Newly DX IDC 1cm, positive node and ER +,PR+,and Her2 +

naiviv

Hi, the info above us what I know from core biopsy and MRI. A second area seen in MRI and biopsied was neg. I am 52 and still have regular monthly periods.

This is all on left side, right is ok.

I have seen 1 surgeon who recommended Lumpectomy with rad and chemo, my primary thinks I should have mastectomy because of lymph node,saw a plastics who told me about nipple sparing mastectomy with reconstruction after treatment finishes. Sounded doable to me. Saw 2nd surgeon said good candidate for nipple sparing and explained risks.

Met chemo DR recommends AC 4 rounds every 2 weeks, then 16 weekly rounds of TH then complete a year of H but don't remember if weekly or longer. Then tamoxifen.He does not like nipple sparing, says not enough data. I don't see radiologist until 8/5 to see what she will recommend. I go back to first surgeon tomorrow,

I've been reading a bit here and chemo and rad seem to be pretty much standard treatment. Surgical decisions I know are very personal. I have been told prognosis same for mast or lump, reoccurrence is 2% more in affected breast and 5% in healthy breast?

I want to reduce risks as much as possible , but the idea of bi lat mast terrifies me without nipple sparing.

Would appreciate any thoughts or comments.

I am seeing what is considered the top breast Drs in Miami.

Thanks

Obxflygirl1

So sorry you have joined our group but we are here for you.  I also was given choice of lumpectomy or Mast.  I chose Bi-Lat. Mast.  It's a personal choice but I just didn't want to worry about the other shoe dropping on the healthy breast.  Plus, I didn't want to go through Mammograms and the waiting for results every 6 months which is  recommended by most physicians after BC diagnosis.  This just felt right for me. I'm a worrier anyway.

I had implant reconstruction and am very happy with it.  I also have recon. nipples and will get the 3-D tattoos in September.  The downside to Bi MX is that I have no feeling in my breasts at all.    I think that's one of the major complaints when they take everything.  It has taken some getting use to but I still would do it all over again.  My new girls are perky, look good and I don't have to wear a bra if I chose not to.  The scars are nothing like I thought they would be and are hardly noticeable now.  Plastic surgery has come a long way.  There are also other choices besides implants if you decide to do the MX. 

My girlfriend had a lumpectomy and she's fine with that.  Again, it's a personal choice but you are doing the right thing by asking for other's thoughts.  I did the same before I made my decision.

good luck and PM me if you have any other questions about my surgery.  I'm glad to help if I can. I'm sure others will also respond for you on this board.

rozem

mastectomy recommended because of lymph node involvement?  never heard of this...did the doctor explain the reasoning behind this?

as for nipple sparring - my surgeon wont do them, but lots will, i think its comfort level.  Even if you keep them they arent "functional" - but if you feel strongly about it then find a surgeon that will do them (as long as your tumor is idealy situated)

as for chemo for her2 -standard of care is AC-TH or TCH

for more info and great advice visit the triple positive thread on the her2 positive forum

naiviv

Thanks for info.

I would really like to attempt a nipple sparing. But concern is over my breast size and nipple survival. I am a 38 DD.

Plan is lumpectomy with reduction lift to make breast smaller and give nipples time to adjust to different blood flow. Plus the node dissection.

Then chemo, then radiation if more than 3 nodes positive , then have mastectomy keeping nipples.

The surgeon I saw is leaving so I will be seeing a partner so that the same surgeon can do all surgeries.

Knowing that I have a plan for surgery seems to have made clearer.

Still a lot of unknowns but not as afraid.

Best to all

Vivian