What would you do? New primary in opposite breast

gerrib

Hello

I had SNB, lumpectomy and radiation and Tamoxifen for IDC in L breast in 2012. Today I found out I have ILC ( estimated size 2.4 cm) in the other breast. The surgeon has given me the option of lumpectomy UMX or BMX.

I have CT scan to look for secondaries tomorrow so I guess I will need to wait for those results. There is no sign of lymph node involvement on mammo and ultrasound but I know that is not conclusive.

I am 65 and live alone in a rural area. I would prefer to just do SNB and lumpectomy again for ease of recovery and non-disfigurement. Has anyone had a lumpectomy in each breast?

Gerri

KBeee

You certainly can have a lumpectomy if it'd ease your healing concerns. I would consider genetic testing to see if there is a genetic reason that increases your risk of this cancer; there often is when it comes back like that. If so, then you might consider BMX. If not and it was just bad luck, then go with lumpectomy. Talk over all of your concerns with your doctor and perhaps get more than one opinion. Sorry you're dealing with this again. Best wishes.

momof2doxies

After my second primary tumor, I chose a BMX...1) I would not have to endure the stress of mammograms 2) I was allowed to skip more radiation. My PS was able to place implants even on the side that had gotten rads from the first lumpectomy. Now after 2 1/2 years I still feel I made the right decision. The second tumor was triple negative and I did not find that out until the oncotype test was completed. Best wishes on your decision.

etnasgrl

When I was going through radiation, I met a woman who was dealing with a new primary in the opposite breast.
She opted for another lumpectomy and then radiation.

If your doctor says having a lumpectomy again is okay, go for it! It's absolutely easier to recover from than a mastectomy! If I had to face what you're going through, I would also choose to have another lumpectomy.

BookWoman

I am one who had lumpectomy on both breasts. DCIS in 2010 and tubular carcinoma in 2012. I did have genetic testing and they didn't find any genetic reason, so I didn't see any need to have a mastectomy. Radiation was really not that bad for me, just a pain going every dayMy recovery time for lumpectomy was only a few days--I'm sure mastectomy would have been a lot longer.

gerrib

Thanks for all your replies. It is really helpful. The CT scan results were all clear so that is good. I'm now worrying about my path report of biopsy which says infiltrating carcinoma with features favouring pleomorphic lobular carcinoma. Apparently pleomorphic is aggressive. I haven't got the histology back yet so don't know what grade. I'm still undecided about what type of surgery to have. See BS tomorrow.

5graces

Yes I have had lumpectomy in both breasts, at the recomendation of my surgeon.

Molly50

If I had a second primary, especially ILC which is hard to find on imaging, I would opt for BMX. You can choose not to reconstruct. If you are alone or have limited help then maybe lumpectomy is the way to go for you. BMX would be a big surgery to recover from.

gerrib

I have decided to have breast MRI to determine more accurate tumour size and to see if there are any other hot spots. In Australia breast MRI is not Medicare rebatable unless you have 1st degree relatives who have had BC and I think there are a few other rebatable situations. So I will be paying AUD$600, but I consider it worth it if it gives me more information.

Deebo

I was diagnosed with a new primary cancer in my other breast. I had a double mastectomy and could not be happier with my results. No going back for mammograms. The surgery was not too bad at all. The most uncomfortable part was having drains for a couple weeks. The pain from the mastectomy was by far much easier to deal with than the burns from the radiation. I figured no radiation, my prosthetic breasts match and I can take them off at the end of the day. With my lumpectomy I was always checking my breasts and always worried. My dr said I will still go in yearly for a manual exam. FYI: I also had a MRI and I had new calcifications in my right breast. Instead of getting more biopsies and having to watch them this was what prompted me to have both breasts removed. I don't regret it not even a little bit.

YATCOMW

I will tell you that my ILC was not seen on a mammogram or sonogram.....I felt a hard spot and insisted to still have a biopsy done.

There were no palpable nodes either.

The ILC was pleomorphic and 8cm.... I also had 17 nodes positive. ILC may be a game changer for you as it is very difficult to get imaging that is accurate. Be prepared for a lumpectomy but know that it may be larger than you expected and may go with a different choice.

Jacqueline

gerrib

Thanks J. I had breast MRI yesterday and will get results tomorrow, so hopefully I can make my decision re surgery tomorrow too.

KBeee

Keep us posted!

gerrib

Hi,

i have decided on a UMX next Wed. The MRI indicated 2 areas, one which has been biopsied as pleomorphic ILC (~2.4cm). The other area nearby is smaller and BIRADS 5. I could have had another core Bx but decided after reading all the posts about ILC to have UMX. I wanted to have BMX but would have had to wait for a month so have decided to have one at a time removed. I'm not having reconstruction. My other breast where I have had Lx and Rx for IDC appeared clear but I will probably have it removed later.

KBeee

Sounds like a good plan!

bluepearl

I Had IDC in both breasts, two years apart. Chose mastectomy again. Discussed lumpectomy but doctor said it seems I have "active" breast tissue sp decided to part with them. That said, lumpectomy + radiation confers better survival but only if you do not test + for genetics. However, I rather think there are genetics that aren't tested yet so I played it safe...well as safe as I could I guess.

