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Topic: Dcis lumpectomy or mastectomy

Forum: High Risk for Breast Cancer — Due to family history, genetics, or other factors.

Posted on: Nov 22, 2018 09:21AM

Manna1 wrote:

1 1/2 high grade dcis with palb2 gene mutation.

Should treatment be double mastectomy or lumpectomy

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Nov 22, 2018 09:36AM BluGene wrote:


That’s a very personal choice, but I will tell you mine. I have 1.8 cm DCIS grade 3 with comedo necrosis. I also have a cancer gene: RAD51D.

I had a lumpectomy (it was called a partial mastectomy cause they took more than just the lump - 3 areas actually).

I had the lumpectomy bc it was scheduled as a biopsy, but I ended up having a core needle done a week before due to something else they saw on ultrasound. Once I had that initial confirmation, I already started thinking about dmx. I had the lumpectomy to if/what else was going on.

My grade increased, but not too much else. So it’s been peace of mind as I sort through next steps. Next would be radiation or dmx. I’ve decided on dmx and if no surprises, I won’t need radiation.

I’m 35, have family history, that gene, and other microcalcifications in my breast. This is what made me decide. I didn’t want to do this over and over in my life. I have a lot of years with these breasts and I didn’t want those years worrying and getting chopped up over and over.

I’m scared of the recovery process, but I’m completely at peace with my decision. I hope you will be too.

Dx 10/22/2018, DCIS, Right, 2cm, Stage 0, Grade 3, ER+ Surgery 10/29/2018 Lumpectomy: Right Surgery 12/13/2018 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Nov 22, 2018 01:48PM Moderators wrote:

Indeed, a very personal decision. Listen to what your doctors and genetic counselors recommend, and consider a second opinion. It's not easy, and sorry you even have to decide. Medicating

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Nov 22, 2018 11:07PM Kerri_Oz wrote:

It's a super hard decision to make. There are so many things to consider. What is your future risk of further cancer? Do you want to have babies and breast feed? What if they don't get clear margins with the lumpectomy? What else is happening in your life in regards to how quick you need your recovery to be? Are finances an issue? What does your doctor recommend? What other treatment will you need with a lumpectomy vs. double mastectomy? What are you personally comfortable with? What is your gut telling you?

Whilst on one hand, my instinct would be screaming get rid of as much of the risk as I can as soon as possible, I know not everyone feels that way. The bottom line is, I think, that if you have a lumpectomy, you can always have a double mastectomy at a later date, but once you have a double mastectomy, there's no going back. Huge decision, and in the end, it has to be what you are most comfortable with.

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