I am going insane!

First of all, I'm sorry, and I wish you well.

Here's the one thing I wish I knew. Yes, lump + rads = mamm (w/ no rads); however, if you get a new primary (God forbid), or decide to have a mamm w/recon for some other reason down the line (e.g., find you you are BRCA +), the rad interferes with your reconstruction prospects. It's not insurmountable, but it's an issue.

So, if I had known more, I would have probably opted for a mamm instead of lump and rad. Because I was only 41 years old, and although the surgeon was very excited with herself for "preserving my breast", I didn't really care about that, and would rather not have to spend the (hopefully) next 30 or 40 years worrying about the darn thing.

It's a personal decision, and you need to do what feels right to you. But I wish I had asked the, "what if I have a local recurrence, or develop a new primary in the same breast?" question before I had the surgery. Knowing the impact it would have on my recon options, I think I would have gone with mamm and recon instead of lump w/rads. But again, that's just me, you need to do what you feel comfortable.

Just don't rush into anything. I know that panic get this out of me NOW feeling, but you really do have time to thoroughly investigate your options, and be fully educated about your decision.

I'm sure you'll get lots of different answers. The women on this site have helped me survive this from every perspective, and they will help you as well.

My cancer was located very close to the chest wall also so I first had chemo and then opted for blm. Prior to the surgery I had a second mamagram and was told that the cancer was not longer visable but it was recommended to go forward with surgery with 6 weeks of radiation after surgery. The path report showed no cancer cells in either the breast tissue or nodes. I am now in third week of radiation and wish it would hurry up and get over. I am forty three and just did not know how much this would affect both my husband and I emotionally. We know I did the right thing for me but life without boobs has been a hard adjustment. It will be a while before I become a candidate for reconstruction and at this point am not sure I want another surgery. Wearing the prosthesis has helped although I cant wear it during radiation. I thought it was going to be no big deal but after surgery I was very emotional. Im much better now but it was tuff the first couple of months. These are all hard decisions to make and everything is thrown at you so quickly its hard to know what to do. I am thankful I have excellant Doctors who guided me and a very supportive family. I am an ex smoker to so rad scared me a little to but so far things are going ok and Dr. has assured me that only a very small portion of the lung is involved. I would discuss your past smoking history with your dr prior to radiation. 

JONILEE,

Glad you got that really good feedback from the radiologist today. His comments reinforce the choice I made. I also had a Stage 1, Grade 1 tumor very close to the chest wall. I had a lumpectomy and the margin was .6 mm. My breast surgeon went right up to the fascia at that margin, so she couldn't have taken out any more breast tissue there even if she had done a mastectomy. I then followed up with radiation. These days, radiation fields are so carefully calibrated that risk to your lung is very small. I felt that, given the close margin, I was giving myself some extra insurance by having radiation to the whole breast and a "boost" aimed right at the area with the close margin.

As it turned out, three years later I was diagnosed with extensive DCIS in the other breast, necessitating a mastectomy. At that point, I opted for a bilateral mastectomy with no reconstruction. For the reason stated above (extra insurance), I don't regret my earlier choice of lumpectomy plus rads. Also, I enjoyed still having my breast during those three years! I chose not to have reconstruction because I just felt it wasn't right for me, but if I had wanted it, there were still good options despite the earlier radiation.

Good luck whatever you decide. With the input from the radiologist you'll be able to make a very informed decision.

Barbara

BreastFree.org