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Patient Story: Diep Surgery

April 6, 2011

 

Personal description:

 

I am 33 years old and the mother of two children aged 2 and 4 years.  I was 32 years old when I was diagnosed with breast cancer in March 2010.  With ultrasounds, I had been tracking a few lumps in my left breast for a full year before I was finally diagnosed.  When they did the biopsy in March, I had 8 lesions and 3 nodes involved.  I immediately met with my oncologist and surgeon and they recommended starting with chemotherapy to shrink the tumors.  The cancer I had was Estrogen and Progesterone receptor negative and Her2 positive.  I also did genetic testing and my results were negative for both BRCA 1 and BRCA 2.  My surgeon recommended a unilateral mastectomy with reconstruction with the chance to remove my right breast if I wanted later on.  She also suggested getting an implant so that my recovery time would be shorter and I could get back to being active with my kids.  I met with Dr. Macadam right after my first chemo treatment and she told me I was a candidate for either implants or tissue reconstruction.  Depending on which one I chose, it would affect the timing of my radiation: With implants I would have radiation after surgery, with tissue reconstruction I would have radiation before surgery.

 

Why did I choose DIEP reconstruction?

 

At first I wanted to get back to my daily routine with my kids as soon after my surgery as possible.  I had decided on only doing a unilateral mastectomy with an implant for the shortest amount of recovery time.  The main issue I had with a double-mastectomy was that I still want to have kids and wanted to breastfeed.  After a lot of discussion with other women who have been through the surgery, I decided that because I did not know the cause of my cancer that I would be safer to have a double-mastectomy and that this would allow me more peace of mind than a unilateral mastectomy.  I then had to decide about the reconstruction.  My husband asked me, “If the recovery time was the exact same for both procedures (implants or DIEP) which would I choose?” This was easy: DIEP.  I would use my own tissue, not have to be replaced ever, would grow and shrink with my body size, DIEP breasts were natural looking, I would get a tummy-tuck at the same time, I get to keep my tummy muscles, and it was a one-time only procedure (no pumping or expanders).  My husband pointed out that really, in the long run (the rest of my life), a month and half of recovery was not a lot. 

 

I totally understand that the experience is different for every woman, and that not everyone can do the DIEP reconstruction, but for me it was the right choice. 

 

Prior to the surgery:

 

I only had two meetings with Dr. Macadam prior to surgery.  The first meeting she showed me photos of the procedures and talked about the pros and possible cons of each of the procedures.  She also did some measurements and gave me some handouts.  I was totally overwhelmed.  By the second meeting I had a lot of questions for Dr. Macadam and she spent a lot of time with me addressing my concerns and answering all of my questions.  Andrea gave me a form for a blood test and told me that she would contact me to get a CT scan on my abdomen.  I completed chemotherapy and radiation and continued Herceptin treatments before surgery. 

I got my CT scan the week before the surgery.  Two days before the surgery I went in to VGH for a pre-admission clinic.  I was able to talk to a nurse and an anestesioligist. 

 

Day of surgery:

 

I checked in and was taken to the admission room.  My husband came with me.  The nurse came and took all my information and then Dr. Macadam came into the cubicle.  She asked how I was doing and then took a Bic marker to my breasts and tummy to mark all the incision areas and where my veins were on my CT scan.  Then my