Need help thinking through prophy on my good side

sunshinegal

Hi ladies,

I haven't been on this forum much in recent months. Life has been very good to me since my mx/reconstruction -- I had a baby boy in April of this year and enjoyed 4 months of maternity leave breastfeeding him on my good/remaining side.

My plan has always been to get a reduction/lift on my good side after we're done having kids (this is #1 and we want at least one more). But I just got off the phone with my sister, who is on a 6 month rotating mammo/MRI schedule because she has two 1st degree relatives who have had BC (me and our mom). A calc showed up near her chest wall this time and her docs are recommending either Tamoxifen or prophy mx!

It has kind of floored me and has made me wonder if I am being too laissez-faire about my good side. I haven't had a mammo or MRI on it in nearly two years because I was pregnant last year, and I'm breastfeeding this year. My surgeon was pretty casual about the whole thing, saying images are hard to read in a lactating woman and to make an appointment whenever I finish breastfeeding. I had a rough start to breastfeeding but it's going well now and I'd like to keep it up for a year if I can.

It seems like my sister's doctors are way more vigilant/concerned about her than my surgeon is about me, and I wonder if I've gotten lulled into a false sense of security as a result. My sis reminded me that a close family friend died of BC a few years ago after her docs pooh poohed the lump she found while breastfeeding. She didn't get it checked out til months later and by then it had spread.

I guess my question is... if you were me, would you be thinking about doing a prophy mx on your good side? Should I forget this nice breastfeeding thing to ensure that I won't have to face another dx?

(And/or do you think I'm overreacting?)

Beesie

Honestly, right now I think you are overreacting.  It's not that a PMX isn't the right decision for many women - and maybe it does turn out to be the right decision for you - but right now you are thinking about it only because your sister has some calcifications. So by definition that says that you are reacting to something that's happened.  It's a reaction.  And since it appears that you were never overly worried before and never considered a PMX before, that would suggest that for you, this is an over-reaction.  If you'd always wondered about whether or not to do the PMX, that would be different. But if the idea is occurring to you only because of something that's happened to someone else..... in my books, that's an overreaction.  Or maybe it's more appropriate to say that this is a knee-jerk reaction.

It could be that a PMX is the right decision for you, but please don't do it because of a sudden fear or concern. Take your time and really think it through. Understand your risk, understand the impact to your life and your life plans, weigh the pros and cons and make a well-thought out decision.  And don't do it - or not do it - because of what someone else says they would do in your situation.  We all look at risk differently and we all deal with risk differently and we all have different priorities.  What I would do in your situation has no relevance to what you should do.  Only you can figure out what you should do.

It happens that I just responded to a post in a thread asking about contralateral risk. Take a read through this thread:  Topic: Chances of getting cancer in healthy breast not removed? 

And if you decide to not have the PMX, be sure to get back to a regular screening schedule. Having had BC one time, and with your mother having had BC, you are high risk.  That doesn't necessarily mean that your risk level is so high that you need to have a PMX (only you can know what risk level you can live with) but if it should happen that you are diagnosed again, you want to do everything you can to ensure that the BC is caught at the earliest possible stage. 

sunshinegal

Beesie,

Thank you so much for your reply! Now that a few weeks have passed, I have a bit more perspective. And, actually, I am beginning to consider PMX. Not in a panicked, reactionary way, but in a more measured, considered way. I have an appointment with my surgeon in two weeks and I'll begin the conversation with him. Lots to consider, but the bottom line is that now that I have a child, I am less willing to take a risk that I was okay taking before he was born. I'm not sure I would be able to forgive myself if I got a new primary on the good side, knowing that I didn't do everything possible to prevent another cancer dx. Still mulling it over...

LAstar

An MRI or ultrasound might provide useful information without affecting your ability to breastfeed.  If there is no need to rush this decision and you can nurse another year, it might be nice to wait.  I had PMX, and I am happy with my decision.  

sunshinegal

Thank you, LAstar! I will ask my surgeon about this on Nov 2. For some reason he has seemed reluctant to do MRI or ultrasound when I've asked about it in the past.