The following appeared in Women's Health Magazine
Reconstructing Hope – Breast cancer survivors share their reconstruction stories.
Locust Valley, New York
Founder, No Surrender Breast Cancer Foundation
Author, Intimacy after Breast Cancer: Dealing With Your Body, Your Relationships and Sex (Square One, 2010; $16.95)
When Gina Maisano was diagnosed with triple-negative breast cancer in 2001, she underwent a lumpectomy followed by chemotherapy and radiation. But when she received a second diagnosis—this time of estrogen receptor–positive breast cancer in her other breast—another lumpectomy was not an option due to the size and the scope of the tumors, so she underwent a bilateral mastectomy.
Gina knew she wanted to include reconstruction in her plan, and she investigated various types of reconstructive surgery to find the model that would suit her unique history and personal expectations. The reconstruction began with the placement of tissue expanders, which were later exchanged for silicone implants. “My previous radiation posed a bit of a challenge,” she says, “but my reconstructive surgeon reassured me that he could overcome any of the radiation damage and provide me with a beautiful outcome.”
During her initial surgery, Gina says, “the breast surgeons removed as much breast tissue as possible and tested my lymph nodes to search for any cancer cells that may have spread there.” They found cancerous cells, necessitating the removal of the entire axillary lymph node sac. “The skin over the breast tissue was spared,” she says, “and the tissue expanders were placed under the pectoral muscle to stretch that space for the future implants.”
Though this procedure did provide a good result initially, Gina ultimately underwent a latissimus dorsi (LD) flap reconstruction procedure two years later because her skin was very thin and she and her medical team decided she would be better served in the long term with the LD flap approach. During the LD flap surgery, Gina says, “the latissimus dorsi muscle was removed from my back and placed on top of the implants, creating a softer look using my own tissue.”
This second reconstruction effort, while producing a great result, was a more extensive procedure and entailed a longer recovery. “When I had the latissimus dorsi reconstruction, it was more involved because I had to deal with the removal of a large back muscle and I had incision sites on my back as well as my chest. Recovery was longer, but once I passed the three-week mark, I felt immensely stronger and on my way to recovery.”
Having been through the recovery from extensive surgery, Gina advises other patients to do a few things to prepare: “If you live alone, make sure that things on high shelves, such as coffee mugs or cereal boxes, are brought down to the counter because you will have trouble raising your arms to reach for them.” And she encourages wearing slip-on shoes, comfortable pull-on pants, and a button-down shirt to the hospital to make it easier to dress when it comes time to go home.
In addition, Gina recommends the following insider tips for managing recovery.
“You will have surgical drains, and the doctors will attach them with safety pins to your post-surgery bra or dressing, or they may even attach them to a bit of gauze made into a necklace around your neck. If you want real comfort, go to a home improvement store and buy a cloth nail/tool belt, tie it around your waist, and slip your drains into that. You can sew some pretty fabric onto it if you are so inclined, but it really is much easier to wear your drains in a belt than have them pinned to anything.
“Once you are home, get up and move as much as you can. Walk, move your arms as much as your doctor permits, and eat a well-balanced diet. You will find you will recover ever so much faster if you do.
“Go the distance: get the final touches of reconstructed areola and nipples. They are the icing on the cake and make you feel like you again.”
It’s clear that Gina can speak to the challenges of recovery, but she also has an important, positive message about the emotional impact of undergoing reconstruction. “When I woke up from surgery and was able to get up from bed, I walked to the bathroom to look at myself. I looked down and saw a cleavage, my own skin, and new breasts. I felt a sense of relief, of being clean and free of the cancer-harboring old breasts. It was a liberating feeling and I was grateful I could have such a positive, uplifting feeling after such a stressful ordeal of being diagnosed with breast cancer for a second time.
Ultimately, she says, every woman must make a personal decision about if and when reconstruction is the right choice. “Do whatever you feel is right for you. If you are not certain, do not fret. You can always get reconstruction at a later date.”
For those ready to undergo reconstruction, Gina offers the following advice: “Choose your doctor carefully. Get a few opinions and ask to meet some patients. Once you see another patient who has been through it, your mind will be at ease and you will be excited to get started on your journey because once all the surgeries are behind you, you are left with a lovely new you.”