Need help deciding on surgery date for likely microinvasive DCIS

sunshinegal

Hello there,

 I'm writing from my honeymoon in Hawaii with a surgery scheduling question for the board.

My surgeon & plastic surgeon have offered me November 15 for mastectomy/reconstruction/SNB. They are also apparently able to slot me in on October 27.

For work reasons, November 15 is much, much better for me. I have a client gig in Nigeria that I am having trouble replacing me for, and if I could do that trip, I would be better off professionally and financially. This date would also give me a few more days to get a second opinion, even though from everything I've read I don't see any way around mastectomy. I think I just need the reassurance that this is the right/only surgical option for me.

I asked the surgeon if there were any medical concerns with doing surgery on Nov 15 vs. Oct 27. He said no, he was not worried about a 2.5 week delay.

I have high grade DCIS with comedonecrosis. There are likely to be microinvasive cells in the DCIS - the pathology report found a "suspicious" focus but subsequent stains on that area failed to show evidence of microinvasion. The path report said "microinvasion cannot be ruled out" and from what I've read, a tumor of my size (greater than 8 cm in its largest dimension) is likely to have microinvasion.

Main question: I don't want to make a penny-wise, pound-foolish decision here. Should I take the Oct 27 date? 

 Side question: does anyone have experience with the Lahey Clinic in Burlington, MA? The surgeons who would do the procedure are Dr. Stephen Karp and Dr. David Bryan (plastic). 

roseg

I wouldn't worry about two extra weeks, particularly if it's going to be for work and there is $$ involved.

It takes a long time for DCIS to develop. A few extra weeks won't make a difference.

lago

They made me wait 1 month (actually 2.5 months from my mammo/ultra sound)  for my surgery for IDC, grade 3, fast growing HER2 tumor that at the time they thought was 7cm (ended up only 5.5cm).

In my case the MRI and physical exam indicated it wasn't in the nodes but I was worried it might move in there during that time. My BS was worried about a micro invation (due to size and aggressiveness) but not worried the extra time would  change anything. Ended up I didn't even have the micro invasion.

I think you are safe waiting a couple of weeks. Even a fast growing cancer doesn't grow that fast. If you had IBC the I would say do not wait.

helenap

i was disgnosed right after my daugther's graduation from college... early May, I wanted to visit my mom (who i never told and if I didnt visit would know since they told me I couldnt fly for 6 weeks after surgery)... and a friend. so I took two long weekends and had a great time. My daughter was going to europe for a graduation gift and i wanted her there when i was going through radiation so i had the surgery the third week in June.. the time also helped me to make sure i was doing the right things. when i first heard i thought take them both OFF.. but in teh end i had a lump and mammosite.. *(who would ever think I did radiation in one week) and the best words i read on this site. was.. they can cut out the cancer but it remains in your heart and mind... it is the emotional side of this disease which is harder than the surgery.

GOOD LUCK...

momof3sofar

I was diagnosed on Sept 14th and will not be having my surgery until Nov 10th.  Right now they are saying only DCIS but there is no way to tell until after the pathology report to be 100% certain.  I do not feel waiting is putting me at any further risk.  If I had a choice to make some extra money and earn some experience that would boost my career I would definately do that.  2.5 weeks is NOT a long time in the life of a cancer.

Enjoy your honeymoon!!! 

Dawn

speech529

It's okay to wait.  I was diagnosed with the same type of DCIS you have (grade 3 with comedonecrosis) on 3/27/10 (after waiting 3 years to have my routine mammo!!) and did not have lumpectomy til 6/2 which was followed up with mx on 6/28. 

Take advantage of the career and $$ boost.  

I used to live in MA and am familiar with Lahey Clinic for their excellent cardiac care (of an older relative).  I think the clinic as a whole has a great reputation.  There's a thread called "How to choose a hospital - Lahey Clinic?" on bc.org....you can search for it and other facilities/docs are mentioned in that thread. This may give you some ideas for 2nd opinion, too.

I hope that you will focus on enjoying your honeymoon and being in the moment. Rest in your loving husband's arms, enjoy the beauty of Hawaii and pamper yourself.  Soon enough you will be attending to all this.

Diva

I was diagnosed with breast cancer in February 2009 and was referred to Lahey Clinic in Burlington, MA.  The staff at Lahey are top notch and I would highly recommend them.  I had a bilateral mastectomy with immediate reconstruction and am very pleased with the results.  The doctors I used were Rebecca Yang (breast surgeon) and Adam Vernadakis (plastic surgeon), and they were both excellent.  I honestly felt that they both wanted me to be happy with my results and I am.

jbesse24

I, too, had Dr. Vernadakis and Dr. Yang.  They were both kind and compassionate.  I felt like I had the all-star team.  I am currently under "construction".  Dr. Vernadakis is very maticulous.  I feel very lucky to have him as my doctor.  His nurse, Sue, is also amazing.  She is always interested and never makes me feel rushed.  I highly recommend this team!