Simple mastectomy for More than one DCIS

Alfieval

Hi I have just been told by my Breast Surgeon that I Need simple mastectomy for more than one DCIC. This is not what is worrying me as I am 71 but he wants me to have SNB as well and this can cause under arm problems. I don't understand it's a DCIS but he insists

juneping

i would ask for a second opinion and you can suggest do the MX first to see if any tissue turned cancerous then do the SNB. just because it's convenient for the surgeon to do everything all at once doesn't mean its the way you should follow.

SpecialK

Once a mastectomy is completed you cannot go back and do the SNB unless you have already been injected with the dye/tracer - it requires breast tissue to travel to the nodes.  You can request to have the dye injected, remove the breast tissue and do the pathology to check for any invasive component, but not remove any nodes.  If an invasive component is discovered in post-operative pathology you can then go back and do the SNB surgery - the nodes should still be blue and/or radioactive, but not for very long. Just wanted to point out that while handling things this way does preserve your axilla if there is no invasive component, should you have to go back to surgery it means being anesthetized again and another having another surgery in pretty short order.

Ariom

Alfieval, I was in the same situation. I was having a Mx and my Surgeon explained to me that "He couldn't, in good conscience, not perform a SNB at that time!" If I was having  a Lumpectomy it would not have been required, just as SpecialK explained above.

Although, it wasn't expected, I could have had an invasive component, and that would have meant going back in and doing an axillary clearance, which was the last thing I wanted to happen.  

The method of doing the tracer and the dye for the SNB without excising the sentinal node is a fairly new thing, which I believe was done for Angelina when she had her BMX. I don't have any idea if it is a procedure that is widely done yet, but I would definitely ask.

I understand your fear of LE, I am very aware of the consequences, my Mother had a Mx and Axillary Clearance in '94, before the SNB was available. She didn't have any invasion, but she did have LE for the rest of her life.

I decided to take the risk, with the SNB, I was lucky, there weren't any surprises. I now take the precautions to avoid LE. I know the risk is small, but it is still a risk.

 

Radical2Squared

I had IDC in both breasts and they were small tumors. My bs did a SNB before my mastectomy as a separate surgery. She took 2 nodes from the right and one from the left. She showed me the data on people suffering from lymphedema after SNB compared to those who need all nodes removed and I felt pretty safe.

Since they found no cancer in the nodes, there was no need to remove the rest during my mastectomy and they could easily stage my cancer. Of course, then they told me triple negative bc has a habit of popping up where it's not supposed to even without traveling the nodes so I'm set to get chemo anyway!

I did have a tiny bit of nerve damage after the SNB on the left...like diabetic nerve pain...but it was gone before my mastectomy. I'd do the SNB. I can't imagine anything worse than needing to be opened up to remove nodes AFTER the mastectomy! (Ok, I can imagine worse, but it wouldn't be related to lymph nodes.)

Alfieval

thank you Ariom I'm also concerned about cording, this can also happen after snb?

Annette47

Yes, cording can happen after snb.   I had some - it started about 6 weeks post surgery and lasted for a couple months.  I just did lots of gentle stretching and it resolved on it's own.   So far at least (knock wood) I have not had any lymphedema issues.

Alfieval

Thanks for your helpful reply Radical2Squ  I am also concerned about cording after sn

Alfieval

thanks Annette  That's a lot to go through off a DCIS

Alfieval

thanks juneping. Sounds like a good idea but what is MX please

SpecialK

MX - mastectomy, BMX - bi-lateral mastectomy

Radical2Squared

Alfieval,

For more abbreviations (my head still spins over the ones I'm not familiar with) scroll up to the top of the page. Under the menu on the left where you can click on you fave topics etc...there is a link for common abbreviations. I just check that when I see one I don't know...and it happens to me a lot!

Kicks

Alfieval -

UMX - unilateral mastectomy/single mastectomy

I did not deal with DCIS so have no experiemce with it to comment from.  Though I have no info to back up this thought, as you say you have more than one DCIS site, it would seem logical, to me, that SNB would be in order to be sure.  Also sometimes the post op path report changes the final DX from the original DX.

LE (lymphedema) can happen after any surgery rather or not nodes are removed.  Some with many nodes removed never develope it, some with none or just one or two removrd develope it.  There is no way to be sure how our body will react.  (I have a friend who deals with fairly major LE issues in her leg - she only had minor, non-invasive knee surgery.)  Certainly no one ever wants to develope LE but IF it does it is handleable/manageable.  Yes, it can be 'inconvient' to deal with it but quite doable with knowledge and 'tools'.  I'm not far from you agewise - I'll be 68 next month and have been dealing with LE for a bit over 4 years and I can assure you, it does not slow me down or keep me from doing whatever I want to.  I am a very active outdoor woman,  I ride (care for) my horses, bicycle, garden, mow with my push mower, fishing, boating - all of these I have done "forever".  Since LE, I have taken up flyfishing (tie my own flies, build my own rods), took classes in flint knapping and Woodfellow carving (got a lot of practice to do with those).  This summer, my new project is kyaking.  I know that most do not want to do what I love doing and that's as it should be, but rather to show that IF LE does ever develope - it isn't the end of life as lived at all.