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Topic: Had a plan..now unsure

Forum: Stage I Breast Cancer — Meet other members with a Stage I breast cancer diagnosis to share information and support.

Posted on: Jun 13, 2018 07:02AM

Smd0816 wrote:

I am scheduled for a right mx on june 18th. I have a great BS and PS. I was comfortable with this plan until I met with my MO yesterday. He went on and on about a lumpectomy + radiation. I'm feeling like being stage 1 "isnt a big deal" and may not warrant such an invasive procedure. I really dont want radiation and at 36 I do care about how my boobs look and feel.

My husband isnt willing to talk to me about anything cancer related so I really appreciate anyone who is willing to share their thoughts...

Dx'd at age 36 Dx 5/4/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/18/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement
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Jun 13, 2018 07:30AM - edited Jun 13, 2018 07:33AM by Lula73

so... lumpectomy & mastectomy have similar survival rates (keeping in mind that the survival stats are based on death from all causes, not just BC), HOWEVER, lumpectomy has higher recurrence rates. And lumpectomy comes with rads that can and dies often cause tissue damage and affects healing from surgery.

They say that if cancer is only in 1 breast that it does not up the chances of cancer developing in the other breast. HOWEVER, the remaining breast will need to be intensively monitored every 6 months with mammos and mri. The logical question then is, “Why intensive monitoring if no risk increase?" Many women do not want the stress of imaging every 6 months, would prefer to lessen the odds if cancer developing in the other breast below that of the overall national average seeing as how they are currently finding themselves on the wrong side of the odds, they may think it would be odd to have different feeling from one breast to the other and would prefer them to be the same, and they would like symmetry. And so many opt for bilateral mx vs uni. At the end of the day, it is you that lives with the decision whether it turns out good, bad or indifferent. Don't let people who don't have to live with the outcome of the decision dictate, make, or significantly influence the decision.

Best advice I can give is to go with the option that leaves YOU with a feeling of peace.

Since you mentioned you're 36 and care about how your breasts look and feel, have you looked into natural tissue reconstruction instead of implants? Recon can be done at time of mx without tissue expanders and the result is natural looking and feeling breasts - natural feeling to you from the inside and from the outside if you or someone else touches them. They take tissue from your tummy or hips and build breasts out of it. So you get new breasts at time of mx + a tummy tuck or butt lift. These are muscle sparing surgeries. If you have any questions about this type of recon, I'm happy to answer them. And yes, you can cancel your current surgery date and reschedule elsewhere if you so desire. Most women go 4-10 weeks from diagnosis to surgery.

Here's a link to one of the top centers that women travel from all over the country to for their mx and/orbreast recon surgery. They only focus on breast recon-no facelifts, breast augmentations, or other procedures unless they come along with restoring your body to asclose to the pre-surgical state as possible. The before & after photos tell their outcome story quite well (I'm living proof) and if nothing else, the video on the main page titled, “I Wish I Knew..." is a very informative one no matter the type of recon you're planning and is worth the time to watch.

www.breastcenter.com

I hope this helps!

-Lula Dx 1/2017, DCIS/IDC, Right, 1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 2/13/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 3/2/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 11/1/2017 Prophylactic ovary removal Hormonal Therapy 1/2/2018 Femara (letrozole)
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Jun 13, 2018 07:36AM nonomimi5 wrote:

SMD,

I had a lumpectomy and doing radiation right now, but I am 54. Do you have any family history of BC? Are your BS and PS insisting on a mx? In many cases, lumpectomy + radiation has similar recurrence as mastectomy, unless you have family history or your BC is aggressive. You are very young so I would get a second opinion if you have any doubts.

Dx 3/23/2018, DCIS/IDC/IDC: Tubular, Right, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (IHC) Surgery 4/30/2018 Lumpectomy; Lymph node removal Radiation Therapy 5/29/2018 Breast Hormonal Therapy 7/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 13, 2018 12:02PM - edited Jun 13, 2018 12:03PM by NancyHB

Just a point of clarification: a lumpectomy + rads and/or UMXin one breast does not require increased surveillance in the other breast. I had Stage I initially, had lx and rads; recurrence required unilateral mx. Even after a recurrence, none of my doctors require more than a screening mammo once a year on my remaining breast.

