Reconstruction zone ahead

Feel it on the First! Early detection is key!

Despite going through surgery and treatments over the last 10 months, I have struggled with the uncertainty that I am “cancer free” moreso after the news from my oncologist in December. He had another pathologist look at my case and discovered there were a few microsatellites, or tumour cells, around the primary tumor removed 10 months ago. One of these cancerous cells had been cut in half during the surgery leaving the other half remaining in the breast. My oncologist assured me that the chemo and radiation should have destroyed them; however, he recommended a mastectomy to remove the entire breast tissue as a precautionary measure. I had already considered having a prophylactic (preventative) mastectomy but it now felt more real and also very unnerving that there were potentially cancerous cells still lingering in the shadows.

I followed up with my surgeon soon afterwards in the hopes of setting up a date to clear myself of any remaining cancer. Because I had just finished radiation, I was advised that my breast tissue wasn’t fully healed leaving me at higher risk of complications from surgery, including infection. The original lumpectomy site had taken almost 4 months to heal after becoming infected so that was the last thing we wanted to happen again. When he said he wanted to wait at least 6 months though, it made me panic at first. “How I can wait 6 months? What if something is growing inside me?!” He assured me that any residual cancer cells had been destroyed by the treatments and that the benefits of waiting greatly outweighed the risks. One of the benefits being that I would get immediate reconstruction done at the same time as the mastectomy.

Two weeks later, I sat down with the plastic surgeon who would be reconstructing my breasts to discuss my options. There are three options available here for breast reconstruction: implants, DIEP flap, and Latissimus Dorsi flap. I assumed I was getting implants since I thought it was the standard and hadn’t heard of the other 2 procedures. He told me however that there are too many risks and complications with using implants after radiation so that was quickly scratched off the list. We moved onto discussing the second option, DIEP flap, which involves removing the blood vessels as well as the skin and fat connected to them from the lower abdomen and transferring it to the chest to reconstruct a breast. The problem though was the lack of fat in my stomach area due to my petite size. Losing almost 15 pounds since going through treatment hadn’t helped either and I was just slowly gaining my weight back.

That left me with the last and only option, Latissimus Dorsi flap. This procedure involves making two horizontal incisions along either side of my back around the bra line and removing an oval flap of skin, fat, muscle, and blood vessels to reconstruct the breast. Expanders will then be placed in and pumped up with saline every 2 weeks to help stretch the skin until they reach a comfortable size. The surgery, scheduled for June 15, will take between 4 to 6 hours and I will be hospitalized for at least 3 days, with healing time taking anywhere between 8 to 12 weeks. I will have 4 incisions in total, 2 on my chest and 2 on my back, as well as drainage tubes to release any built-up fluids. In 6 months, the expanders will be replaced with a tear drop implant which will be a less invasive procedure with a shorter healing time.

Although I am excited to finally get this last part of my treatment done, I also wonder how I will fare through the process. I remember the day I took off my bandages from the lumpectomy and felt panicked thinking that I had lost half my boob. My breast was noticeably smaller, then swelled shortly after due to infection, then deflated from losing weight during chemo, and then began filling in slightly once I gained some of my weight back. I gradually learned to accept my body and began feeling more confident in myself than before. But as months went by and it healed from surgery and radiation, my breast was left full of thick hardened scar tissue making it difficult to sleep or put pressure on. Coupled with the lack of feeling and sensation, my breast has begun to feel alien to me, like it is no longer a part of my body anymore. I cringe when my doctors examine it and shy away when my husband goes to touch me. I can only imagine the grief and loss I will feel when I have both of my breasts removed and the time it will take to heal both on the inside and out. Physical scars may heal but it’s the emotional scars that can run deep and entangle us in a web of mental anguish and pain.

In the end, I must remind myself that the ultimate goal is to be healthy and to get rid of this stupid cancer once and for all. I am hopeful that the doctors won’t find any more cancerous cells or tumours in my breasts, and if they do, that they will remove it all successfully. But what I long for very much is that feeling of relief where I can finally say that I am cancer free. I want to wake up from surgery and say this is it. To feel that big weight lifted off my shoulders and to say I am finally done. This rollercoaster ride is far from over but I am determined to get through this next big hump, to move on with my life, and to start embracing my new normal.