BMX vs 2nd Re-Excision (stage 1)-cannot make a decision

red332

I am stage 1, node-negative, Triple Positive. Had a lumpectomy, with two margins not clear (DCIS only). After second excision had 1 margin still not clear (again DCIS only). Have moved on to chemotherapy (12x weekly taxol/herceptin), after which time I need to decide whether to attempt another excision or have a mastectomy. Would do bilateral mastectomy with implants. Doctors all say no difference in survival statistics, and a small decrease in recurrence risk (5% vs. 2% with mastectomy, 3% to 2% in the contralateral breast). These statistics seem very generalized...hard to know how they apply exactly to my type of cancer. Also, does the relatively diffuse DCIS near the tumor site mean I am in a higher risk pool? Is there any research on this (haven't found any)? My surgeon isn't being especially helpful as he does not believe I need a mastectomy (at this point, anyway).

I change my mind about this almost every day. My concerns about mastectomy are more about longterm quality of life and less about short-term recovery and appearance, etc (although I have those concerns as well) as a third excision would leave me with asymmetrical breasts anyway. I read about women suffering chronic pain and discomfort, and the potential need for additional surgeries, etc. Are there statistics on what % of women experience this?

But I also have a young daughter and need to be around for a long time.

Any advice--either personal or with the research/statistics--would be most appreciated!

houmom

My cancer appeared seemingly out of nowhere, I had a clear mammogram in April (my first as I'm only 40) and then bam, November rolls around and I have 3 tumors in one breast and something popping up on the other side. I told my breast surgeon at our initial meeting that I knew I wanted a bilateral mastectomy, even though she said I was a candidate for a lumpectomy with reduction/lift on the other breast to match. The way it just came from nowhere like that really shook me and I know I don't want to spend another 40-50 years worrying about every little pain or bump.

Although I will be honest and say that I have wanted a breast reduction of some kind for many years, I hate the way they look and their size so I really have no positive emotional attachment to them. That definitely played into my decision.

I also wanted to go the implant route, to avoid the long and difficult recovery from autologous reconstruction but the plastic surgeon did not think I would have a great outcome because of the poor quality of my breast skin. I decided to bite the bullet and go with the DIEP flap and get it all out of the way in one go. I will eventually have to have a small revision in a few months, but it will be a minor surgery in comparison.

Lita19901

Red332,had a similar problem, but I had radiation after the second surgery and the radiologist was certain he could blast the margins away with focused radiation after the whole breast radiation. My margins the second time we’re narrow, though.