When Diantha Midness was diagnosed with a fast-growing, locally advanced breast cancer with a propensity to spread (metastasize), she was tempted to accept her fate without a fight.

But one glance into the eyes of her children when she broke the news steeled her resolve: She would do everything she could to rid her body of the often fatal disease.

At first, fighting the cancer was Diantha's only objective. That battle involved chemotherapy, a mastectomy and radiation therapy. It wasn't until much later that she began to consider breast reconstruction. After weighing her options, Diantha chose reconstruction using her body's own skin and tissue (autologous reconstruction), rather than implants.

The first sign of cancer Diantha noticed was a thickening on the outside of her right breast. She likened it to a reaction to a bug bite — when the area around the bug bite becomes swollen and hard. Her skin in the swollen area was also dimpled and pitted, giving it the telltale "orange peel" appearance that can be seen with inflammatory breast cancer.

After diagnosing her cancer, Diantha's doctor gave her a 50-50 chance that she'd be alive in 10 years.

Once Diantha decided to fight the cancer, everything quickly fell into place. The plan centered on mastectomy — removing the affected breast. Before doing that she would undergo several rounds of chemotherapy to shrink the tumor. Unfortunately the cancer shrunk very little. Despite the size of the tumor, Diantha's breast was removed. It was three months after her initial diagnosis.

Diantha didn't begin to think about breast reconstruction until several months later.

During the year after her surgery, Diantha continued chemotherapy and endured six weeks of radiation to try to rid her body of any remaining cancer cells. She found it hard to look at herself in the mirror after her mastectomy, but she was relieved to have the surgery over with and was grateful that the cancer was gone. Toward the end of her chemotherapy regimen she started to feel better, and she soon began considering the possibility of life after cancer.

Not surprisingly, Diantha's main motivation for choosing breast reconstruction was again inspired by her children, particularly her daughter. If her daughter ever had to face similar adversity, Diantha wanted to be able to provide her with some guidance.

"It was important to me that she was a part of this experience — as much as she wanted to be," Diantha explained. "I wanted her to understand the choices I faced and see how I did it. Maybe she'd choose something different, but at least she'd have some understanding of the process I went through."

To a lesser extent, cosmetic reasons factored into her decision to have reconstruction. She was tired of looking at the mastectomy scars. She wanted her clothes to fit better. But mainly, she was just ready to move on with her life.

Diantha opted for a free flap breast reconstruction procedure — known as a transverse rectus abdominal muscle (TRAM) flap — instead of having reconstruction with breast implants.

"For one thing, I didn't want anything foreign in my body," Diantha said, referring to implants. "Having cancer was hard enough."

Also, Diantha considered the number of surgeries and doctor visits required for the tissue expansion process that precedes implants. She'd been through so many doctor visits for cancer treatment that she'd had enough. She wasn't willing to go through such a prolonged reconstructive process. In addition, the odds of successful tissue expansion and implant surgery weren't good in her case. It wasn't worth it to her.

Given these factors, having a TRAM flap operation became her most desirable option. It would entail a long, involved procedure, but everything would be done at one time. There would be no return visits. That appealed to her immensely.

During the TRAM flap surgery, a plastic surgeon cut a portion of skin, muscle and other tissue from Diantha's abdomen. Using microsurgical techniques, the surgeon reattached the tissue to Diantha's chest area to create a new breast mound. Diantha opted to have a preventive mastectomy on her left breast — the remaining, healthy breast — and have the left breast reconstructed at the same time as her right breast. She chose to remove her left breast because she didn't want to risk getting breast cancer in that breast as well.

Diantha's surgery lasted more than 12 hours, after which she spent three days in the hospital being closely monitored.

Diantha marked her recovery time in the hospital hour by hour. Her life wasn't in jeopardy, but the viability of her new breast tissue certainly was. In order for the transplanted tissue and skin to heal properly, she was kept in a climate-controlled room at high heat and humidity.

Although the heat and humidity deterred visitors from staying too long, this wasn't a concern. Diantha was none too eager for visitors at that point. She was dealing with post-surgical pain. She also had nurses coming by every hour with ultrasound equipment to check the blood supply to her newly transplanted breast tissue. If blood stopped flowing to the new tissue, Diantha would have to return to the operating room for corrective surgery.

After Diantha left the hospital, things began to improve. "I was confident at that point because if it was going to fail, it likely would have failed within the first 72 hours after surgery," Diantha said.

Once she returned home, Diantha focused on her physical recovery and decided to travel with her family to a quiet retreat to recuperate. She still had a ways to go, but she was starting to feel better.

Invaluable to Diantha was the support she received from her family and friends during her cancer treatments and recovery from breast reconstruction.

"When something like this happens, you find out quickly who your true friends are," Diantha said.

Diantha's support system included her mother and two children, her close friends from high school and members of her church. She was fortunate enough to have someone drive her more than an hour each way to every one of her doctor appointments. Her close friends set up a schedule of who would help Diantha with grocery shopping and other errands. They made sure that someone could stay overnight whenever Diantha needed extra help.

Diantha's reconstructed breasts aren't the same as her originals, but she didn't expect them to be. Among the things she's had to adjust to are breasts that are different sizes. Her right breast — the one that had the cancer — is much smaller and the skin more taut than that of her left breast. This isn't something that happens to everyone, but in Diantha's case, the radiation treatment greatly affected the remaining skin and tissue on the right side of her chest.

The radiation also discolored her skin almost as if it had been burnt. Because of this, the skin on her reconstructed right breast is two different shades — the skin discolored by radiation layered with the lighter skin from her abdomen.

Diantha's scarring is fairly extensive, although the scars will fade with time. One scar runs from hip to hip. The scars on her breasts differ slightly, but both start at the armpit, where she had lymph nodes removed during her mastectomies. On what was the healthy breast, her left breast, the scar runs across the middle of the breast to the area where the nipple and areola used to be. On the breast that had cancer, the right breast, the scar runs underneath from the outside of the breast to the middle of her chest.

Diantha has no sensation in either of her breasts, and she's also lost some sensation in parts of her abdomen. She notices this loss of sensation on a daily basis, but it doesn't interrupt her daily activities. Fortunately she hasn't experienced a significant loss of abdominal strength, which can sometimes happen after TRAM flap surgery. She's adjusting to the permanence of having one of her major abdominal muscles missing — a feeling she likens to being pregnant or having a foreign object in her side.

Diantha has opted not to have nipple reconstruction. At this point, she's not emotionally ready for any more surgeries. She might consider the procedure in the future, though.

Reflecting on the outcome of her reconstructive surgery, Diantha reports being about 75 percent satisfied with the results. She suspects that women who have the surgery but who didn't have radiation therapy might be more satisfied with their appearance after the surgery.

Although she's glad she had the surgery, she admits it's taken her several months to say that.

Would she recommend the surgery to other women? Absolutely.

"It's amazing what the doctors were able to do," Diantha said. "I felt very fortunate to have this option available to me."

Diantha would advise women to approach this type of procedure with realistic expectations. "Talk with someone who's been through it," she said. "Try to walk in their shoes. Of course, it won't be exactly the same for you, but it can give you a level of understanding."

As for Diantha, she's taking it one day at a time. She's feeling better each day and is grateful for the quality time she spends with her friends and family.