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Breast cancer and reconstruction

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#1 i-believe-in-miracles

Posted 24 December 2019 - 06:16 PM


I had a right breast mastectomy, including nipple, two weeks ago, after diagnosis of 2 x invasive tumours plus DCIS.  I had very little natural breast tissue (surgeon removed 240g which was all mine 🤪).  I had implants eight years ago - sub pectoral - so luckily surgeon was able to leave this in place. There is however a difference in size and shape compared to my left side, and of course a 10cm scar where my nipple should be. I am very thankful though that I have a good prognosis with only a need for Tamoxifen therapy for 5-10 years.

My question is, if I decide to have reconstruction down the track in order to regain breast symmetry, is this covered by Medicare/private health insurance? My previous augmentation was completely out of pocket as it was cosmetic, but I’m confused as to whether reconstruction after mastectomy falls under “medically indicated”.

Thanks for any advice.

#2 Mollyksy

Posted 24 December 2019 - 06:25 PM

It was for my mum but not the whole cost was covered as it was done privately. You'd need a surgeon to tell you for sure. Do you have private health? I imagine the public waiting list would be huge.

Some advice here: https://www.cancerco...ial-assistance/

Congrats on a successful surgery. I wish you all the best.

#3 i-believe-in-miracles

Posted 24 December 2019 - 06:57 PM

Thanks for your reply.

Yes, I have private health. My recent surgery was done privately but with no out of pocket costs (surgeon and anaesthetist do not charge extra with breast cancer diagnosis).  They are brilliant.

I don’t see surgeon for six months now, so can discuss it then, but I can’t really entertain the idea of reconstruction of it’s going to cost thousands.

#4 Mollyksy

Posted 24 December 2019 - 08:30 PM

That's lovely of your surgeon and anaesthetist. Wouldnt it be a reconstructive surgeon that would do it? More like the surgeon who did your original implants? Your recent surgeon may have a recommendation?

I remember mum saying something that although the surgery attracted a Medicare rebate the implant didnt? But the prices will range and you may even be able to use that anaesthetist again if they don't charge a gap.

Is your surgeon prescribing the tamoxifen or have you seen a medical oncologist?

My mum didnt at first see a medical oncologist and it retrospect I wish she did. For example, are you pre menopausal? Your tumour obviously is hormone receptive as you'll be taking tamoxifen but have you thought about a temporary or permanent cut off of hormones (assuming you are pre menopausal of course).

Sorry if it is something you, your surgeon and your GP are all over. I worked in the field and my mum had a number of breast cancer diagnoses before finally passing away a few years ago after having terminal cancer for around 11 years.

You were lucky to catch it quite early. Did you have lymph nodes tested at all? They say having implants can make it more difficult to diagnose breast cancer.

You have over 90% plus chance of now being cancer free for life which is pretty good odds.

I hope you are doing ok mentally. Sorry to ask a zillion questions. I hope you have a lovely Xmas.

#5 xxyzed

Posted 25 December 2019 - 01:19 AM

Reconstruction is available in the public system at no cost. As you no longer have active cancer you will be categorised lower down than someone who has chosen to reconstruct immediately at the same time as the surgery to remove cancer. How long the wait is depends on where in Australia you live and what reconstructive surgery you have.

In the private system there are considerable out of pockets expenses. The reconstruction surgery is normally done by a plastic surgeon who is different to the breast surgeon who removes the cancer. They will assess your situation and make recommendation on the reconstruction they recommend for you.

There are support groups to assist in the reconstruction process. Reclaim your curves is one group which I believe is Australia wide.

#6 i-believe-in-miracles

Posted 29 December 2019 - 11:12 PM

Thank you for your replies. From my understanding, my current surgeon can perform the reconstruction as he is an oncoplastic surgeon. As I am only 2 1/2 weeks post-op, I’m still undecided if I’ll bother, but I’ll see how I feel down the track.

Mollysky - yes both my tumours were ER positive which is why Tamoxifen will be prescribed. It will be prescribed and followed by a medical oncologist, whom I haven’t see yet due to Christmas holiday closures etc. So I look forward to discussing the therapy at that appointment.

I had the sentinel node tested at the time of mastectomy and it came back all clear, hence no chemo or radiotherapy needed.

Funnily enough,  I feel that my implants assisted in finding the lumps early. Mine are sub-pectoral so all my breast tissue is superficial. My lumps were very superficial also, and very obvious to feel, particularly the second quick growing one. Also having the implant helped compress the empty space for fluid to build up, so my drain was taken out the next day as I was hardly oozing anything.

I’m feeling pretty good, both physically and mentally. In five weeks I went from facing my own mortality, to be given the all clear after surgery. The worst part was the time between getting cancer positive biopsy results and getting results of CT scan and bone scan, as we had no idea if it had spread. Once I knew those scans were clear, I’ve felt ok about what’s ahead. It was all a whirlwind really.

Thanks again for your replies.

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