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Feb 9, 2020 10:14AM
First of all, I am sorry you have to go through this crap again.
Perhaps, I am going to sound harsh, but you asked for ideas... I would get a double mastectomy at this point. My situation wasn't quite the same, but here goes.
I was diagnosed with invasive cancer in the right breast (found the lump myself) and was about to start neoadjuvant chemo. I wasn't triple negative, bit wanted to be on the trial for neoadjuvant keytruda, and I qualified because my hormone positive cancer was determined to be high risk via mammmaprint test. My tumor was also larger than 2 cm.
As part of the trial they do serial MRIs. The very first MRI found two areas of DCIS in my other breast. That solidified my decision to get a mastectomy, and on both sides.
My treatment and trial was at a second opinion place (large teaching hospital and NCI designated comprehensive cancer center). I started my diagnostics for the lump I found at the local community hospital. Once they confirmed my lump was cancer, they wanted to do a "quick lumpectomy". Nobody offered MRI on the other breast, or even the cancer breast. Mammo saw nothing on the left. Had I stayed there, I would most likely get a lumpectomy, then chemo. I would continue getting mammograms on the other breast,.and they would likely show nothing until DCIS would become large enough or invasive.
Not saying this is your situation, but with two invasive cancers in two breasts within 3 years, I personally would choose to do BMX.
Yes, I know BMX doesn't eliminate the risk of local recurrence. Yes, there are studies saying that lumpectomy and radiation is as effective as mastectomy in local control. Until you dig a little deeper and see that for younger women (I was 40 at DX) there is, in fact, an overall better local control with mastectomy.
It's your decision in the end, and it opens a lot more questions (reconstruction or not, what type - nipple sparing or not) but I know for me in your situation the BMX would definitely be on the table.
8/31/2017, IDC, Right, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2-
9/15/2017, DCIS, Left, 3cm, Stage 0, Grade 1, 0/3 nodes, ER+/PR+, HER2-
9/29/2017 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel)
2/23/2018 Zoladex (goserelin)
2/28/2018 Mastectomy: Left, Right
2/28/2018 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
4/5/2018 Femara (letrozole)
8/21/2018 Prophylactic ovary removal; Reconstruction (left): Saline implant; Reconstruction (right): Saline implant