My wife is 49 and was diagnosed with invasive ductal carcinoma on April 2nd. They say it is stage 1 and don't think it has spread to the lymphnods. When doing the MRI they saw another cloudy area in another quadrant same breast so they biopsied that and desrcibed it as a tissue mass or pash. Didn't seemed concerned but would biopsy it again in surgery.
My wife's options are open to lumpectomy to double mastectomy. She is a worrier and leaning to double mastectomy with implant reconstruction. Her reasonings are, reoccurance, peace of mind that she won't have to worry it will come back, not having to have radiation, if it would come back after radiation she would not be able to do a mastectomy and be able to have reconstruction, disfigured breast with lumpectomy,
I love her dearly and will no matter what she decides, but I hoped she would consider the lumpectomy. There are both pros and cons of both procedures, we have done a lot of research. I fear she is giving up a lot more than she needs to and will end up with other side effects like scarring from reconstruction, pain and numbness and trauma of loosing both breast and may regret it.
I'm finding out how many other people have been down the same road we are about to travel. Surgery is scheduled for May 9th, any input on this will be greatly appreciated.
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otter Joined: Jan 2008 Posts: 1733 |
May 7, 2008 11:28 am
otter wrote:
merk59, You sound like my husband (dh). When I was dx'd with IDC, I was given the choice of mastectomy or lumpectomy+radiation. My MRI confirmed the tumor we knew about, but showed that everything else was "clean" in the affected breast and on the other side. My surgeon and I never even discussed removing the healthy breast. I considered that choice only fleetingly (like for about 2 minutes); but it just didn't seem warranted. As for lumpectomy/rads versus mastectomy: that is the great debate. Did your wife's surgeon tell her that the overall survival rate is exactly the same, whether she chooses lumpectomy/rads or mastectomy (on the affected side)? There is no difference in long-term survival. None. Lots and lots of studies have shown that. There is a slight difference in the likelihood of recurrence of the tumor, but only with respect to a "local" recurrence--that is, recurrence of the tumor on the affected side. I think the figures are, a 1% risk of local recurrence per year (cumulative) after mastectomy, versus a 2% risk after lumpectomy/rads. So, by 5 years after surgery, the risk of a local recurrence following mastectomy would be 5%, and the risk after lumpectomy/rads would be 10%. (I sure hope that's right. I'll check it. I know the risk of local recurrence after mastectomy is half what it is after lumpectomy/rads.) The important thing is, that's a difference in risk of "local" recurrence, which means the tumor reappears at the site of the original surgery, somewhere nearby in the remaining breast tissue, or in the regional (axillary) lymph nodes. That type of recurrence is still treatable. A distant recurrence (i.e., metastasis) is harder to treat; but that risk is the same with either surgical option. This is a very personal decision that your wife must make for herself. You can advise her on it, but don't be too surprised if she chooses something you would not choose for her. My dh thought a mastectomy was "too drastic" and "unwarranted", considering my situation. He may have been correct with respect to the statistics, but it was my body and my level of comfort with risk-taking that needed to tip the balance. I chose a mastectomy on the affected side, for a variety of reasons. Yes, I was worried about local recurrence, despite the statistics. My rationale was that it had been so difficult to find my tumor in the first place, and my gynecologist never did agree there was a possible malignancy there. (I went somewhere else for a 2nd opinion.) I doubted I could detect a recurrence in the "lumpectomy breast" in time to stop it early. There were other reasons, too. And, I decided not to have reconstruction at the time of my mastectomy. I can always do it later. I do not regret my decision--not even for an instant. But, that's me. I think my husband still thinks I made the "wrong" surgical choice, but somewhere along the line he stopped trying to convince me and chose to support whatever I decided to do. That's what's important. otter Dx 1/14/2008, IDC, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2- |
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Msklapkin Joined: Aug 2005 Posts: 183 |
May 7, 2008 11:45 am
Msklapkin wrote:
