Reoccurance in other breast after 4 years

harper7777

Hi, I'm new to this discussion board. I have read some great stories here and need advice. 4 years ago, I had stage 1 BC (no lymph node involvement), had a lumpectomy and 6.5 weeks of radiation and have been taking tamoxifen. I will be 45 this month. My oncologist wanted me to get an MRI, just out of the blue. It showed something suspicious in my other breast. Long story short, it is BC again. 8mm. I am trying to decide whether to do another lumpectomy or just have both of them removed. I'm also thinking maybe I need a second opinion. Any advice would be appreciated.

LJ13-2

That presents a very troubling decision. Not that it makes a great difference, but my onc. has said many times that breast cancer doesn't "jump" across your chest and recur. It is generally considered a new primary if it occurs in the contralateral breast. Point being, it can have a whole different pathology profile. He also mentioned that having had bc once, my lifetime chances of a new primary were 20-40%, which seems darned high.

Second opinion, definitely.

Fearless_One

While this is only your decision (along with your doctors), if it were me and I had another tumor 4 years later, I would get a BLMX.    I had a lumpectomy and am so afraid of this happening again, that I am now planning a BLMX and I don't even have BC again (yet).

You need to take your breast density into consideration.   If you don't have dense breasts, monitoring you will be easier.    

somanywomen

harper7777,...When 1st dx'd last year and facing the Fear Factor, I came so close to having BLMX and now am glad I had lump instead..It is not the bc in breast that will get us, it is the distant recurrence....There are many women on here that do the BLMX and still have recurrence in scar tissue....With the small size and depending on the location, you really some thinking to do, but I think if it were to happen to me, I would do another lump....Best to you, sorry you have to deal with this again mentally and physically...

elena1

Hello, When I was 36 I had a mastectomy. Now here I am 25 years later with BC again this was a different cancer. A lot worse than the first. I wasnt aware back at the first that I have Brac 2 gene, If I did I would have had them both removed then. The sad thing for me is everyone knew I had a family history and very dense breast but onone suggested taking a songram. The only thing that showed in the mamo was my swollen lymph node..they never saw the tumor.The should have been doing sonos on me every year. Im a little angry. I will just say NOTHING can compare to peace of mind.  E

somanywomen

elena1, my doc always orders a sonogram along with my mammo because of dense breast issues, I thought it was common practice...I just feel that we all have a 50/50 chance of recurrence no matter what we do...We either have recurrence or we don't.......Too bad they did not test you for Brac 2 gene, is there more issues with BC with family members?..Best to you also....

lago

I my other breast had a very small LCIS tumor. It wasn't considered part of the 5.5cm IDC in the other breast. I did choose to have a BMX but my breast tissue was very dense and as you can see from my diagnosis I had a very aggressive fast growing cancer. I suppose I could have had a lumpectomy in the 2nd breast but I never even considered it and my BS also recommened a BMX once I had the MRI.

I would also get a 2nd opinion.

harper7777

So those who've had a mastectomy. How long is the recovery? How did you deal with the loss and is implants a good thing? My aunt had a mastectomy and she went crazy afterwards and has never been the same since.

lago

I had my BMX with 10 nodes on one side 4 on the other August 31st. After about a 1.5 weeks I was going places on my own but not driving because I didn't have enough range of motion. It's really the node removal that was more of an issue.

Losing the boobs wasn't great but mine were small so I didn't miss them as much as someone who had larger onese would. My shirts still fit the same. I still have tissue expanders so I can't tell you much about implants yet. I'm in the middle of chemo.

There are other treads that go into this more deeply.  Check out the threads here: http://community.breastcancer.org/forum/91

Beesie

Implants reconstruction is a good option if you are looking for something to fill your bra.  That was what I wanted.  I accepted that I was having a mastectomy (I had a single mastectomy) and I was losing my breast.  I wasn't looking to replace my breast, which was a good thing because the fact is that you can't replace your breasts.  Implants are not breasts; they are facsimiles of breasts.  There's no way around that.  They may look like breasts and they may fill your bra, but they are not breasts.  They don't feel like breasts, they don't move like breasts and they don't provide you with the feelings of breasts. Still, I'm happy that I had implant reconstruction because I like not having to bother with a prosthesis and I like having the same shape that I had before.