"Be happy for this moment. This moment is your life." - Omar Khayyam Dx 11/22/2011, IDC, Left, 1cm, Grade 2, ER+/PR-, HER2- (FISH) Surgery 12/5/2011 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 1/19/2012 AC + T (Taxol) Radiation Therapy 6/12/2012 Whole-breast: Breast, Lymph nodes Dx 1/27/2016, IDC, Left, 1cm, Grade 3, 0/4 nodes, ER-/PR-, HER2- Surgery 2/15/2016 Lumpectomy; Lymph node removal: Left Chemotherapy 3/1/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 7/21/2016 Mastectomy: Left; Reconstruction (left): DIEP flap Dx 1/31/2017, IDC, Stage IV, metastasized to bone
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Jun 13, 2018 12:19PM Ingerp wrote:

Smd--just chiming in that this is a decision many (most?) of us face and you need to do enough research/think through it enough to be comfortable with your decision.

Dx 3/11/2016, DCIS, Left, 6cm+, Stage 0, Grade 3, ER-/PR- Surgery 3/23/2016 Lumpectomy Surgery 4/20/2016 Lumpectomy: Left Radiation Therapy 5/18/2016 Whole-breast: Breast Dx 3/2/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 3/13/2018 Lumpectomy: Right; Lymph node removal: Sentinel Targeted Therapy 5/18/2018 Herceptin (trastuzumab) Chemotherapy 5/18/2018 Taxol (paclitaxel)
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Jun 13, 2018 12:29PM Runrcrb wrote:

I agree with Nancy. I have an annual mammogram on my natural breast.

SMD0618, I think your original question had to do with differing opinions between your surgeon and your oncologist. In my opinion Stage 1 is still cancer - just caught early. I don’t consider it “ no big deal” but can understand how you are trying to minimize, especially if your husband doesn’t want to discuss it. I encourage you to get second opinions (surgical, medical oncologist and radiation oncologist and plastic surgeon), read a lot and then come to a decision you can live with. The plus of finding it early is that you can take time to make treatment decisions- no need to rush. It’s important but rarely urgent for stage 1. You are young and like your breasts as they are; you will need to consider trade offs for each path your treatment can take Ultimately, the decisions are yours

My approach to the various treatments:

Surgery removed the cancer

Chemo tackled any cells that got past the surgical sites

Radiation made the areas inhospitable for future growth

AI reduces the Estrogen in my body that fed the cells

Good luck.

Dx 6/27/2016, IDC, Right, 1cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Dx 6/27/2016, ILC/IDC, Right, 2cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Surgery 9/21/2016 Lymph node removal: Right; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 10/31/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/8/2017 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/23/2017 Arimidex (anastrozole), Aromasin (exemestane) Surgery 12/12/2017 Reconstruction (right): DIEP flap
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Jun 13, 2018 05:34PM Georgia1 wrote:

Hi there Smd. Just chiming in to agree with others that 1) recurrence rates are pretty much the same with both treatment plans and 2) it's a hard choice with no clear-cut answer and 3) second opinions really help. It looks like your tumor is small, so depending on the size of your breasts you may have a great cosmetic outcome. I'm a 34-C and had an area the size of a lime removed with a lumpectomy and today you can hardly tell except for the scar in my armpit! Finding an experienced breast cancer surgeon is super important.

And on radiation, side effects are so difficult to predict; mine were mild and temporary. But if you choose lumpectomy please know it does come with six weeks of daily treatments.

Best wishes to you and let us know if we can help further.

Cancer touched my breast so I kicked its ass. Dx 9/3/2017, ILC/IDC, Right, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 10/10/2017, LCIS, Right, 0/1 nodes Surgery 10/10/2017 Lumpectomy; Lymph node removal: Right, Sentinel Radiation Therapy 11/27/2017 Whole-breast: Breast Hormonal Therapy 1/2/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 13, 2018 06:34PM nonomimi5 wrote:

The accelerated radiation can be done in 16 session if you qualify. I just finished 11 of 16

Dx 3/23/2018, DCIS/IDC/IDC: Tubular, Right, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (IHC) Surgery 4/30/2018 Lumpectomy; Lymph node removal Radiation Therapy 5/29/2018 Breast Hormonal Therapy 7/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 13, 2018 07:13PM Meow13 wrote:

Or possibly qualify for internal radiation, savi.