DianaOl

Good luck, gerrib. I chose bmx (dec 2015) this time around after dcis on left in 2013 (lumpectomy with rads then) and her2+ stage 1 no nodes on right this time. I am very satisfied with my decision, had 4 months during neo adj chemo and herceptin to research and think about it. I made absolutely the right choice for me and have no regrets at all...would do it again. No RC and best decision for me. PM me anytime.

lucypringle

In less than 2 years I now have infiltrating ductal carcinoma of the left breast. 2014 June I has DCIS stage zero. I had radiation and opted not to have the hormonal treatment. Now I have this dx and the tumor is0.4cm, Grade 2 of 3,nuclear grade 1/3,miotic index l/lll. There is associated DCIS small amount of low grade1 nuclei predominantly cribiformDCIS. KI-67 HIGH PROLIFERATE rate 26%3+ intensity. HER-2byIHC negative 1+staining. HER-2 by FISH pending. I am thinking about a BMX. I am 68 and I would not need reconstruction. I have had a Mamogram,MRI, 2 US and a US guided needle bx. can someone help explain this to me.

Moderators

lucypringle, first, welcome to the community, and glad you found us. Tell us what your doctor recommends for you? Are you needing more explanations about your diagnosis, or treatment options?

gerrib

Hi Lucy. I have recently been through a similar situation after 4 years. I am 65 years old. Your tumour is very small 0.4cm. So you probably could well have another lumpectomy and radiation providing that is an option put to you by your doctor.

i wanted a bmx but would have had to wait 4 weeks and was able to have umx in a few days time. I had the operation on 13/3. After all the tests repeat mammo and ultrasound, biopsy, full body CT scan, MRI at my own expense I was really 'over it'. the MRI showed a another area in the same breast which was highly suspicious of cancer. i was too impatient to have another biopsy and rushed into umx. As it turned out pathology after surgery showed that the second spot on the MRI was a false positive so I could have had a lumpectomy.

i have recovered from the surgery really well. It's now 3 weeks. i Have some lingering thoughts that I wish I had not had the umx, but on the other hand i probably would have worried about reoccurrence in the breast that I had removed and I do not have to undergo 6 weeks of radiation. I am not having reconstruction. I probably won't go back and have the other side removed.

I'm sorry I haven't really answered your questions about your pathology results. it looks OK. I had a very high Ki67 result on biopsy (60%) but the surgeon said he didn't believe it.

It's a pain to get BC a second time. Life is too short at my age!

MameMe

I had a new primary in left breast 9 years after a first primary on the right. Both times I went for lumpectomy and radiation, as I so wanted to get on with things and not be at risk of major surgical problems or the whole reconstruction process. As it turned out, less than 2 years later, I had vision problems in my left eye, which was dx'd as mets. Scans galore found scattered, low volume mets in chest, lungs and bones as well. Go figure. I would be inclined to do what I did again, simply because they can't tell where the mets came from or what my response to tx will be. I am doing well and its been 2 years. Most of my choices center around quality of life and preserving vision. So far, so good.

Thanks for starting this thread, gerri. I wondered about how other people with two primaries fared. Best of luck with healing

Valz

I just read your initial post. Yes, I had IDC in R breast in 2001 and then ILC in 2013 in R breast. I did lumpectomy, sentinel node removal, and radiation. Unfortunately, in 2015 it metasticized.

Valz

YATC, hmmm, wish I had known this. I would have had a mastectomy instead of lumpectomy. They had a really difficult time finding the IL cancer the third time. Would not show up on mammogram or MRI. Finally located on ultrasound. Ended up being metastatic, making this my third BC.

Blinkie

In 2007 I had a lumpectomy (right breast) and radiation for DCIS. They recommended tamoxifen which I did not take because of the stroke risk. I have three family members who have had strokes.

This summer (2016) I had another lumpectomy (left breast) and radiation. With the second diagnosis, everything went quickly - annual mammogram showed a problem and so the further testing and biopsy were done the same afternoon. The biopsy showed DCIS. However, after surgery the diagnosis was changed to Invasive Ductal Carcinoma Stage 1.

On the left is a scar above the nipple that curves down and on the right one above that curves up, so I'm a bit like one of those Tragedy/Comedy masks. & like the mask sometimes I feel tragic and sometimes I laugh.

After the treatment for DCIS in 2007, I went for all the appointments, mammograms, etc. I didn't think about cancer, didn't worry about it. I continued to have an annual exam, and to have it at the regional clinic that has a breast cancer center. Even though it is an hour away from my home, it meant that when the news was not good, I was with staff people I already knew and I didn't have to wait for the biopsy, etc.

Also, this year, when I went for the mammogram, I asked my husband to come with me, which I usually didn't do. It was good to have someone with me and was great to not be alone on the drive home.

Now, with this new bout, I am not able to ignore my experience. I do not regret choosing lumpectomy again, but I know that 'next time' it will not be an option. I already know that I will not do reconstruction - I want to avoid as many surgeries as I can plus I have been so flat chested all my life that I'm not concerned about being flatter.

I sure appreciate everyone being willing to share their experiences.