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Sep 10, 2017 01:12PM
I am sorry about your new diagnosis. Back in 2013 you wrote:
I'm BRCA2, 40+ years old, disgnosed with DCIS last year. . .
In another thread, you identified a specific BRCA2 mutation.
I do NOT know anything about your specific mutation. However, in general, although individual risk tolerances and choices may differ, IF a particular pathogenic mutation in BRCA2 carried by a woman was known to confer a significantly increased lifetime risk of breast cancer, then the choice of bilateral mastectomy would be a reasonable choice and I would not consider it to be "overkill" in any way, particularly in a relatively young person who was already diagnosed with two independent primaries (synchronous or asynchronous bilateral disease).
Have you consulted with a Genetic Counselor (preferably at a major academic cancer center) regarding what is known about the lifetime risk of breast cancer (as well as ovarian, Fallopian tube, and/or peritoneal cancers and other cancers) in women with the specific BRCA2 mutation you carry? A genetic counselor may be able to provide an estimate of your remaining lifetime risk in light of the specific mutation and your current personal medical history (with second diagnosis) and family history. This type of information would be very relevant to any decision you may make at this time regarding choice of surgery.
It may be helpful for your husband to accompany you to various appointments (surgical consultations; genetic counselor consultations) and hear directly what the risk and related medical advice is. You may wish to ask your surgical or medical oncologist to explain to him how an invasive breast cancer diagnosis, even if caught at an early stage, may still confer some risk of suffering an incurable distant metastatic recurrence.
As the person who will directly bear the burden and risks of any additional diagnosis, you must decide what is best for you.
Stage IA IDC, 9/2013 BMX. Right: IDC (1.5 mm, grade 2) with DCIS (5+ cm), 0/4 nodes, pN0. Left: DCIS (5+ cm), 0/1 node, pN0(i+).