Dear merk I assume when your wife is having the lumpectomy she will also have sentinel node biopsy to make sure it did not spread to the nodes. At the time I did this, i also did a BRCA test to see if I had a gene mutation. It turns out i did have this mutation which means i had a VERY HIGH chance of another BC or Ovarian Cancer. since i was now considered High Risk, I did have double mastectomy with immediate reconstruction and oopherectomy. I have not had ANY of the problems you discuss and have absolutely no regrets- never did. some people call them foobs and fipples- I never did- these are my new boobs and new nipples and they are ME not fake in my mind. Please make sure your wife talks about genetic testing (I find many BS do not discuss this-I am so happy mine did) her risk factors and makes an educated decision. Believe me, it was a tough journey at times and I only wanted to take this trip once! she is lucky to have a supportive husband like you good luck susan Dx 8/8/2005, IDC, , Stage IIb, Grade 2, 1/8 nodes, ER-/PR-, HER2- |
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newjan Joined: Nov 2006 Posts: 25 |
May 8, 2008 08:19 pm
newjan wrote:
Hi, this is such a difficult time for you and your wife. In Oct 06 I found a lump and had the tests and had to make a decision. My surgeon recommended lumpectomy but I was undecided. There has been a lot of breast cancer in my family and my mother had died at 43. I was given a booklet for 'women who have a strong history of breast cancer and are considering mastectomy'. It really clarified my fears - and so I made the decision to have bilaterial mastectomy. My husband was supportive - but thought it was too drastic. He said 'if you had a bad tooth, you wouldn't have all your teeth out'!! But I felt it was right. As it turned out, there was another lump behind the original one and it was DCIS - so it was definitely the right decision for the mastectomy on that side. But the other side was a preventative for me. And it is now 18 months post surgery - and I have just started the process of reconstruction. In six months or so, it will all be over and I will have breasts again. The intervening period wasn't too bad - I needed to recover from the surgery and the whole idea of cancer and to mourn the loss of my breasts - and of other ideas of health and security etc. I even got to accept my flat chest and felt quite OK with it. I think I am quite a pragmatic person so to choose to remove the risk (as much as possible) of reoccurrence of breast cancer I know I did the right thing for me. A few months ago, my oncologist said 'to all intents and purposes, you are cured'. If I still had my breasts, he would not have been able to say this because of the possibility of future risks. Your wife, with yourself, have to make a decision that sits right with her. Deep down. And then you get on with the all the stuff that happens then. I truly wish you well. Jan |
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southernchi… Joined: Jun 2007 Posts: 22 |
May 19, 2008 09:43 am
southernchick wrote:
Hi, I'm sorry about your wife's diagnosis. I am certainly no expert, I can only add my own story. I was 45 when diagnosed with IDC. I had a lumpectomy but didn't get clear margins. I had two re-excisions, still didn't get clear margins. My only choice then was whether to do a unilateral or bilateral mastectomy. This was an extremely difficult decision for me. I wavered back and forth constantly. I finally sat down with my husband and had a serious conversation with him about this. It turns out, most of my worries were about how he would react. Once he told me that he really didn't care if I had breasts or not, I felt free to make the decision that was right for me. I too am a worrier. I know several people that have only had a unilateral mastectomy and all but one have gotten cancer in the remaining breast. I realized that I could not live with wondering. I had the skin sparing bi-lateral mastectomy with immediate reconstruction with expanders. There is some numbness around the scars, but can feel the rest of the breast. There is some pain, I guess it is because the implants are actually behind the chest muscle. The pain is when I lay down, not when I am up. Most nights it isn't really an issue, but on those nights when they hurt, a couple ibuprofen fix it. I think those nights are when I've over done it during the day. My last surgery (exchange surgery) was just in November 07. I never "mourned the loss of my breasts" I'm not really sure what that means. Yes my natural breasts are gone. Yes, the scars on my breasts bug me sometimes. But I am alive!!! Hopefully I will be alive for many more years to raise and enjoy my children. I have never regretted the decision I made. I know if I had done less, I would have always worried. I hope whatever decision your wife makes, you are able to help her accept it. It sounds like you are a caring husband who will support her. That will be more important to her than you realize. At least it was for me. Good luck. |
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