As for dealing with the loss, everyone is different. Some lucky women get through it without being impacted but a lot of women are more severely impacted that they ever expected.  The feeling of loss sometimes happens right after the mastectomy, but more often, it's months or years later that when this feeling really hits.  When you first have surgery, you're more likely to feel relief that the surgery is over and that it went well and that your cancer is removed.  Then you are busy dealing with treatments and reconstruction.  It's only when all that is done, and often it's only when you've lived with the "new you" for a while, that you suddenly realize that this is it - it's permanent.  The lack of feeling, the difference in how a hug feels, those strange breast contortions when you move your chest muscles, etc..  Yup, at some point most women (but not all) do feel the loss, some severely and some to a lesser extent.  After a period of sadness or mourning or even depression, most women get through it and come to accept their new body and just move on with life.

As for the surgery and the recovery, I felt great by the next day and was out taking walks 2 days after surgery. However with a mastectomy and implant reconstruction, your skin has been cut and your muscle has been cut.  It takes 6 weeks for an incision to regain 90% of it's original strength and for this reason, after any major surgery patients are given the "6 week rule" of no strenuous activity.  After a mastectomy, this means no heavy lifting, no reaching, etc., nothing that might stress the incisions.  As my plastic surgeon told me, even if I felt like I could do any of those things, don't do them.  The last thing you want to do is affect the healing of the incision.

Fearless_One

Harper, what do you mean your aunt "went crazy"?   Did she ever have reconstruction?   While this is a very personal decision and only one that you can make, I can tell you that many of the women here seem pleased with their results and seem to have gone about their lives.   I haven't had mine yet, but will be.  

I think as long as you have realistic expections - i.e. they will not look like your original breasts - you should be okay.   I would think recovery varies among individuals.

harper7777

She had a mental breakdown and no she didn't have the reconstruction.

Mina1

Hello Harper

I am in the same situation as you and am wondering what you decided to do and if you are happy?

Mina

harper7777

Mina1, I had a BMX just to be on the safe side. Because I had previous radiation on the right side, it did not expand like the left one. I've gotten the tissue expanders out, implants in and one is a size C and the other probably an A. Now the PS wants me to do a latisumus dorsal flap to correct this. I am once again, undecided. I hear it's a tough surgery and I've already been thru so much this year. I also had a hysterctomy 3 weeks ago, just as preventative of cancer popping up there. Sometimes, I second guess myself, but I had sooo many people say "cut them off" Good luck!

VJSL8

My concern with having another lumpectomy would be the amount of radiation. I was told that the radiation I received could possible cause another cancer later on--so do you would you have to have radiation again too? or would it be too much? I would talk to your radiation oncologist and get their opinion. 

Anonymous

Ladies, I found this article a few days ago.  I think some of you will find it interesting.  

 ------

Radiation Treatment for Breast Cancer Causes Cancer in the Other Breast

Young women who receive radiation treatment after breast cancer surgery are significantly more likely to later develop cancer in the other breast than women who did not undergo such radiation.

The findings come from a study, published online in the Journal of Clinical Oncology, on more than 7,000 women who were treated for breast cancer in Netherlands between the years of 1970 and 1986. All study participants were diagnosed with breast cancer before the age of 71.


Learn more: http://www.naturalnews.com/026257_cancer_radiation_treatment.html#ixzz1dBQgrqaf

morgaine109

Hi. This is Morgaine. I had DCIS in the left breast in 2006. I had 2 lumptectomies and 6 weeks of rads. I thought i was fine and then in 2007 they found more DCIS after another lumpectomy. Then my older sister was diagnosed with BC and she was a stage 3C, triple negative. That scared me. My aunt also passed away in 2006 from BC at 72. In late 2007, I had a mastectomy and SIEA flap to left breast. And yes, I am BRCA negative. 

My sister passed away in January 2011 from BC. It was really rough. Then, in September, they found DCIS in my right breast (this is a new cancer). I am having a mastectomy and flap surgery in january (haven't decided which one).

I am basically jumping for joy that I have an option and can do something about this. The way my sister died was horrible. Am I sad I'm losing another breast? Sure. Am I happy I'm alive? You betcha. 

If I could do it all over again, I would've gotten rid of both my breasts in 2006. I know this is really tough but try to take a long term view. 

LtotheK

My radiation oncologist said there is no comparison today with how they deliver the radiation--this study follows women from donkey's years ago. 

What would be helpful in this case is to post directly to the study they post on Natural News (with a very alarmist title, I might add).

