Pioneering op after mum's 'crazy idea'

A SWANSEA mum's "crazy" idea after a second cancer diagnosis has led to her undergoing a surgical procedure believed to be a world first.

- IAN LEWIS

Nicola Purdie had cancer of the right breast in 2020 shortly after having her first baby. She had a bilateral mastectomy, or removal of both breasts, with immediate reconstruction using tissue from her stomach.

This is known as a DIEP - deep inferior epigastric perforator flap.

The flap needs a strong blood supply, or else it will not survive. So the tissue carries its original blood vessels, which are then "plumbed" to the vessels in the chest wall using microsurgery.

All seemed well after Nicola had that procedure, but last year, while she was pregnant again, the cancer returned in the skin of the reconstructed right breast.

The only option appeared to be to cut out the cancerous breast and resurface the skin defect using muscle and skin from her back, known as an LD flap, using a muscle called the latissimus dorsi (LD).

However, from a relative's unpleasant experience of this procedure, Nicola knew it was the last thing she wanted while raising two young children.

Instead, she came up with what she calls her crazy idea - removing the cancerous right breast and reconstructing it with the healthy DIEP flap breast from the left side.

Consultant plastic, reconstructive and breast surgeon Reza Arya is one of just a handful of experts in the UK who performs both cancer removal and microsurgical reconstruction of the breast.

In all his experience, he had not heard of a complete DIEP re-transplant having been attempted and did not know if it was possible.

But after long discussions with secondary school teacher Nicola and conversations with other experts across the country, he finally concluded it was not such a crazy idea but could be the perfect solution to Nicola's unique situation.