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Jun 13, 2011 08:13AM
Bruthd52 - I'm so sorry. That is fast. Of course - I've been dragging my feet on resolving the issue - it's been six months since my initial diagnosis. (I justify that by saying if I had not gotten a second (and third) opinion, I would not even know I had dirty margins.) My local surgeon is big on breast conservation, as am I; the cancer center is understandably more focused on curing and preventing cancer.
Two studies I've read recently are making me believe mastectomy might be appropriate in my case. Dr. Silverstein published a 2010 study using the VNPI scoring system that showed for my size and grade of tumor, I had a 40% chance of some recurrence at 12 years even after radiation, and a greater than 20% chance that it would be invasive.
On top of my VNPI score - I have dense breasts, which the VNPI doesn't even take into consideration. So, if you factor that in as well, it looks like odds are pretty high I'd be doing chemo 12 years from now, when I'd rather be traveling. :-)
They can do reconstruction for partial mastectomy, although there's the potential for radiation to damage the breast tissue. They do anything from saline or silicone implants to autologous tissue implants. The cancer center here does a lat flap for reconstruction after a partial mastectomy, but I've read of other places that do DIEP flaps. I'm guessing DIEP flap is not standard for partial mastectomies because the DIEP flap is difficult and a very invasive surgery. Regardless, if I have the mastectomy, which I am now leaning towards, I'll do DIEP reconstruction.
For you - Grade 1 is pretty good, but triple negative, not so good, as I'm sure you know. I am ER/PR positive so haven't done that research.
I think there are many compassionate surgeons but it is sometimes hard to tell. :-) Some are very fine surgeons but haven't developed all the human interactive skills one would like.
Good luck to you. I'm still thinking but those last two studies make me think perhaps mastectomy may be in the works, for me.
1/15/2011, DCIS, 6cm+, Stage 0, Grade 3, ER+/PR+