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Nov 17, 2018 03:41PM
I just wanted to share my story with doing neoadjuvant therapy before lumpectomy. I too was told to try an AI (Arimidex) to shrink the area for a better surgical outcome. We monitored it with MRI every 3 months. The first 3 months, the MRI showed very little difference, however, after 6 months the area was had reduced to about 85 percent as seen from the original MRI. I was hopeful that the lumpectomy followed by radiation would be enough for a good outcome.
I did get a good margin on the ILC. However, the pathology report then revealed PLCIS area which I am now getting second opinions on. I felt I could and always can have a BMX if needed. I thought that taking smaller steps and seeing the results would give me more information to make better decisions.
Had the lumpectomy path report been clear, I was well on the way to having this behind me after radiation and not faced with reconstruction decisions that come with the BMX. None of those options were or are appealing.
I was diagnosed almost a year ago. And if I had to do it all over again, I would still choose to try and shrink the area, see if the medication was effective before removing the ILC. I do now feel confident that the AI is effective for the ER positive biology. Our ages are different, I'm 61, post-menapausal with grown children and I calculate my absolute risk as 2% per year for the next 20 years for recurrence.
You are much younger, so maybe if I were in your shoes, I would make a different decision just based on the absolute risk percentage per year. You may want to ask your Dr. their opinion on that. I'm not sure this helps you, but I wanted you to know that there are those of us choosing the option to shrink the area for a better surgical outcome. I wish you the best in making your decision. I think the common surgical approach is less is more if successful and if not, the BMX is always on the table.
Pleomorphic ILC and Pleomorphic Lobular Carcinoma In Situ 4.5 cm
12/1/2017, ILC, Right, 2cm, Stage IIA, Grade 3, 0/2 nodes, ER+/PR-, HER2- (FISH)
2/1/2018 Arimidex (anastrozole)
9/24/2018 Lumpectomy; Lymph node removal: Sentinel
12/19/2018 Lumpectomy: Right
3/4/2019 Whole-breast: Breast