MIDDLE-AGED WOMEN 40-60ish
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justamy, Let me clarify...a breast surgeon is a general surgeon. Some, but certainly not all, may have done a fellowship for surgical oncology for breasts; but others are called "breast surgeons" because that is the specialty area they handle for their practice. The latter is not inferior as it means they do the majority of all breast cases which (in a fair sized city) can amount to dozens or even over 100 breast surgeries a year.
My surgeon was a general surgeon but he did almost all the breast surgeries out of one hospital. He had a great rep. and my lumpectomy surgery went very well, clean margins, etc. The bottom line is you DO want an experienced surgeon who does upwards of 50-100 breast surgeries a year. The more the better. If you live in a small community, this might mean going to a larger regional facility.
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My surgery will be in Springfield MO which is a fairly large city (3rd largest in MO). If I were to travel it would be at least 4 hours to St. Loius or Kansas City. This would be difficult for me. The breast clinic here is one of the best in the nation and my Oncologist was the one who set me up with the surgeon. He has been doing surgery since 1974. I will inquire about the number he has done. I know it is a lot because he was describing some to me. I will do my homework. I never even thought about there being a specific breast surgeon until now...Thanks for your concern and info.
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ok a quick phone call told much more. He is a certified breast surgeon. They list him as general because he does some other minor surgeries as well. He is also certified to deal with lyphodema. Sorry for the confusion. I feel better now that I checked it out.
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Thanks elimar. I also found he does most of the breast surgeries in Springfield which is a city of 162,900 people that also serves much of SW MO. I think I am good here as far as his credentials.... Now just the prophylactic thing.
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Good job, justamy! Those are all good things to know. he must be at least 60, then, and that would explain his reluctance to do the prophylactic one.
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He is over 60 I would say. The good thing is that he also does not take lymph glands unless the few he tests are cancerous...many older docs still do that regardless.
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That is very good news! we like good nodes to be left alone! justamy, i started to feel bad a while ago, because i felt that my cautions might scare you, and that was not my intent at all. please do not worry ok? all of us here did it just fine, and i am sure you are as sturdy as us. i am glad that you found this particular thread, its pretty cool, well, because of the great women, and also all the revolving fresh headers elimar does at the top. sometimes i get on the computer and go there first, just to see what she's thinking.
Does anyone else tell any of their doc's about this website? you would think they would be interested to hear what patients are reeeally saying, but sadly, no. at least the ones ive talked to. sadly, only my LE therapist seems at all interested, and she promised she would ladies new to bc about us. one of my NP's even warned me away, saying there was bad info there. huh. but then, she is also the one who got mad at my pharmacy for leaving package inserts in the package!!! no wonder i am a little leary of the med proffession. its weird tho, because i have always admired what science and medicine and docs can do,...just.. not on ME!
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KatheC: you didn't scare me but you did make me check out my surgeons credentials which is a good thing. I need to know that the guy removing my breasts is qualified to do the job. I didn't know what to check out or about my right to a Bmx if I feel it's necessary. You all are amazing women and we will all get through this together!
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:}
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justamy, I have to weigh in here. My breast surgeon was a female over the age of 60. In fact I had to wait a couple of extra weeks for surgery because she was recovering from a hip replacement! I was given the choice of having one side done or both. There was nothing found on the right side in the mammo, MRI, or the needle guided biopsy but I still opted to have the BMX and I am grateful that I did. My insurance never even questioned it and I don't think by law they can dictate if you do one or both. Turns out from the pathology done on the right, non cancerous side, that had I not had a BMX I would have eventually needed the other side done. As the surgeon put it, "is was a very busy breast". That right there validated my decision. Please get a second opinion. As far as the husband goes I am sure he is just as much in shock as you are and will come to his senses and support whatever decision you make!
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Talked to hubby last in night. He worried that the insurance won't pay unless the doc says I need it. He wants me healthy over everything else but he trusts the doctor. I think by the time we get to surgery in 6 months it will all be OK. I do not want to do this twice.
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I sure wish I had known about this site prior to my mx. I was so naïve and "obedient" doing just whatever I was told needed to be done. MX - could choose to do recon at anytime. I had no idea that there was time to stop and think about it all and to gather some info as to what options were out there.
You gals are a wealth of information and experience - thank you so much for being here and sharing your thoughts, experiences and knowledge.
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kathe, the loss of sensation we talk about in a breast is not from a lumpectomy (I had four before my double mast), but the lack of sensation when you have your breast removed. All those wonderful sensations are gone, even though skin is still there. I actually asked my surgeon where those wonderful nerves from the nipple snapped to when they were cut. He told me to have fun looking for them...hehehehehe!