Here is what I believe to be the original article:  http://jco.ascopubs.org/content/26/34/5561.full?sid=3f138e6e-e167-4def-8b51-63220c0ad00f

It states clearly that information is lacking on whether radiation from 1986 onward has the same implications.

The website is also full of other great articles on this topic.

KiwiDiana

Hi girls,

5 years ago I was diagnosed with DCIS in my righty (had been there 18 months at least) had CNB, 2X lumpectomy and eventually 1x quadrantectomy to get a decent clearance. 6 weeks of rads started 12 weeks later, scar revision two years later and all was good. 

4 weeks ago I found a small lump in my lefty at 6 o'clock  Am recovering from lumpectomy/SNB surgery as I type, and beginning of Feb will start rads. 

Was wondering who has had only 2 lymph nodes removed and if your arm was actually affected?

I'm thinking that because the nodes were the ones nearest the lump, which was low in my breast, and the lump is now gone, thus reducing the need for drainage from that area, that there shouldn't really be much of a problem?

Has anyone been here and can tell me how they got on?

My prognosis is really good  because I found it quite early. yay! I was quite terrified though up until yesterday.

Happy Holidays!

hrf

I'm also BRCA2+ ... same thing happened to me. Had bmx second time round. My breasts were NOT dense - very easy to read - but bc did not show on mammogram or on u/s.....don't count on those tests - they are not 100%. So if you are thinking that close monitoring will catch it early - don't. 

mikita5

Had bc in right breast, DCIS...BRCA1&2 Negative. Huge family history of bc. Mother died of ovarian cancer.  As soon as they said the word "cancer", I knew I'd have a bilat mx. .. Had it, pathology came back with 2 more DCIS spots in same breast.. Other breast  was ok... These other 2 spots didn't show up in mammo, so I agree with hrf.....don't  trust tests!  Had I stopped at the lumpectomy, I'd have been dealing with bc again soon because of the other 2 spots...

I had bilat mx, and immediate DIEP reconstruction... Do I miss my DD breasts? Yep!  But I'm glad I did what I did!  Would I do it again? Yep!! The DIEP reconstruction is as close as you'll get to the real things, but no one will ever measure up to what God gave us.

Go with your instincts and don't let anyone talk you out of it!

God bless you. You have a lot of decisions ahead of you.. Hugs coming your way!.

lizcarolan

I had DCIS in 1992. I just had 2B Cribiform in the opposite breast. Dense breasts, brca2+. I decided to have a BMX. I also went for implant reconstruction. It's a personal decision, but my only regret was in letting the PS talk me into implant reconstruction. But I also know women who are happy with their squishies. I HATE these TE's though. But always get a second opinion.

bdavis

HARPER...I was diagnosed a year ago, had lumpectomy and after chemo chose to skip rads and have a BMX and immediate DIEP/hip flap recon. I knew that the tests were inadequate and monitoring was not a good path for me. I knew I would worry too much. Here I am 5 months post BMX and my breasts look and feel natural... and are the same size as the originals, C/D. It was not without effort for sure. I travelled to New Orleans from New Jersey for the surgery, but thats what I wanted.. as I knew I did not want implants.

As for recurrance, my risk has dropped from 15% to 2% in left breast (cancer side) and reduced my risk of new cancer in either breast from 25% to 2%. I still have 14% chance of distant cancer, but the fact that I could reduce my risk that much, have peace of mind and hopefully put it behind me, is worth a million bucks. And after going through chemo, I do not want to spend another year of my life battling cancer.

It is a very personal choice, and doing your homework is important, but  if it were me, I'd have the MX.

Chevyboy

Harper....You said you had been taking Tamoxifen inbetween your cancers..... Did your docs ever say if both of your cancers were related?  I mean have you had the surgery yet? 

 I've been trying to find out if those of us on Tamoxifen, Femara or Arimidex have been diagnosed with cancer again.....and if it came back as the same type, or something different?

I would think having a mastectomy is assurance of cancer not coming back, but what about the other side?  And do you have to take Als anyway?  Are those just for breast cancer, or any kind?

