josirus

Hi Everyone,

I haven't posted in a long time but I'm back! I got the results of my pathology report and I was absolutely relieved that my Dx was not upgraded. It stayed DCIS, ER+/PR+, but showed some evidence of Grade 3 with necrosis. The only negative was that the margins were less than 1 mm on a large surface of the tissue sample. My doctor/surgeon told me that he is never happy with anything less than 2-mm, and for someone of my age (32) and family history (mother Dx at 45 with Stage IV), he prefers a minimum of 3-4 mm. So I will be back in the OR soon.

I thought long and hard about things and decided that I will opt for a mastectomy. I am very small chested, and a second lumpectomy will probably dramatically change the shape of my breast. Not to mention that even before my first surgery, my surgeon told me there was a 50-50 chance I would lose my nipple. I am convinced it will go with a second lumpectomy.

 I am meeting with a plastic surgeon in 2 weeks, and with geneticists. My doctor/surgeon told me he prefers his patients heal on their own for 6-12 months before reconstruction, but he also told me it is a gut feel and not substantiated by any kind of data. I feel pretty strongly that I want to wake up with implants.

I still have bad days, where I worry about the future and my little 2 year old being without his mother. But as every day passes, I am feeling more and more confident that a bi-lateral mastectomy will allow me to move forward in the best possible way.

I'm keeping my head clear of negativity! And trying to surround myself with friends and fun as I contemplate these difficult decisions.

Hope all of you are well. :-)

Thanks for all your replies. sam408, I will definitely consider all my options, also given that my scars heal terribly with keloids. I meet with my breast surgeon on Wednesday to get the full pathology of the lumepctomy sample. Hope all goes well. If the margins are not clear, I am leaning towards mastectomy so I will not have to worry about any of this. Happy Thanksgiving to the Canadians! I just stuffed my turkey.

Just wondering if there is anyone perusing these discussion boards who has had lumpectomy followed by radiation, and then at a later time (after radiation), decided on mastectomy with reconstruction?? Whether it was for recurrence or for prophylactic reasons.

I had a LB lumpectomy last week for DCIS, even though I was leaning towards mastectomy due to strong family history (mother Dx at 45 with Stage IV). I wasn't given a whole lot of time to think about my options because within less than 3 weeks from diagnosis, surgery was done. I am waiting for pathology of the tissue sample right now. If the margins are clear, and my Dx remains the same, I will be starting radiation shortly after. If the margins are not clear, I have a second chance to get a mastectomy (uni- or bi-lateral) and skip the radiation.

My doctor was explaining that the breast skin can thicken and change with radiation, making any possible future reconstruction after mastectomy difficult. Has anyone experienced this?

I will be seeing geneticists soon for BRCA1/2 testing, and even if I do not have a mutation, it is possible at some point that I decide to have prophylactic mastectomies. Reconstruction would be important to me, and I am worried about it not being possible or that the radiated left side will not reconstruct like the non-radiated right side.

Does anyone have any experience to share? Thanks.

I am 32. I had a lumpectomy for a single focus DCIS (Grade 2) located in the upper left qudarant of my left breast one week ago (Sept 29). I entered surgery with a preference for lumpectomy, but told the doctor that if he had to take the nipple (which was a possibility given close proximity of the DCIS), to take the entire breast. And I also told him that if he took the left breast, to take the right one off as well. He seemed surprised by this. But my mother was Dx with Stage IV BC at 45, and died at 50. And I have a two year old boy. Even though I came out of surgery with only the lumpectomy with nipple intact, I still feel it is a matter of time before I have my breasts removed prophylactically. My surgeon (who is the most wonderful doctor I have ever had or met) promised me that anytime I felt ready for that surgery, he would do it.

I didn't have a lot of time to think about things. Exactly 3 weeks after I got the phone call about the biospy result, I was in the OR. This included getting an MRI and all my pre-op tests done (sometimes the CDN health care system does work!). Yesterday, 6 days after my lumpectomy I ran 5k in a BC fundraiser. Probably should not have, and imagine my surprise when I literally ran into my doctor at the finish line. He gave me a big warm hug and kiss, which is better than the trouble I thought I was going to get into! But I did get a call from his nurse this morning telling me (with a laugh) that I should take it easy for 3-4 weeks.

I am waiting patiently for pathology results. I'm scared, no doubt about that, and hope the Dx stays the same as with the biopsy result. I do have a question. If a re-excision is necessary, is it also through general anesthesia? I am thinking long and hard about whether I should go ahead with mastectomy if the margins are not clear on the tissue sample.