New here with some questions re. treatment decisions

wyllikers

Hello, everyone.  I'm an unwilling new member of the club, but happy to see that there are other people willing to share their stories and opinions.  I am 43 years old (premenopausal) with three children: 11yo son, 7yo son, 3yo daughter).  I have been a stay-at-home mom since my first child was born.  I was divorced last year (unexpected), so I had to decide how to raise my kids without any current marketable skills and no higher education.  I do receive child support and alimony (still at poverty level, but get by) and I am a full-time online college student seeking my Bachelor of Science degree in Computer Science.  According to my planned timeline, my daughter will start full day school a few months after I complete my degree and my alimony ends.  That will give me a few months to find a good job!

My timeline has now changed.  I have no health insurance, so when I found a lump in my breast a few months ago, I waited to see if it was just swelling that coincided with my monthly cycle.  It wasn't.  My lovely, wonderful GYN that I have known for 10 years, gave me a cash discount so I could have a clinical exam.  She easily felt my lump, along with some other suspicious spots.  The next day, she sent me to the hospital for my first-ever mammogram.  I had two that day, along with an ultrasound and a core biopsy.  I had to pay all of my rent money to get it done, but I'm so glad I did.  The next day, the radiologist called to inform me it was grade 2 IDC, ER+/PR+/HER2-.  Last week, I met with a breast surgeon and we discussed options.  I am opting for a bilateral mastectomy (too much to do with what time I have left to be stressing about these stupid boobs all the time!).  The BS recommended Tamoxifen until I told her about a blood clotting disorder I have.  So, Tamoxifen is off the table.  I'm opting to have both ovaries removed.  I'm unsure about taking AI afterwards because of the side effects.  I need my full cognitive ability to finish school and support my children!  I don't know how much difference AI would make.  I'm sure a MO will have some input.

I'm waiting to see if I will be approved for Medicaid so I can begin treatment, schedule surgery, etc.  Another two weeks of waiting, probably.  I did decide against having an MRI pre-surgery since I'm already having a BMX.  If I chose to have it, it would add another two weeks for Medicaid approval, provided they will pay for any of it anyway.  Originally, the radiologist said he didn't think chemo would be recommended, then changed his mind.  The BS said she didn't think I would be recommended for chemo, but I think until the Onco test, the BRCA1 and BRCA2 tests, and my surgery pathology reports are back, it's up in the air.

If chemo is recommended, I'll have to take off fall semester of school because I doubt I'll have enough brain power to get through Calculus II and Physics.  Putting off school for a semester is doable, but not preferable.  Beyond that, though, I am more concerned about hormone therapy lasting for several years with the possible cognitive side effects.  How will I possible be able to finish school and get a decent job?  Losing my breasts is the least of my concerns, oddly enough.  I'll have tissue expanders, probably, then implants.  I wanted autologous reconstruction, but again that blood clotting disorder leaves me out of that camp.  I'm not worried about losing my hair if I have chemo.  It's just hair.  They are just boobs.  They did their job when I needed them; I nursed all three of my children.  Now they are rebelling, so they have to go.  No more kids coming, so I'm fine with the loss of fertility.  What I am MOST concerned with is losing my memory, my ability to do math quickly in my head (or at all!), and being able to care for my kids.

How realistic are the long-term "brain fog" chances with AI?

Moderators

Hi Wyllikers and Welcome to BCO!

We're sorry you have to be here, but really glad you found us. You'll find this community an amazing place for support, knowledge and great advice!

You may want to also post your question in the Hormonal Therapy forum to better reach others who are experiencing or have experienced side effects with AIs.

In addition, there may be some helpful information for you on the main Breastcancer.org site's pages on Help for People Without Heath Insurance.

Hope this helps!

--The Mods