breast, but it is not impossible. Having had a lumpectomy with radiation has no effect on your ability to have the breast reconstructed with your own tissue by using your abdomen, buttocks or thighs as the most likely donor sites.

We work with multiple excellent breast surgeons in our area who could do the mastectomy immediately followed by reconstruction in the same surgery. Depending on your overall risk and preference, you could also have the non-cancer breast removed and reconstructed, but we leave that decision up to you and your oncology team.

Our reconstruction procedures are most commonly a staged process that involves at least two surgeries to achieve something close to a satisfying result. We would be happy to meet you in the office for a consult with one of our surgeons, Dr. James Craigie or Dr. Richard Kline, to discuss your best options and give you more information on the different procedures. If you live out of town, we can often offer a phone consult first to help you better understand the process before you make a long trip here. We also can set up a meeting for you with a local breast surgeon on the same day as your consult with us if you are interested. Please let us know how we can best help you, and we look forward to hearing from you.
Sincerely,

Audrey Rowen, PA-C

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After Radiation, Mastectomy and Reconstruction, I’m Having Extreme Back Pain…Solutions?

October 11, 2013 by

This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q:  About 6 years ago, I had a bilateral mastectomy with reconstruction. The plastic surgeon took one muscle from each side of my back to reconstruct each breast. Now I am experiencing extreme back pain on the right side. This is the side where the tumor was. This was a second occurrence.

In 1993, I had a lumpectomy with chemo and radiation to this right breast/side. The extreme pain feels like it is muscular in nature on the right side. Is this normal and something I just have to live with, or might there be some other treatment for muscle pain? Should I have it checked out for a possible disc problem causing the radiating pain in my back? Should I check out physical therapy or is it too late for this therapy? I am at a loss and hate enduring this constant pain.

A: Thank you for your question, I am sorry you are experiencing pain.

When the pain first developed and exactly where it is located could help determine what the cause is and how to treat it. If it is your back in the area where your back muscle was removed it could possibly be related to your spine discs or from your body compensating for not having the muscle. If you have an implant and the discomfort is in the breast area it is possible that scarring around the implant is the cause.  Most importantly you should let your plastic surgeon,  breast surgeon and oncologist know so they determine the cause and treatment.

Your oncologist should determine if you need any special scans or tests with regard to your breast cancer history and your plastic surgeon can determine if it has to do with the reconstruction and if there is a fix.

 

Q: I had nipple reconstruction a month ago. After a summer with not having to wear a bra, I’m now having remorse that I didn’t go for 3-D tattoos. Two questions:

Can one have the reconstructed nipples removed?

Is there a way to flatten the nipples over time?

I understand that some nipples flatten naturally but others don’t. I wish I had thought all this through the way I did for every other decision I made during the breast cancer journey. Is there any thing else you would suggest for someone with buyer’s remorse regarding nipple reconstruction? 

A: Thank you for your question.

I suggest you ask your surgeon as it may depend on how the reconstruction was done. Otherwise I would also expect over time the nipple will flatten. It takes about 9 months. It can always be made smaller easily in the office with only numbing medicine.

Dr. James Craigie

Center for Natural Breast Reconstruction

 

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

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