Making Decisions

HI,

I had a small IDC the first time, not DCIS, but the situation is the same. I had lumpectomy and rads and Femara, then 6 years alter, a new primary in the other breast.

I chose not to do rads a second time. I had both breasts removed, and implants put in. (Which I'm getting rid of next month, but that's a whole  'nother story.) And I'm back on an AI again, this time Aromasin.

I chose the bilateral mastectomies because I lost my ability to trust my breasts.  Going through this all a second time was tough. And I never wanted to go through it again! I tried to keep the emotion out of it, and to base my decision on rational science. And given that my second cancer was lobular, it was a no-brainer to remove both breasts.

Two cancers and still a chemo virgin. I feel lucky in a weird way.

Anne

I had a second cancer in the other breast, unfortunately it was large enough that a mastectomy was recommended.  I was pushing for a bilateral but my doctors were reluctant.  We eventually agreed on neoadjuvant chemo (I had node involvement) and if the tumour shrank enough for a lumpectomy we'd do that, if not I have a bilateral.  We all looked at it as a sort of experiment.  Well my tumour shriveled up to nothing, I had my lumpectomy and we were all happy as pigs in a mud hole.

However 2 years later I had a 3rd cancer in the breast first affected.   It was small, but deeply situated and there was no question of anything but a bilateral.  I didn't want reconstruction, it was just more surgery.   I don't really regret the choices I made, but I'm happy to be done with mammos, etc. 

My wife was diagnosed with DCIS in her left breast in 2005 (Stage 0 no nodal involvement) and had lumpectomy (and follow up to clear margins) followed by radiation. At the end of March 2009 after a clear mammo, during her routine ultrasound check with her BS a shadow was found in right breast, confirmed suspicious through FNA and MRI and lumpectomy done a few days later. Found to be ILC (mix of lobular and tubular!) and there was some early stage DCIS but no microcalcification - basically a lot of stuff going on! Stage 1 cancer no nodal involvement and 1cm tumor. The treatment that has been recommended is radiation plus tamoxifen. However, we have both been thinking long and hard and my wife is leaning towards a bilateral mastectomy (BiMx) because the chances of recurrence are much lower. The BS says if BiMx is done she will do a simple Mx and put in saline implants right away - no tissue expander etc. We met an Oncologist who said if she did Mx then Tamoxifen would not be necessary even though her tumor was ER and PR +. All very confusing especially when I research this and am getting different viewpoints. 

Would greatly appreciate any views on the following:

1. BiMx vs lumpectomy + Radx

2. Tamoxifen in either scenario

3. Any issue with skin sparing Mx with no tissue expansion - does that mean that more tissue gets left behind and therefore more risk?

4. Experience with saline implants - understand there is a 7% chance of leakage/rupture - but are these lifelong things or need to be replaced every so often? The BS indicated they were kind of permanent unless they rupture.

 5.  Is it harder to diagnose a recurrence if all the tissue is gone - i.e. will it get caught too late?

6. Does it make sense to do radiation after a Mx on the right side just as further insurance for the tissue that is inevitably left behind? 

 My wife is 44 .

 Thank you for your help and I wish all you courageous ladies all the best always.