A British breast cancer survivor has undergone what may be a first of its kind surgery: a breast transplant, using her own healthy breast tissue. And it was all her idea.
Nicola Purdie, 38, was first diagnosed with breast cancer in 2020, after which she had five months of chemotherapy, a double mastectomy and breast reconstruction.
When her cancer returned a couple of year later — in only one breast — her treatment plan looked quite a bit different.
“This is not run of the mill mastectomy we’re talking about,” her breast surgeon, Dr. Reza Arya, told the BBC.
Purdie’s first bout of cancer was also only in her right breast, but due to family history, she decided to err on the safe side with a double mastectomy.
Her reconstructive surgery involved a DIEP (deep inferior epigastric perforator) flap, in which skin and tissue are taken from the stomach.
The upside of that procedure is the breasts are still “natural” — no implants that need to be changed, and they grown and shrink with weight loss.
In 2024, she was healthy and five months pregnant with her second child when she discovered a lump in her right breast — the cancer was back.
Testing was limited due to her pregnancy, though she did have a lumpectomy to remove what they knew for sure was cancer.
After she delivered her son early, further tests confirmed that she actually had several cancerous tumors, both in the skin and in a lymph node.
“The skin was the only bit of the breast tissue left after my previous reconstruction,” she told the Swansea Bay University Health Board.
Purdie underwent chemotherapy again, all while caring for her newborn.
“I finished that in February this year, and then I had what we call the ‘crazy idea,’” she said.
For the next step in her treatment plan, doctors suggested removal of the entire breast that was infected with cancer, as well as LD flap reconstruction. The latissimus dorsi — a flat muscle that spans across part of the back and over to the side — would be swung around to replace the removed breast tissue.
But Purdie didn’t love that approach. For one, her aunt had had the procedure and the recovery was rough. It could also limit her future movement.
“All these matters are now clear to us, but at the time the idea was so out of the box that I needed to gather my thoughts.”
Dr. Reza Arya
For another, it would leave her flat-chested on one side, because there would not be enough skin to accommodate an implant. Purdie wanted symmetry, so that would mean removing her left breast as well.
So she asked her doctor: What if they did another DIEP flap like she had done before, but this time used tissue from her healthy left breast to reconstruct the right?
“I remember [Dr. Reza Arya] sitting back in his chair,” Purdie said. “I could see the cogs whirring.”
That’s because the idea was new to Arya — and the medical field in general.
“All these matters are now clear to us, but at the time the idea was so out of the box that I needed to gather my thoughts,” he said.
“I was analyzing what the benefits and disadvantages could be before even thinking if it would be technically feasible.”
“I had never seen or heard of such a procedure being talked about or published.”
He had conversations with other doctors, but no one was quite sure if it would work.
“We didn’t know if the vessels were still running, whether the flap needed to be detached to be transferred and, if so, whether the vessels could withstand the microsurgery again,” Arya said.
“We went through the pros and cons of all the different options,” Purdie added, “but something was telling me that because I’d had this idea, there was a reason why I’d had it. I needed to plough on and just trust the process.”
She decided to move forward with the seven-hour surgery, and tests conducted afterward showed no signs of cancer. After radiation, she will get an implant on that side — and because of the procedure, there is enough skin for it.
Arya calls the surgery a “world first” and says he will soon publish about it.
“I think that would help others with that very rare question — is an entire breast DIEP flap reusable? Can you freely move it again? Now I can say, absolutely yes. We have successfully recycled a reconstructed breast,” he said.
Meanwhile, Purdie is thrilled that they found a solution that “has allowed me to maintain being a woman”
“I would have been left with only one breast permanently. Radiotherapy would damage the skin and tissues too much to allow for an implant, so this surgery gives me the possibility of having two breasts,” she said. “I’ve been so lucky.”