As for nodes - thank GOD! that surgeons aren't taking as many as they used to!!! That was the harder surgery part to recover from and has blessed me (not!) with truncal LE (mild). I HATE hearing that someone had 2 out of 4 nodes positive so the surgeon went back in and took more...WHY?????????? The nodes did what they were supposed to do!! They weren't ALL positive, so why take more?? You were going to get chemo probably anyway, so what was the point??????? I really DO think they are streamlining and customizing the process to the individual, but the individual does have to gain knowledge, too. THIS is the kind of information we all need from actual PATIENTS, not someone sitting in an office somewhere typing up a website!!!
I had a general surgeon for my masts (no recon) and my scar line is BETTER than others who had breast surgeons!!! I showed it to some bco ladies here and they were envious of my clean, flat line. They had bulges and dog ears and folds and basically a crappy line. I had told my surgeon I had NO intention of recon and he respected that. I think a breast surgeon leaves excess skin because they want to SAVE and/or rebuild a breast. It's in their nature....
Back to my "good" breast (right one). Well, I bled all over the mammo machine from my LEFT nipple. Then they wanted me to get an MRI on my RIGHT side due to "architectural changes" (calcifications) and I was upset they were ignoring my left side - MRI did both sides thank goodness!! Then they wanted an ultrasound-guided biopsy on my RIGHT side!! The tech took me to the department and kept insisting it was the right side and I kept saying LEFT!!!! Well, she left me there and then came back 15 minutes later while I was still waiting and KNELT down in front of me and took my hands, said I was right, it was the LEFT side and GOOD LUCK.
Gee...thanks for the warm fuzzies, sweetheart!!
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Barbe, I can really see now why you went BMX. If you went UNI, they probably would have lopped off the wrong one!!! You missed a good opportunity to give her a kick while she was kneeling right there, too.
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I was spared the lymph node dissection because I argued that since I was Stage IIIc and those other nodes could not be removed, relying solely on chemo and radiation should be good enough for my poor blameless armpit if it was good enough for my collarbone node, etc. I was so bummed when I left the surgeon's office where she had insisted it was standard protocol, but she had actually listened to me and consulted with her partner, my MO and RO, and the other doctors on the tumor board. They all agreed that if my post-chemo PETscan was good, I didn't have to be subjected to "standard protocol". My MO was happy to have an excuse to order a post-chemo PETscan, and said that the trend was towards not removing so many (or any) lymph nodes. That second PETscan was absolutely clear and I consequently had a quick recovery from a bilateral mastectomy without ALND. There's still a risk of lymphedema due to having radiation on that side but it must be a much lower risk than having both surgery AND radiation to the same area.
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Good for you for sticking up for yourself, shycat, that is EXACTLY what I was talking about that we have to be our own advocates. You done good!
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Barbie is absolutely right, we have to ask lots of questions, do our homework and speak up for what we want, good doctors will respect that. When I had lumpectomy 3 year ago there was a second questionable spot near the first and they wanted to do a second biopsy, my husband spoke up and said if you are going in anyway why put her through another biopsy? Doctor said you are absolutely correct.
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man, that was alot of stuff going on in there, 3rd. the lumpectomy after mastectomy is what really sucks, you would think that havin em off would just take care of the whole business, right? thats why a ladie and i that met on another thread discussed multiple lumpectomies. she has a good reason, though, she has rheumatoid arthritis, and it would be a very dangerous thing for her to have such a surgery. and she also had necrotising fascitis, and i guess that can happen to you easily when you have that, and also from the medicine they give you for that. she had told me also that her oncologist told her that anyone that has chemo has a greater possibility of NF, because of compromised immune systems.
i knew that about mastectomies, Barbe. its just that the BS i had told me that since my tumor was close to the nipple, there was a great possibility that i would lose nipple sensation. the thing is, i dont know what i was thinking,when i chose a lumpy. they WERE a good feature of mine, even at 52, and my man was crazy about them. they were his favorite thing.and i didn't realize that there would be so much scar tissue, and also the huge hematoma i had after surgery, has turned into fat necrosis. funny thing tho, after taking tamox and an AI for over a year, i can really see on the mammos that my breast are less dense than they were two years ago, when they were all white inside,now they are not so much. the tissue "rearangement" that they did on me feels like a slightly flattened slightly bigger golf ball is in there. And like you too, barbe, there is an area with no feeling on my skin towards the axilla, and the node dissection has left me with both numb areas, and painful areas. pretty much it all sucks, having it anywhere, and having the treatments. Cancer of any kind is just....so wrong. the best thing about all of it, is i met all of you here. it seriously makes me happy to talk here with everyone, i would hate to be alone with it. thank god again for the internet, and for all of you.
