What would some of the drawbacks (or risks) of a DIEP be?

The DIEP flap is a significant surgery, in that it can be a lengthy procedure averaging 4-8 hours, depending on size of the breast, size of the patient, unilateral or bilateral reconstruction, and unforeseeable anatomical variations that can increase the technical difficulty of the surgery. The hospital stay is a minimum of 3 days and the recovery can be relatively difficult, taking 4-6 weeks to get back to normal. There is also a small but real chance that a blood transfusion will be necessary. Patients can donate their own blood in advance if time permits. There is also a sizable scar left on the abdomen, although similar to that left by a tummy tuck.

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Candidates of DIEP surgery

One out of nine women has the possibility to have breast cancer. Every year, tons of women suffer and undergo the same situation-- fighting the same disease. Consequently, women suffering from breast cancer can choose to have breast reconstruction at the time of mastectomy, otherwise they may opt to go through reconstructive surgery at a later date.

Practically, every woman can prefer for a DIEP flap procedure, with only one exception. Women lacking sufficient abdominal tissue to create or reconstruct a breast can’t undergo such operation. Younger women who are exceptionally muscular or into sports, may fall in this category, and may select substitute reconstructive solutions.

In addition, women who are medically not capable to endure a lengthy surgery (six hours or more), should talk about further options with their oncologists. If they won’t be able to carry on the extensive procedure brought about by DIEP flap, they can opt for other short- timed operations—that has almost the same reconstructive measures.

Radiotherapy

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After mastectomy, radiotherapy is given to patients who are considered to be at risk of recurrence. Radiotherapy kills cells that are growing and has greater effects on cancer than on surrounding tissue.

After a few days of radiotherapy, the patient's skin may look red and feel a bit sore. Towards the end of treatment, there may also be some blistering of the skin.

Chemotherapy

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Chemotherapy involves being given a combination of anti-cancer medicines, often up to three at a time. It may be preferable for more advanced cancer that is not hormone responsive and for aggressive disease, particularly if the cancer has spread to other sites, such as the liver. It is sometimes administered prior to surgery in order to shrink a tumor.

Surgery

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Surgery can be an excision of the tumor with surrounding normal breast tissue (breast conservation) or removal of the whole breast (mastectomy). Clinical trials comparing mastectomy and breast conservation have shown that the two produce identical results.

If the lump is relatively small it is usually possible for the surgeon to remove it along with a small amount of surrounding normal tissue. This is called lumpectomy, wide local excision or breast-conserving surgery.

With a larger lump, this breast-conserving operation may not be possible because so much of the breast tissue would have been taken away that it would badly distort the breast.

Once the lump and surrounding tissue is removed it needs to be examined under the microscope. In some women, the surrounding tissue is abnormal and a further operation is necessary.

Risk Factors

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Some risk factors, such as age, sex and family history, can't be changed, whereas others, including weight, smoking and a poor diet, are under your control.

But having one or even several risk factors doesn't necessarily mean you'll develop cancer — most women with breast cancer have no known risk factors other than simply being women. In fact, being female is the single greatest risk factor for breast cancer. Although men can develop the disease, it's far more common in women.

Other factors that may make you more susceptible to breast cancer include:

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Age

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A personal history of breast cancer

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Genetic predisposition

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Radiation exposure

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Excess weight in upper part of body

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Late menopause

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First pregnancy at older age

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Birth control pills

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Mammographic breast density

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Precancerous breast changes (atypical hyperplasia, lobular carcinoma)

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