Mastectomy after lumpectomy

Hi Michelle, so sorry to hear of you and your sisters dx.  I had a lumpectomy and after careful consideration, have decided to do a bmx.  Well, lets say Im 97% certain.  My Onc and BS said that the recurrance rate may be similar between bmx and lump/rads however every year, an added 1% risk is put into your risk factor for a new breast cancer.  For me, at dx of 35 that means I have an additional 25% chance of getting a new breast cancer by the time Im 60.  This isnt always cut and dry.  After seeing the study that otter posted regarding young breast tissue being dense having a higher recurrance is what brought my decision from 80% to 95%.  The remainder 5% is a. I don't want to lose my breasts. b. if i did careful breast care (not a lot around but I do belive in the iodine aspect) and very regular follow ups, maybe it won't happen to me. ..but if it does, Ive heard many women say they would do mx then.  Im just cutting to the chase.  It is such a personal decision.  I for one do not want to lose my breasts but the surgery pictures the strong women have posted have made me more assured of the decision, so Im in the 97% aspect.

I asked about if I recur and wouldn't it be better to have more breast tissue so the cancer has somewhere to go vs my chest wall/bones/lungs/spine.  He thought I was stupid, nice right?  He said having a bmx does NOT increase my chances of Mets.  I wasn't really going in that direction with my question but I had to ask it.

You mentioned insurance.  I asked my BS (who supports my decisions either way) about this and she said and I quote, its less expensive for the insurance companies to do a bmx than for them to do a lifetime of scans - I still need to confirm with my insurance.

Good luck.  Keep me posted, we may be going thru surgery at the same time and can compare notes.

Insurances will most likely cover BMX. Have you and your sister been tested for BRCA gene mutation? If not, please consider that test right away. If you are positive, then a BMX is strongly recommended.  If you are negative, that's still something you could ask for. Also know that with ER/PR+ cancer you have such excellent prognosis that doctors may advise against BMX.

Have either you or your sister considered  being genetically tested? It might go a long way in helping you make all these difficult decisions.

anne

Hi Michelle,

I'm 38, with a similar diagnosis (and date of dx close to yours), have significant family history and am BRCA-.  I'm having a great deal of difficulty deciding on lumpectomy vs. bilateral Mx, but am lately leaning toward Mx.   With prophylactic mx, especially when a lumpectomy would work this round, and not having been through full treatment, I find it so difficult to be the one to decide.  Although I guess choice is better than no choice...

Also, a family member had a recurrence on mastectomy scar and new positive nodes- I'm confused about the question someone related earlier about best to have tissue or not for recurrence...

Good luck on your decision,

Melanie 

Barbe, sorry to hear about it.  I hope your testing goes ok.  What types of tests do you need to do with a bmx?  Do you have follow up scans yearly as well?

..what I was referring to earlier regarding my question to my onc, basically - if you are going to recur are you going to recur regardless of bmx/lump+rads.  His response was the bmx does NOT increase your chance of mets.  ..so basically if I had a lumpectomy and had some cancerous tissue around, yes it would be easier to get a recurrance in the breast but if I didn't have the breast it would not jump to my bones bc I had no tissue in the breast. 

thank you for validating my question barbe, he didn't need to be a jerk about it.  He told me I ask too many questions.  Oh I could go on but Im really trying to channel my energy towards positive health these days.

xo

..sigh, I hear you!  Oh it's been said so many times that many people spend more time researching a new car than their cancer care but I think with all of the research outlets available to patients these days, more questions are being asked.  I had heard my onc was a 'patient and caring' dr, but it's times like these when individuals ask them questions and if they feel compromised, how they respond is a testament of their character.  I wouldn't say he is patient by any means.  ..a very good dr, yes, which is why I put up with him. 

-My last scare was a calc and so of course they biopsied it. It was leftover sugery tissue.  Could be hopefully a similar situation for you since they thought originally thought it would be fat necrosis but it was from my surgery which was in May this year.  Maybe scar tissue? Good luck!

Hi ladies,

I was diagnosed at 30, 32 now. I had a mastectomy on the cancer side...BUT I have decided NOT to get a mast on my healthy breast. This is my reasoning: even with a mastectomy breast tissue is still left so if cancer is gonna grow..its gonna grow. I don't have dense breast tissue, so I feel self exams would pick up something (it picked up my original BC).Im ER+, so taking Tamoxifen and probably an AI for years after, reduces the recurrence greatly. I have also adopted a more healthy lifestyle to help reduce my recurrence chances

This of course is just me. We all have to do what feels comfortable.

If I had the BRCA gene or was Triple negative? I would do a bilateral in a hearbeat. I asked my onc about my chances of developing a new BC in my healthy breast. He said 25-30% lifetime risk. Lifetime....I see that as 75-80% I won't.