Advice needed after biopsy

Pasomom

I just had a wire guided biopsy on two birad 4 growths located in two ducts of my right breast a couple days ago. As I wait for results, I am trying to prepare myself for the next meeting with my surgeon. I have extremely dense breasts, which will cause issues of finding new growths later on down the road and a family history of bc, all of whom were very young (30-45). We just recently lost a cousin at 38.

I am only 31, with 4 beautiful healthy kids and our family planning is done. I am prepared to do whatever it takes to kick cancers ass if it turns out malignant, but My question is this: I briefly touched on prophylactic mastectomy with my surgeon before the biopsy, is this something that I am justified to pursue in the event of benign results?

MelissaDallas

I think you should have genetic counseling before you consider it. Even if your mom was BRCA (or other gene) positive you would only stand a 50% chance of inheriting the gene. Of course this all goes back to your biopsy results too.

mustlovepoodles

I think you're getting the cart waaaaaay before the horse here. 80% of BIRADs 4 is negative, so your chances are very good that this is negative. Since you have a strong family history of pre-menopausal breast cancer, I would beg you to get genetic counseling, and go for the expanded test. There are other gene mutations than BRCA.

I have a terrible family history, 32 cases of various cancers in just the 1st & 2nd generations. Five cases of breast cancer, including one at age 24! There are seven people in my family, 5 of us have had cancer--1 sister w/BC & uterine, another sister w/uterine. So, my risks were already greater than average. My breast surgeon recommended that I get tested. The genetic counselor actually offered me two tests. One was a 5 gene test, which included the BRCA genes. She could get this test back in about 7-10 days. She also offered me an expanded test, which tested for about 20 or so genes. Those test results would take about a month. So I did both. When the initial test came back negative for BRCA we celebrated. I had my lumpectomies.

Then the other shoe dropped...it turned out that I have TWO serious gene mutations, PALB2 (the pathway to BRCA 2) and Chek2. My genetics counselor estimated that my actual risk was closer to 45% or more. Had I know all that 1) I would have gotten better surveillance, for sure, and 2) I would have gone straight for the bilateral mastectomies. Ultimately, my oncologist and breast surgeons strongly recommended the BMX because of the gene mutations.

I am not in any way trying to influence any decision you might make. I just want to soothe and encourage you--don't take on this fear and grief unless you have to. Don't waste precious weeks of your children's lives grieving and worrying. If your lump turns our negative (and it very well may be negative), then get genetics testing so you can learn more and make a treatment plan for the future. If your lump turns out to be positive, well then, it does. And THEN you'll grieve. And be upset, anxious, and fearful. But don't jump the gun on that.

As far as choosing between LX and BMX, that's an individual choice. For the average woman with no risk factors, LX has been shown to have equal long-term outcomes, is a safer procedure, and results in less down-time and physical changes. I can tell you from my own experience, my lumpectomies were a walk in the park compared with what I have experienced with my mastectomies. It's an extreme measure and once it's done, there's no going back. Reconstruction will not give you back your real boobs. They will not look, nor feel the same. In fact, they will probably be numb for a very long time, probably permanently. Believe me, you don't want to go there unless you absolutely have to. And right now, you don't have to.

Best of luck to you. The waiting game is awful. I hope your lump is negative and you can get on with your life.

Pasomom

thank you for the quick response. The waiting game sure is awful. The surgeon did remove both growths completely during the biopsy so I am hoping for clear margins there. I have discussed genetic testing with my doctor, this is something I will pursue pending results. I was not aware of the PALB2 and Chek2 testing.

I am just trying to get all my questions ready before I meet with my doctor next week, as I felt I left my last appointment with lots of unanswered (on my part).

I hear from so many friends/family the 'if I knew then what I know now' and am in the gathering of as much info as possible stage.

Dearjaimee

I feel like I can relate to your situation and am (sort of) in your shoes. Although I do not have family history of breast cancer, my dad and his dad both passed away from cancer. I actually just had my 2nd wire guided excisional biopsy in 9 months, the first surgery showed ADH and radial scar; I'll get the results from today's surgery by Tuesday.

Even though I don't have family history, because of my history with ADH and radial scar, my surgeon told me I have 42% lifetime risk of developing breast cancer. I'm only 25, have been married for 2 years this September, and we have no had any children yet. I'm wondering if a prophylactic bilateral mastectomy would be a smart move to make soon before having kids so I can nip this in the bud and never have to worry about it again.

At this rate, I'm not looking forward for a new mass to pop up on my 6 month post op scans that are just going to lead to surgery soon there after.

Best of luck to you dear