11. Post DIEP Flap Reconstruction / Nipple Reconstruction / Genetics

As I get ready to head back to the hospital on the one year anniversary of my mastectomy for some revisions and nipple reconstruction, I realized that  I have neglected my blog for nearly a year. First think I need to do is take a moment to thank some people, namely my mom Jane and my boyfriend Kevin. Then I will update you on the DIEP Flap procedure and nipple reconstruction and effort to find a genetic link to breast cancer.  

My mom Jane was there for me every step of the way to offer support and knowledge. Having gone through breast cancer herself, she was a great resource for information and for helping know what to expect. She drove me to my appointments and listened to the doctor explain my options and was a great sounding board for how to get through this. Thank you mom, I love you and appreciate you so much!

My boyfriend, Kevin, is AMAZING! It was only about four months after we me that I was diagnosed with this invasive ductal carcinoma. Rather than turn tail and run as fast as he could, he decided to stand by me and help me through this. From diagnosis, to treatment and through recovery, he has been here for me every step of the way. He is cooking great food and I am not eating out all of the time. He is a truly wonderful addition to my life! Thank you honey, I love you!!

In January 2012, I went in for my first post-surgery mammogram and all was clear! Will continue to have them annually for a few years. Also have to have a breast MRI in July and will continue that annually for a few years as well. 

Time for the post-op update from my DIEP Flap Reconstruction on May 20, 2011. The surgery was done at UC Davis and was very long. About 6 hours I believe. They took a large portion of my stomach skin and fat by cutting me from hip to hip. They took several inches of tissue from my just above my belly button to my pubic hair line.and used that tissue to make my new breast. The new breast has the stretch marks from my old belly which is kinda weird, but its all me and not an implant so I am definitely happy with the results. The doctor had to make me a new belly button since they removed the old one. CRAZY HUH!?! It is healing nicely, but I don't thing I will be wearing a bikini anytime soon. 

When they stitched up my tummy and breast, they used a glue so there really weren't many stitches. The stitches I did have dissolved. The breast had a little bit of trouble healing in one spot so I had to use neosporin regularly for a month or so. There is extra skin on my hips because when you lay on the operating table, they can only cut so far. I have what the Doctor Sahar calls dog-ears. They are going to be removed today as part of the "revisions".

When they took out all of the stomach skin and fat and then stitched/glued it back together, it made my stomach skin very tight. I was hunched over for a little while as the skin stretched out so I could eventually stand up straight. Nice little tummy tuck in the process :)

Luckily, I have not had to go on any medications, at least not yet. Met with my oncologist to discuss my options. Since my cancer is estrogen receptor positive, it feeds/grows on estrogen. The theory is that if you block estrogen production, you reduce the risk of recurrence. Not sure to what extent this prevents a new tumor from forming in the other breast. I am too young for menopause so I don't want to block estrogen production unnecessarily. The risk of going on Tamoxifen include increase risk of uterine cancer. My goal is to determine my genetic predisposition to breast cancer to help me decide whether or not to go on Tamoxifen. 


I find it interesting that the mother who raised me got breast cancer but the mother who gave birth to me didn't get it, but her sister did. I have an older sister on my dad's side that recently was diagnosed in her 40's. Very curious to know whether the cancer was nature or nurture. I discussed this with my oncologist who referred me to the geneticists at UCD. They decided it was worth looking into so I had some bloodwork done to determine if I am a carrier of the breast cancer gene. Still awaiting the results. 

Here is a link to cancer.org article about genetics and breast cancer 
http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA


Today I am heading back to UC Davis for nipple reconstruction and "revisions" to my hips and stomach. Doctor Sahar was originally going to use my dog ear skin to make the new nipple, but he decided for whatever reason that the best chance of the nipple reconstruction taking is to use a flap of skin from the existing new breast tissue. I trust his judgement. Because of the stretch marks, it may cause issues with the flap healing, but I am hopeful that it will all work out just fine.