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Hi Everyone,

I'm having a bilateral mastectomy on November 6th., and I wanted to make a cast of my breasts prior to the surgery.  I have the kit, and my husband is going to help me make the cast, but I have some questions about how to do it.  The woman who sent me the kit said that we should just make one layer of plaster strips going horizontally from outer armpit to outer armpit.  She said that we should make sure to overlap the strips.  However, in the directions that came with the kit, it says to make three or four layers, as opposed to one.  I would think that this is the correct way to do it, to ensure that it is really sturdy.  Any suggestions/help from anyone who's done this before would be greatly appreciated.  Thanks!

My pathology report indicates that I have DCIS and that there is "extension into lobules".  Has anybody else had this?  Does that mean that there's a greater likelihood of microinvasion?  I'm meeting with a surgeon on Thursday and I will definitely ask her about it, but I thought I'd see if anyone on the board had experience with this issue.  Thanks.

Hi Everyone,

I'm in the process of deciding which surgeon I want to use for my bilateral mastectomy.  Dr. Zingale is one of the doctors I'm strongly considering.  He works out of Huntington Hospital on Long Island.  Does anyone have any experience with him--i.e., did he do your lumpectomy or mastectomy, or has he operated on any women you know?  Any feedback would be most appreciated!  Thanks.

Thanks for all of your replies!  I am feeling a lot more positive after reading that radiation was not necessary in a number of cases in which the margin was only about 1mm.  Also, I just assumed that the breast tissue that remained was tissue that was close to the breast wall.  I was surprised to hear that it's actually tissue from the outside of the breast.  Ultimately, I know that I will have to wait to see my final pathology report, and take it from there.  So, I have decided to stop worrying about this issue for now, and focus my attention and energy on choosing the right surgeon, and getting through the surgery.  I do have a new question, though.  Sheesh1961 asked if my cancer is DCIS w/microinvasion.  The pathology report from my biopsy indicates that it is DCIS-- "low to high grade with calcifications and extension in the lobules".  There is no indication that there is microinvasion.  Is there a greater likelihood of microinvasion when the cancer has started to extend into the lobules?

Hi Everyone,

I was diagnosed with DCIS on October 3rd.  Five years ago, a biopsy indicated the presence of ductal hyerplasia, and I've been seriously worrying about developing cancer since then.  On Sept. 29th. I had my 5th. breast biopsy, after an area of calcification was seen on my mammogram.  Two radiologists who reviewed my films felt that it was benign, as I have calcifications throughout both of my breasts.  My surgeon felt that way, too.  Additionally, on my mammogram, the calcified area appeared very small--it looked like a cluster of about 4 tiny calcifications.  The radiologists felt that I should have a surgical biopsy, as opposed to a stereotactic breast biopsy, for two reasons--one, my small breast size, and two, the location of the calcified area.  My surgeon agreed that a stereotactic biopsy shouldn't be done, as he felt that the needle could puncture my chest wall.  The area that was excised was 2 x 3 x .08 cm.  For something that appeared as basically nothing on my mammogram, that seems large to me!  Plus, the pathology report indicated no clear margins, so I have absolutely no idea how large the cancerous area is.  I do know that the types are cribriform and solid, and that it is estrogen and progesterone positive.  As far as the grade goes--there wasn't one given--the report just indicated "low to high grade", so I don't know what to make of that.  Plus, the cancer is extending into the lobules.

I've decided to have a bilateral mastectomy, and feel at peace with my decision--I had been thinking of having prophylactic bilateral mastectomy for the past year and a half, so, for me, the decision was not difficult.  I'm now deciding if I'm going to go with my surgeon (he's a general surgeon who does a lot of breast surgery, but also does a lot of other types of surgery) who's done all of my biopsies for the past 14 years, and with whom I feel really comfortable, or go with a "dedicated" breast surgeon.  I have an appointment with a breast surgeon, who comes highly recommended, next week.

My new concern, which just surfaced a few hours ago, has to do with the fact that the cancer is so close to my chest wall.  Will any surgeon--breast or general--be able to get out all of the cancer if it's that close to the chest wall?  I know they never get out 100% of the breast tissue, so now I'm starting to really worry that some cancer cells will be left behind, and that not only will I have a recurrence, but that it will become invasive breast cancer.  When I met with my general surgeon on Tuesday to go over my pathology report and ask questions, I didn't even think to ask about that--as I said, this is a totally new fear!!  Something else which fuels my worry--when I saw my surgeon in the hospital after the biopsy on 9/29, he said that he thought that the finding would be benign.  If the surgeons cannot always tell the difference between cancer cells and normal cells--how do they know they've gotten all the cancer out?!  My surgeon assures me that I will be cancer-free with mastectomy, but again, I am worrying about that small bit of tissue that will be left behind.

Has anyone else had a similar situation, with DCIS very close to the chest wall?  Any stories, information, reassurances, etc. would be much appreciated!  Thanks.

Hi Everyone,

I am new to the board, and newly diagnosed with DCIS.  Because of my history with benign breast issues (especially hyperplasia), multiple biopsies, and my extremely dense breasts, I have been contemplating prophylactic bilateral mastecomy for the past year and a half.  Unfortunately, I was diagnosed prior to the "prophylactic" part, but I know that even if I had done the mastecomy last year, they would've found DCIS at that time, as well.  I have decided to have the bilateral mastecomy, and feel fine about my decision.  The surgeon who has done all of my biopsies to this point (4 over the course of the last 14 years) is a general surgeon.  He was recommended by my prior gynecologist after she found a lump (turned out to be a fibroadenoma) during my breast exam.  I had just moved to the area, and never contemplated having to have multiple breast surgeries (I was 27 at the time), so I decided to take my doctor's recommendation.  I have always felt good about my surgeon--I like him, and I really trust him.  Additionally, I don't have any scars or deformations, in spite of the fact that my breasts are tiny (I truly wear bras that I got in the children's department--and they're not even the largest size!!), and he has had to remove fairly large sections of my right breast (relative to my breast size) during two of my biopsies (2 x 2 x 1 cm., and most recently, 3 x 2 x .08 cm).  I saw him today, and he took my bandage off from the biopsy I had last week, and there is no deformity whatsoever.  I am not planning any reconstruction at the time of my bilateral mastectomy, and, at this point, I don't see it in my future, at all.

In spite of my very positive feelings about my surgeon, I have a nagging feeling that perhaps I should have the surgery performed by a dedicated breast surgeon.  On the one hand, that's all they do, so shouldn't they be more adept at removing all of the tissue, etc.?  On the other hand, I read a book in which the author made a good point.  He said that often the best outcomes he sees as far as breast surgery is concerned are from general surgeons, as they are continually doing other types of (more challenging) surgery to keep up a high level of expertise in their overall surgical work.  His feeling, therefore, is that a general surgeon who is well versed in breast issues (mine definitely is) may be just as good, if not better, than a breast surgeon.  By the way, I don't know how many mastectomies my surgeon does over the course of a year, but he told me today that he does "several" per month.  I know he's been in practice for at least 14 years, and I know he's been named one of the best surgeons in the "Top Doctor" guide for my area (Connolly's) multiple times--most recently, last year.  In spite of that, I keep feeling as though I should talk to a breast surgeon.  On the other hand, I think that even if I talk to a breast surgeon and like him/her, I won't really know much about him/her or his/her work.  Of course, I really want to feel comfortable with the doctor who's going to ultimately perform the surgery.

I would love to hear anyone's opinion regarding this issue.  Plus, is there a special area of the board where people rate/discuss their experiences with their doctors?  Thanks a lot!