So chemo is to kill any cancer cells....and the Tamoxifen binds to the estrogen to keep it from feeding any stray cancer cells......Femara and Arimidex stop your estrogen production.... But can you get a different type of  breast cancer the "next" time?

bdavis

Chevy... I would imagine the answer to that is yes, unfortuantely... One of the reasons I had a bilat MX... The Tamoxifen will only help with the estrogen...

mrsb45

Hi Harper,

I definitely know how difficult and personal this decision is and sometimes you just need someone else to tell you as my then 23 year old daughter told me. I had stage 1 , nodes neg in 2008 with 2 lumpectomies, 7 wks radiation and tamoxifen and was told less than 1 % of recurrane. well 10 mos. later local recurrance in same breast (4 small area's,  (don't understand why radiation didn't take care of these). Realized at this point this must be much more agressive than previously thought. I opted for BMX with reconstruction on left (modified radical with node dissection) and simple mastectomy on right with implant.. The right was totally neg of any disease by US and MRI but path report post op showed already had ADH, so already producing abnormal cells. Eventually trying to decide on chemo my oncotype was high at 39 so I know I made the right decision. I'll admit that not a day goes by that I don't miss having my own breast but also every day I'm so thankful to be alive and almost 3 yrs now free of BC and on Arimidex .. This disease  has soo many variables that I feel you just have to do as much as you can because all the stats etc is just a guessing game. Good luck with everything and your decision but I think you will not regret having BMX and constantly worrying... Also 2nd local recurrance came back triple neg as 1st  time was er/pr + her 2 neg, so was a much more aggressive cancer.

bdavis

Mrs B... doesn't that mean it was a second primary, and not a recurrance per se?? If it were a recurrance it would have the same characteristics.... no?

Chevyboy

I found another thread on here, talking about cancer after Tamoxifen!   That's what I've been trying to find out, about how much the Als help us....or not.  

After reading all the stories, it seems like our Docs can't determine that we will not get cancer again, even by taking Tamoxifen.  But that is the only thing they can prescribe after our chemo or radiation.   There ARE a lot of women who have had cancer again after their med treatment ended. 

So bdavis, if you DO have a "recurrence" that would mean that it was related to the first?  If it had the same ER & PR characteristics? 

I just want to make sure I made the right decision in stopping the Tamoxifen after 14 months.  I lost my hearing, and told my Onco that I wouldn't be trying any more drugs.... 

I've been thinking of trying something else, but the SE's are just brutal for someone my age.  Also, I want to believe that I had the type of cancer that would not come back...that they got it all, with the clear nodes.....and radiation.

bdavis

Chevy... Obviously I am not a doctor, but my understanding is that you got a ER+ cancer. You had clean nodes, had radiation as well... That SHOULD have resolved all local recurrance or new cancer that might have been lurking at that site... BUT there is always the worry that even with node negative that a cell might have escaped your breast. If you had had chemo that is one safeguard against those cells... Tamoxifen is another. Tamoxifen basically starves that cell that was ER+ and it eventually dies (hence the 5 years of T)... Tamoxifen would also protect against any new ER+ cancers in the other breast... but it would do nothing for a triple negative cancer for example. A recurrance is the return of the original cancer, with the same characteristics... If a woman were to get a cancer in the same breast but with different traits, it would not be considered a recurrance, but rather a new primary. Of course, in general speaking, women may say they got a recurrance when in fact they had an all new cancer.

mrsb45

B Davis,

My Onc told me you can never be sure if radiation or AI's work for everybody. my 1st Cancer was er+ with low pr receptors and also her 2 neg and in the exact same spot so she called it a local recurrance,, It came back the same in the path report but the oncotype called it neg for er/pr receptors. They met with a team and felt I should still take Arimidex as onco test might not have been as accurate as the original path report. i guess I have to have faith that their recommendations are trying to give me the best odds that this crap won't come back.. I never had any risk factors to get this in the 1st place, got period at 15, had children before 28, breast fed them, jogged (ran 1/2 marathons + marathon), ate healthy, mother 83 and older sister 57 no Bc so who really knows ??

bdavis

IMO, taking the Al can't hurt as you did have an ER + cancer, even though it wasn't the most recent cancer... I guess though keep an open mind that it may be a second primary... not that you would do anything different... And now you have had the BMX too... Interesting thing... you had ADH in the other breast... I have been told by my MO that Tamoxifen takes care of ADH as well, while he was encouraging me to just have lump/rads, and I wanted BMX... I have heard some women don't metabolize Tamoxifen well, so maybe that is your problem... there is a test to see how well these hormone drugs work, although my MO won't give it to me ... says thatrecent studies show they are reliable...