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Against Breast Cancer

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Re: Post Mastectomy Pain

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Posted by Betsy Mullen on 3/5/2000 from 205.188.197.52:
In reply to: Re: Post Mastectomy Pain posted by Rose Berg on 3/4/2000 from 209.20.9.226:
Dear Rose:

Sending you feedback is our pleasure -- thank you for your kind words.

Regarding the surgeon's comment (and response to your original posted message) "Replace the scar with a flap", I will contact him for clarification. Here are my thoughts, and please keep in mind that I have not yet spoken to him regarding your new questions, nor am I an MD or RN.

I in no way think that the feedback "Replace the scar with a flap" in any way, shape or form, meant that you should reconsider your TRAM flap reconstruction. We were completely unaware that you were planning on any type of reconstruction based on your earlier messages. In addition, we do not have all of the facts of your case so we would not be in a position to comment on the efficacy of a TRAM flap reconstruction in your case.

Given that, and given your original message, our medical advisor was commenting on you post-mastectomy pain. What I think he meant in his comment regarding replacing the scar with a flap (and again, I have not updated him on your latest questions and I'm not a physician) was excising the mastectomy scar and any scar tissue associated with your original scar and incision at the site of your mastectomy. Once the scar, scar tissue and any other tissue and skin are removed during such a surgical procedure, I think that then, a flap/skin graft are required to replace the scar, skin and tissue that have been removed.

Just as an FYI, I have had a few scar revisions on the scar on my back from my lattisimus dorsi breast reconstruction, during which the skin removed was actually used to create the skin graft for my nipple reconstruction.

Nipple reconstruction cannot be performed at the same time as the initial breast reconstruction because of symetry issues.

Back to your case and to your questions:

I am sorry for any confusion or angst you have experienced in sorting through the information we previously sent. Please feel confident in your decsion for a TRAM flap reconstruction -- it is a great procedure that can produce incredible results! And I am sure that your plastic surgeon and the rest of your health care team have thoroughly reviewed your case and discussed any risks and benefits regarding your reconstruction with you so that, together, you were able to arrive at a well-informed treatment decision.

I wish that I could give your our surgical advisor's telephone number. Our medical advisors are all very generous with their time and expertise, but would be overwhelmed if we made their telephone numbers available to the public-at-large and would then not be able to help us answer anybody's questions.

I will, however run this message by him for further clarification, and will see if an exception can be made for you to speak directly with him. By the way, where do you live? I do not know, because of his patient load at present, if his practice is taking any new patients, but that might be an option.

Since we do not have all of the facts of your case and therefore do not have complete information on which to offer you feedback, it is very important that you feel fully empowered to dicuss all of your questions and concerns with your health care team. You are entitled to receive complete and understandable answers to your questions and concerns. In addition, we strongly advocate for second opinions.

Thank you for giving us the opportunity to provide you with clarification on this matter. We will get back to you as soon as possible.

Until then, be well and I hope that you have a renewed feeling of confidence in your decisions!