Decisions! Decisions! Help!

susie_2017

I'm 44 and just diagnosed with IDC.  I'm stage 1, grade 3.  Here is my dilemma.  The cancer is in the RIGHT breast.   However, the MRI showed 3 spots in the LEFT breast they wanted to do biopsies on.  I went in for US and they were unable to locate those 3 areas.  So a MRI with biopsies was ordered( this was all being done by the hospital's women center and no doctor was making these decisions). I had an appointment with a breast surgeon 3 days before that MRI with biopsies was scheduled and she said not to worry about left breast it was "an overkill on their part".  So I didn't go to that MRI appointment. I did the gene testing and it came back negative.  The doc said if it was positive I would need a bilateral mastectomy but if negative the lumpectomy would be sufficient.  Therefore, if my chances of it reoccurring are the same with both surgeries why would a mastectomy be the preferred surgery if gene was positive?  It must have a better outcome over lumpectomies. She feels a lumpectomy followed by radiation and Tamoxifen would be my cure.  The oncologist agrees with her.   I'm torn about just letting the left breast go and do the watch and wait route.  My fear is because my aunt had breast cancer in 1992 at the age of 35 and then reoccurred in 2002 that spread to her bones and brain killing her at 45 years old.    I feel as if the mastectomy on both breast is what I want to do.  I feel as if I'm going against what the doc wants me to do. 

What did you do? Am I being drastic by doing bilateral mastectomy?

gb2115

if the gene had been positive your likelihood of cancer in the other breast soars quite a bit, that's why they choose mastectomy a lot over lumpectomy. Without a gene defect, yeah I think rates are close between mastectomy and lumpectomy plus rads. Having a mastectomy doesn't always mean you avoid rads either.

I had a close family history (mom with same type of cancer) but BRCA negative. I chose lumpectomy without hesitation, realizing there is no guarantee, but if I would have been BRCA positive I don't know.

ElaineTherese

gb2115 is right -- women who are BRCA+ are at a higher risk for contralateral breast cancer. If I had been BRCA+, I would have gone for the double mastectomy and would have had my ovaries removed (higher risk for ovarian cancer, too). But, I am not. So, even though I was diagnosed at Stage IIIA with an aggressive form of cancer (Grade 3, triple positive), I chose a lumpectomy. I didn't want reconstruction (often requires multiple surgeries) and I wanted to keep my real breasts (have more sensation than implants). If the cancer comes back later, I can always take them off. But, once your real breasts are gone, they are gone.

I don't really mind the mammograms every six months, but that's me. I know that many women get scanxiety and that having a double mastectomy gives them peace of mind. If that's you, it's definitely a consideration. Best wishes!