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Topic: BRAC + Diagnosed with DCIS In Stu -Confused on treatment plan

Forum: Living Without Reconstruction After a Mastectomy — Discuss prostheses, swimsuits, bras, and other options for women not having reconstruction or waiting for reconstruction.

Posted on: Oct 18, 2019 07:22AM - edited Oct 18, 2019 07:22AM by Confused516

Confused516 wrote:

hello- I am 50 diagnosed with DCIS in Stu stage 0 BC. I am BRAC positive

totally confused on what to do - Mastectomy and go flat, or have implants (not candidate for using own tissue) or lumpectomy with radiation

So much fear with each option!

Flat what will I look like?

Implants fear of foreign things in body, uncomfortable, complications. Fear I went to radical what if it doesn't come back - 50% chance

Lumpectomy with radiation- fear of cancer coming back doing this all again, coming back stronger?

I change my mind every 5 min trying weigh on what to do.

Any input on someone in same situation would be appreciated.

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Oct 18, 2019 08:03AM Yogatyme wrote:

Confused, I’m not sure what has been discussed w you re: treatment options w DCIS with the BRCA mutation, but when I was dxed w stage 1A micropapillary bc, they told me my risk of recurrence was 85% for both breasts bc of the BRCA1 mutation. For me, it was a no brainer and I opted for bilateral mastectomy. I absolutely have no idea if this is true for stage 0 but you might want to discuss this w your team. As for the decision about reconstruction or going flat, that is not an easy one and I have seen that you’ve been asking for others experiences w these options. It is a very personal decision but also worth having a discussion w your team. Keep reading on this forum, it’s very helpful and lots of good information. Wishing you the best with all your decisions and treatments.

Yogatyme Surgery 3/3/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/13/2019 Mastectomy: Left, Right
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Oct 18, 2019 10:56AM 2019whatayear wrote:

Im BRCA 2 . Had a BMX and no implants. I am pleased with my decision. Frankly I wasn't very attached to my boobs and didn't want numb replacements and bc I had cancer and also will be having surgery to remove my ovaries and tubes next year- I wanted as few surgeries as possible. The moment I got the BRCA 2 test lumpectomy was off the table for me. I want to do everything I can to avoid more cancer. IF I had found out I was BRCA2 prior to cancer I would have gotten the BMX as a preventative measure and gotten the reconstruction- but since I had cancer-- fewer surgeries the better is my motto-

Hope that helps by the time I had my surgery I was very sure I wanted to live flat. I don't mind my flatness or my scars.

I found myself reading others signatures & comparing my dx to others. I decided to delete my info off my sig, b/c I felt like I was viewing people as their dx vrs. as individuals BRCA-2-BMX 6/25 -chemo 7/24 AC/T
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Oct 18, 2019 11:33AM Yogatyme wrote:

whatayear, I, too, went flat and no regrets. Also no regrets about BMX or prophylactic oopherectecomy. The fewest surgeries were also important to me. If I were younger I might have had a different decision, but at 68 these seemed like the best options for me.

Yogatyme Surgery 3/3/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/13/2019 Mastectomy: Left, Right
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Oct 18, 2019 12:12PM SimoneRC wrote:

Hi Confused516!

While I am not BRCA, I have a different pathogenic mutation. With a strong family history of cancer and a potentially bad outcome from radiation with my mutation I did not hesitate to have a bilateral mastectomy with reconstruction at age 51 after being diagnosed with cancer. I have not had any complications with any of my surgeries. For me, I would not have been happy without reconstruction. I did pre-pectoral reconstruction with tissue expanders. Yes, they are uncomfortable for a few weeks. My outcome so far has been good and the implants do not bother me. I also had a total hysterectomy and ovaries and tubes removed (BSO). That was a longer recovery since I had to add the hysterectomy. BSO alone is supposed to be a quick and easy surgery with easy recovery. I am post menopausal and had been on Aromatase Inhibitors for a year and have not had any issues not having my ovaries.

Cancer sucks. I prefer to try to avoid having more of it! I am a very fit and active 53 year old and am very happy that I chose the path I did. Everyone is different though!

Good luck! I hope you find your clarity!

ATM Gene Mutation, Deletion. IDC w/Lobular Features and Focal Mucinous Features. Pre Pectoral Reconstruction. Hysterectomy Surgery 4/6/2018 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 5/6/2018 Arimidex (anastrozole) Surgery 7/3/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 4/30/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 4/30/2019 Prophylactic ovary removal Surgery 8/6/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Oct 18, 2019 03:10PM MBPooch wrote:

Confused516 - I was not BRCA positive but wanted to treat as aggressively as possible and at 45 did not want to be completely flat. I was not a candidate for reconstruction using my own tissue but my plastic surgeon suggested Direct To Implant. I was able to have my BMX and implants put in at the same time. I knew it was a game time decision and there was a small chance that depending on the skin after the BMX that I may have had to go the expander route but thankfully everything went perfectly. It was nice to avoid a second surgery and motivating to wake up with breasts that were similar to what I had. The recovery was way better than I imagined it would be. Only down and out with limited mobility for a couple weeks. I've had no complications and am so happy I chose the route I did. As you continue to gather more information I'm sure your decision will become more clear. Wishing you the best!

Dx 10/16/2017, DCIS/Paget's, Left, 1cm, Grade 3, 0/3 nodes, ER+/PR+ Surgery 11/29/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant

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