'I had a tissue expansion breast reconstruction'

Marie Salter, 61, had a breast reconstruction after mastectomy for breast cancer in 2005. Here she talks about her experience and making the decision to have a reconstruction.

"I had a reconstruction on my right breast in 2005, and I don't regret it one bit. I didn't have it at the same time as my mastectomy – at that point, I just wanted to deal with the cancer and move on. But a year later I felt ready to have a reconstruction," says Marie.

Noticing a lump 

"Before my diagnosis, the first sign that something was wrong was when I was in the shower and felt something strange in my right breast. It wasn't a lump exactly, but long and fibrous. A week later I leant over the sink to brush my teeth and noticed a little dip in the skin, about an inch and a half long.

"I saw my GP, who referred me to the consultant, whom I saw two weeks later. Within a few days of that, after a needle test, mammogram, ultrasound and core test, I was told I had breast cancer. I have two grown-up sons, and my first thought was, 'how am I going to tell my boys?'."

Marie was prescribed tamoxifen (hormone treatment) that day and was booked in for a lumpectomy (removal of the lump) 10 days later. Her friend Nickie was with her at the initial consultation. "I'm glad she was there, because when you're told you have cancer you're in shock and you can't take it all on board. Those 10 days until the lumpectomy were an emotional roller coaster.

"I felt I had an alien in my body and I just wanted it out as quickly as possible. At the same time, I was trying to be positive. I was very determined to get on with it and do what I had to do," says Marie.

The lumpectomy showed that the cancer hadn't spread, but there was bad news – the lump contained lobular cancer cells. Lobular cells tend to "pepper", or sprinkle over a wide area. The consultant couldn't be sure they had removed all the cancer, and suggested removing the entire breast (mastectomy).

The shock of mastectomy

"That was another shocking 'wham!' moment for me," says Marie. "The cancer hadn't spread, but I needed more surgery, and it was radical – a mastectomy. I went to see an oncologist [cancer specialist], who advised the same thing. Radiotherapy wasn't an option, as the cells were probably spread too widely.

"They didn't want me to have more surgery for six weeks, so I had some time to think. I didn't know if I could face having a reconstruction at the same time as the removal of my breast, so I decided against it. I thought, 'I just need to do this one step at a time'.

"I had the mastectomy in May 2004, and no chemotherapy or radiotherapy. The only thing I couldn't really do after the surgery was heavy housework, and my friends would come to do the ironing and vacuuming. Four months after the surgery, I went back to my job at a Tourist Information Centre.

"I'd tried to go back a month earlier, but hadn't felt up to it – every so often I was just overcome with emotion. I went to see the GP and she told me to be kinder to myself and not to rush it. So I waited another four weeks and after that I felt much better physically and mentally."

Thinking about a reconstruction

At first, after the surgery Marie used a prosthetic (false) breast that slipped into her bra, but eight months later she went to the hospital breast clinic to ask for a contact prosthesis – a false breast that sticks to the chest.

"You can't use a contact prosthesis until at least six months after your surgery, so that your scar has time to heal. When I went to the breast clinic to ask about it, the woman there suggested I could be a candidate for tissue expansion reconstruction. I'd never heard of it, and she explained that they gradually stretch the skin of your chest and then put in a silicone implant to make a new breast.

"I'd always thought that a breast reconstruction would be very invasive, but this didn't sound too bad to me. I had an appointment with the consultant six months later, in June 2005, and by that time I was keen on a reconstruction.

"I was having hot flushes, either because of the tamoxifen or the menopause, and the sweat was making my prosthesis slip all over the place! I asked to be referred to a plastic surgeon to discuss my options, and the plastic surgeon said that tissue expansion was the best choice for me.

"Some types of reconstruction use skin from your back or your stomach, but he said I didn't have enough skin on my back and the skin on my stomach wasn't suitable – I've got a number of stretch marks."

Tissue expansion breast reconstruction involves making an incision in the mastectomy scar and inserting a small bag under the muscle on the chest.

The bag has a plastic valve just under the skin under your arm, and over several weeks the bag is gradually filled with more and more saline.

Once the skin is stretched, they can put in a silicone implant to match your remaining breast – in Marie's case, an A cup.

Tissue expansion surgery

"I decided to have a reconstruction done, but then I had a massive doubt. I worried I was being vain and that it was not for my health. I went to the breast care clinic and one of the helpers there reassured me that this was all part of my recovery, and that it was about making my body right for me. A month later I had the bag put in.

"Over the next three months I went back for monthly visits to have the saline topped up. It was painful for the 10 or 15 minutes when they were putting the saline in, but there was no ongoing pain. The stretching of the muscle and the skin felt as though something was growing in your skin, but wasn't painful.

"Twelve weeks after having the bag inserted, I had an operation to put the silicone breast implant in. My first thought on seeing my new breast was, 'wow!' It looked good. I can wear what I want now, and when I've got a bra on no one would know which is the real breast. I haven't got a nipple because that would involve minor surgery, and as I scar quite badly I decided against it. I feel happy with how I am – a nipple wouldn't make any difference.

"I did have a little panic about PIP silicone implants [French-made PIP implants were found to contain industrial silicone rather than medical-grade silicone] but I phoned my surgeon's secretary and she said they only use British implants and mine was safe. That was a relief.

"Having breast cancer made me realise that life is very special, and it gave me a new lease of life. I was going through a divorce when I was diagnosed, and as soon as my treatment was over I just wanted to move on.

"For the last year I've been working on the reception in the local secondary school, and I love it. I like the focus of work. The support of my sons has been wonderful, and I've got really good friends who were there for me."

Take the time you need

"I'd advise any woman considering a reconstruction to find out as much as she can. I discovered Breast Cancer Care after my treatment, and I think they're an amazing organisation to support people the way they do. The breast clinic at the hospital was very supportive too.

"It's every woman's decision what she wants to do. For me, it was a gradual realisation that a reconstruction was something I wanted, and the breast clinic and my doctors supported me on my own timescale."

Marie had her breast reconstruction in 2005. Treatments offered today might not be exactly the same. Find out more about breast cancer treatment.

Page last reviewed: 04/11/2014

Next review due: 04/11/2016


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