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You're right Kathec, it all sucks, but grateful to have people who understand what we are going through. Hope you all have a restful and peaceful weekend. Stephanie
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I went to a mall with my DH yesterday and kind of choked as we passed Victoria's Secret with all the beautiful new lingerie and bras/panties now.....
He was (is?) very much a boob-man and I know he feels this as much as I do. I used to be able to just flash him some cleavage and that was enough.....0 -
I come to this page via the "dashboard" and usually I don't scroll down to the bottom of the dashboard but today, when I scrolled down, I had one user blocked and one topic blocked. I didn't block them, so that was weird. Could be I inadvertantly clicked something wrong. But twice??? Check and see if any of you have things mysteriously blocked.
Maybe I have multiple personality disorder and one of my other selves did this?
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ShyCat, I declined to have any chemo, rads, or allow them to touch my lymph nodes AT ALL. Man, did I get a lot of flack for that! I have been blessed to have clean margins from just DMX. Awaiting swap of TE for squishys - next month can't come soon enough. After explaining myself to Hubby & attempting to explain myself to one dr, I simply declined to explain myself any further. My treatment is my decision. Lots of stress induced by the "counseling" of well-meaning drs did not help my state of mind, but I am past that for now. Once I have the squishys installed, I'll be declining any more surgeries. Doesn't make sense to me to have nipples if I can't feel them anyway. These things are just so I don't look like a total freak with clothes on. Maybe I'll get flowers tattooed over the scars some time next year, and then what I look like with clothes off will at least be interesting. LOL
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Calico, gotta admit I was loving your post until you said you would look like a "total freak" with clothes on (and a flat chest from DMX) and a double mast. I have had a double mast and go flat. Dead flat. No recon, no foobs. I have "won" so far over cancer and am NOT ashamed of my victory! I don't NEED fake breasts to feel normal. I am so sad that you do......forget the tattoos over your fake breasts, who cares?
I am a large woman, many on bco have met me and I do carry my 210 pounds well, even though I am only 5'4.5". My belly is larger than my chest, yes. But it's the way I stand and project myself that counts. Because I am not ashamed of my cancer, or embarrassed, or guilty or whatever it is, I stand with pride that so far, and God willing, many more years, I have won. I didn't get chemo or rads and am not on an AI, either, but you'd better believe I didn't NEED recon surgery!!
Edited to add the word "recon" to the last sentence. I DID need surgery to get rid of the cancer. But I certainly didn't NEED recon. No one does. They desire it. They want it. They bitch and moan till they get it. Someone coerces them into it. Their DH's demand it. They have no self-confidence. They feel useless without tits. I have NO friggin' idea why many women get recon but after almost 6 years on this forum I've heard all the reasons, but not the truth.
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I had a uni MX, no recon, and I don't feel like a freak. I just have a scar on half my chest. Big whoop. Recon is up to the individual. With all the potential complications, there is no way I wanted it.0 -
barbe, every one is just different, the heart wants what it wants. if it comes back on me, i would want another lumpy, cause to me, there is more "room" if it comes back again after that, i would not want it on my chest wall. they can get out the melon baller, especially since i went thru all of the trouble of rads. if i had to have em both off, i dont want recon, cause i dont want my muscles messed with. at all. and both just for the sake of symmetry.
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Calico, what stage were you DXed with?
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Barbe, I am not sure what "truth" you are looking for. How people feel about the tit-less thing varies a great deal, and I do not think someone is somehow "better" or more enlightened for going flat.
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My point was just that. To prove a point!! So my post was to show that it goes both ways. And just as much as some people think being totally flat is looking like a "freak", some of us think the Frankenstein-stitched breasts with cadaver skin (Alloderm) and all those scars look "freakish" to us.
I do know that if I only had one breast removed I would wear a foob for my OWN comfort level, not anyone elses. But when I told a woman at work I wasn't going to wear foobs she was shocked and I said "Why should I wear fake breasts to make YOU feel better?"
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To each his/her own I always say. No one should be made to feel like they are making the wrong choice, it shouldn't even be a debate. We do what will make our recovery from this easiest for us individually.
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We know "to each their own"...the point was that someone called being flat "freakish" and there are a TON of people who read but don't post and I stick up for them. I get a LOT of PMs thanking me for saying what they are too afraid to say. We have to be careful what we post as it could affect someones' entire decision!!!!
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