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Jun 14, 2018 04:34AM MiCyn wrote:

Smd.. It wasn't difficult decision for me, BUT I'm older. I don't know what I would've done had I been your age. My BS agreed that what I chose, lumpectomy, radiation would be her recommendation. She did tell me 35% of her patients choose Mx when dx w stage 0, which was my original dx w biopsy. After surgery it changed to Stage 1A. I think many of us second guess our decisions. Do what you feel is best for you, after weighing your options.

Good luck, 🤗Cyn

Dx 4/25/2018, IDC: Papillary, Left, <1cm, Stage IA, Grade 2, ER+/PR-, HER2- (IHC) Surgery 5/22/2018 Lumpectomy: Left Surgery 7/6/2018 Lymph node removal: Left, Sentinel Chemotherapy 7/31/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Jun 14, 2018 06:47AM NotVeryBrave wrote:

I had a very similar issue in terms of MO recommendation. Initially upon diagnosis, the BS and MO discussed the choice being up to me and being influenced by genetic testing. After very successful chemo - they were really pushing for lumpectomy. To the point where I felt like they were finding fault with me for considering MX.

I went back to my second opinion BS. She felt that either was okay and respected my concerns. I had her do my surgery in the end. I really needed a doctor that was listening to me. And part of my worries were radiation exposure, things they were watching already in the other breast, and my age (50).

You will lose sensation with a MX. And it is more difficult to match a reconstructed breast to a natural one. What does your PS say about that?

It's important to know your risks. And that both treatments are equal in terms of recurrence for most cases. No one wants either surgery. Where do you feel most comfortable in the end?

And why can you not talk to your husband about this? It's a big deal for you. He should be involved in helping you to figure it out and supporting you.



TCHP x 6 with pCR. One year of Herceptin. DTI pre-pec surgery. Quit Tamoxifen after 3 months. Dx 11/21/2016, DCIS/IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2+ (IHC) Targeted Therapy 12/18/2016 Perjeta (pertuzumab) Targeted Therapy 12/19/2016 Herceptin (trastuzumab) Chemotherapy 12/19/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 5/9/2017 Lymph node removal: Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 9/9/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 14, 2018 12:34PM Rrobin0200 wrote:

here’s my take on it. I know that lumpectomy vs mastectomy has the same survival rate, etc. The recurrence rate is the same, etc/

I’ll probably get backlash for this BUT, I wanted to take the most aggressive approach possible. What if 5, 10, 15 years down the road “they” change the statistics? I would rather have one major surgery at one time, than have a lx and then a year down the road have to have a MX. Does that make sense? And why subject yourself to radiation if there is another option? I do understand that a BMX is a major surgery.. I went through it but I got through it. I don’t regret my decision at all. It puts my mind at Ease.

That’s just me. There’s no right or wrong way, everyone Is different. I wish you the best of luck and well wishes.

Dx 3/6/2017, DCIS, Left, 1cm, Stage 0, Grade 3, 0/4 nodes, ER-/PR- Surgery 3/30/2017 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jun 14, 2018 04:51PM SLL101984 wrote:

I had a BMX on May 21, I went that route because it is actually leaving me less disfigured than a lumpectomy. The location and size of my tumor in relation to my breast was not ideal. I also chose to do both even though nothing cancerous was in my right because I wanted to feel even.

Dx 4/18/2018, ILC, Left, 2cm, Stage IA, 0/5 nodes, ER+/PR+, HER2- Surgery 5/21/2018 Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Jun 15, 2018 03:14AM gb2115 wrote:

Something to keep in mind is that mastectomy doesn't always rule out radiation. Sometimes they still recommend it for various reasons.

Dx IDC in October 2016, stage 2A, 1.2 cm ER/PR+ Her2-, Grade 2, 1/3 nodes. Mammaprint low risk luminal A, Lumpectomy + radiation + tamoxifen. Age 38 at diagnosis.

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