Can DIEP flap breast reconstruction prevent the detection of breast cancer recurrence?
This is a very important issue that is often not discussed.
A handful of studies have shown that breast reconstruction (with any reconstructive technique) does not impact local recurrence or long term survival in patients with early breast cancer (stage I and II). The rate of local recurrence and length of survival is the same in patients with stage I and II disease whether they undergo immediate breast reconstruction (ie reconstruction at the same time as mastectomy) or not. For this reason, most institutions (including ours) will offer breast cancer patients with early disease immediate breast reconstruction whenever possible.
Patients diagnosed with advanced disease are more likely to be candidates for delayed breast reconstruction, once they have completed all their cancer treatment and have received clearance from their medical oncologist to undergo reconstruction.
Breast reconstruction (with a DIEP flap or any other method) does not increase the risk of breast cancer recurrence or decrease survival in any way.
Women with breast cancer faced with treatment decisions are often not told by their surgeons about the possibility of breast reconstruction after a mastectomy, a study confirms. When these conversations do occur, many more women choose mastectomy, researchers found.
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Nan
Yet, as a stage III PT, the question still remains how ‘best’ to monitor recurrence after Diep recon at chest wall? Or is this concern not necessary?
PRMA Plastic Surgery
Hello Nan. No real consensus I’m afraid. Here’s another blogpost I wrote on monitoring after mastectomy and reconstruction: https://breast-cancer-reconstruction.blogspot.com/2009/06/mammograms-afte… Hope this helps. Dr C
Holly
I had the deip flap procedure done 16 months ago. Lately the left breast, the one where the tumor was, has been tender, almost like when I had my period. Can the be cancer reoccurring?
PRMA Plastic Surgery
Hello Holly! We will always recommend that you contact your physician as soon as possible if you have concerns. Although it is probably nothing, it is better to let your doctor know so he/she can review your symptoms and provide you with their recommendations.
Hui
HI Dr. C, I had DIEP Flap reconstruction with you 7 years ago for DCIS. It has been great till one week ago, when the recurrence was diagnosed and this time it is invasive and involved some dermal soft tissue. I plan to do mastectomy this time without any reconstruction (because of the recurrence and skin involve). I know there are not a lot a patients with DIEP flap reconstruction, so might be a very small number of patient with this type of reconstruction who needs 2nd mastectomy! The breast surgeon I saw said my case would be a bit complicated due to the reconstruction and skin involvement. So I am wondering if there are any advice from you who performed the reconstruction to me and to my breast surgeon? Look forward to hearing from you!
PRMA Plastic Surgery
So sorry to hear about your recurrence Hui! Sadly, even with after mastectomy there is still a chance (even though minimal) of a breast cancer recurrence. We would be more than happy to discuss any upcoming surgery with your breast surgeon any time! We are thinking of you and wish you all the best!
Angel
Hi Dr. C. I was 2 1/2 yrs cancer free until Oct 1st. I had zero lymph node involvement, clean margins. I had BMX w/immediate Diep Flap, then implants for volume. My PS here in Dallas did a fantastic job. The very day I found out I was going to schedule my 3D nip tats. I did not do chemo or radiation. Less than 1% chance this could happen I was told. I feel like women should get mammos after diep. This would have been caught sooner. I will find out early next week the results of MRI, CT, & bone scan. I’m a friend of Terri’s btw!! I may contact you for any reconstruction as I already know I need another mastectomy. Cancer sucks! Any feedback would be great! I dont think doctors should tell you they cured you because it’s a lie!
Thanks Doc C!
PRMA Plastic Surgery
Any time you are concerned about a possible recurrence, we highly recommend you follow up with your oncologist or breast surgeon for proper screening.
Jennings
Can cancer recur within the flap itself or just around the periphary – skin and axilla? I originally thought that the flap tissue wouldn’t support breast cancer spread.
PRMA Plastic Surgery
The recurrence would only occur in the surrounding skin and residual breast tissue, not in the flap itself.