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Surgery after “horse is out of the barn

ohionana1605 Member Posts: 65

This may be addressed somewhere else but I can't find it. Original bc 2013 with lumpectomy in left followed by 30 radiation. 8 years later shocked to learn MBC in liver. Been treated 19 months and lesions have shrunk and now CT shows some increased activity in that breast and I have been referred now to a breast surgeon specialist to talk about if she now thinks I should have a mastectomy. Anyone else been here.. I'm 77 and I would just as soon have both off and just be flat. They nursed 2 babies and I don't need them anymore. Please share your experience. Thanks. Be


  • dulcea
    dulcea Member Posts: 88

    My story is a little different.

    I was diagnosed with DCIS at 57 and then 4 months later, 2.5 cm of IDC in the other breast. Due to the timing of the epidemic of covid and actually having covid which delayed things even more, I had a lot of time to do research and make an educated decision.

    A mastectomy was a no-brainer for me at this point, but damn it, I didn't want one! I finally did decide on a double mastectomy with reconstruction. My only regret is the reconstruction part, but I have these jelly things in me so I'll just live with them until I can't anymore. I just can't have any more surgeries right now because I had so many is such a short period of time.

    The pathology of the mastectomy turned up three atypical areas so I was glad I got rid of those things that were trying to kill me.

    I am relieved that there is little breast tissue left. I am part of a breast cancer exercise group and we often are all terrified when one goes in for their 6 month or yearly mammo or mri. We all wait for the results with our fingers crossed. I am relieved that I will only have these scary moments once every two or three years with MRI. Basically, I feel safer having had a mastectomy.

    Just make sure you get what you want. If you want a double mastectomy, don't stop until you get it. Best wishes and I'm sending you strength to make this tough decision.

  • sondraf
    sondraf Member Posts: 1,548

    At diagnosis they wouldn't take out my breast tumor because the horse was out of the barn. Well, the damn thing reignited itself last year about this time and that was cause to finally get the mastectomy and node removal. Im 45, and tall/robust body shape so the surgeons said mastectomy with DIEP recon, no discussion. I was going to be all brave about going flat as I have hated my breasts my whole life, but they were right, I needed the balance of reconstruction both for shoulder/back health and it just really wouldnt have looked right at all. They were not open to removing the healthy breast but I am not in the US and I didn't push it because I was just glad the main tumor was finally coming out.

    At your age and your wishes, and potential risk profile with the liver mets, I imagine they would be more than happy to go with mastectomy and flat closure. Most of my surgical time came from the reconstruction, the mastectomy itself is relatively quick I believe. But if you want the double then push for it and if they say no, ask why. You may want to find out if there is a greater risk profile for the surgery at Stage IV, both for healing and in terms of being off treatment.

  • vlnrph
    vlnrph Member Posts: 474

    It appears that dulcea does not have metastatic disease. I think that makes a huge difference in discussion of this topic. Historically, it was felt that, if the cancer had already spread beyond the breast, there was no point in removing the tumor because treatment would take care of it.

    However, with vastly improved imaging, previously “dormant" areas can be now easily visualized and need to be addressed when they become active. I don't have personal experience to relate but have seen journal articles assessing survival in these situations, etc.

    It might be my inclination to remove and get current pathology on any new spots of concern. Of course, biopsy can also provide that information. Best wishes for clarity in making your decision. Getting a second opinion from a separate surgical oncology group could be helpful

  • sondraf
    sondraf Member Posts: 1,548

    Its local management, kinda like radiotherapy. But, at Stage IV, you and the team really need to weigh the risks of surgery vs being off treatment or potential surgical complications vs being off treatment. Its a lot more to consider than for early stage ladies for sure.

    However, in this instance Id be curious as to what type of cancer the lumpectomy breast is growing if its already had radiation and she's been on anti-cancer drugs. If its completely different then surgery would be a good call before you start getting too many heterogeneous cancer cells around.

  • ohionana1605
    ohionana1605 Member Posts: 65

    I should have also mentioned my lumpectomies left a large dent in. My left breast and my MO said it could possibly break out of the skin and what maybe bleed. ( I can’t see how to post a question mark on this iPad)

    Thanks for responses.

  • ohionana1605
    ohionana1605 Member Posts: 65

    the surgeon said she would not recommend surgery now.
    best wishes to all.