Confused after MRI results

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KC71579
KC71579 Member Posts: 73
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Hi Ladies

 So I had my doctor's appointment yesterday at 4:45 with my mind ready to have my breast(s) taken off until Dr. Adams informed me that my MRI showed that he got all of the cancer out in the biopsy.  He wants me to do a wide margin lumpectomy (with biopsy on 2 nodes) and have 25 treatments of radiation (2 mins a day, 5 days a week), all upon the fact that the pathology comes back clean.  If we did lumpectomy and it didn't come back clean by some twist of fate, mastectomy would be one week later.  I am 30 years old and he understands my fears about recurrence.  He gave me information to visit a radiation specialist, and the plastic surgeon before making my decision.  He told me that in my case, both would have similar success rate and the "wait 2 years" for children has nothing to do with radiation, but would be the case in either event because I should be a 2 year out survivor first.  I am getting married in July and I did want to start a family right away.  Now I understand that is not an option for me but my question now becomes what do I do.  Ladies who had lumpectomy and radiation, how closely do they follow you?  I am a worrier when it comes to my health, so I need to be followed closely enough to put my mind at complete ease.  He told me they would do that, visits with him, 2 MRI's and yearly mammograms, plus oncologist follow up.  Would frequent bloodwork tell them if my cancer came back at all in addition to testing?  Also, does radiation hurt?  My dad had radiation in the early 90's for prostate cancer and it ultimately ate away his hip.  My doctor said that now a days, radiation is a lot more precise and pinpoints the exact spot, especially for breast cancer.  And will it hurt my chance of having babies?  Any young ladies been through this and have success afterwards with having babies?  I know we are talking the top shelf, but I fear that I will become sterile some how.  I need some input and help deciding so anything that any of you can offer me would be appreciated.  My decision is tough and I don't want to make the wrong one.  My fiance and I were encouraged by my doctor to get the information and then decide.  Any links that you can send my way would also be wonderful. 

 Thanks ladies!!!  Also, when it rains it pours.  My truck got rear ended on my way to the doctor yesterday while sitting at a traffic light.  Dr. Adams told me not to leave my house this weekend after the bad week I've had. LOL  <3 Hugs to all my sisters!

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  • dsj
    dsj Member Posts: 277
    edited February 2010

    I think you should get a second opinion.  I also think you might consider seeing an oncologist before you decide.  I have very little experience with this, but I do know that when I saw an oncologist, he seemed to have a much more thorough understanding of outcomes and treatment options.  Hope this helps. 

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  • roseg
    roseg Member Posts: 3,133
    edited February 2010

    I think you'd do well to post this on the Stage 1 forumn. Most likely they'll want you to take tamoxifen after your surgery/radiation and you haven't mentioned that at all.

    If you are going to have more breast cancer it will most likely show itself within 2 years. The radiation won't make it harder for you to have children but you most likely will not be able to breast feed from the radiated breast. 

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  • redsox
    redsox Member Posts: 523
    edited February 2010

    I think you should see a radiation oncologist, a plastic surgeon, and a medical oncologist -- whew!  Ask all of them for their recommendations and see what you are comfortable with.  Your doctor's recommendations are perfectly reasonable, but it does sound like you want to explore the options.

    If you have wide excision (with nothing more showing up) and radiation you should have a recurrence risk that is quite low and be highly unlikely to die of this as long as you have frequent follow-up.  Radiation techniques have improved in the last two decades.  Tamoxifen would probably be recommended but skipping that because you want to get pregnant should not hurt your risk too much.  If all goes well you should be done with treatment within three months and in good shape by the time of your wedding. You would keep sensation in the breast and, hopefully, good appearance.  Most doctors will follow you every 6 months for a couple of years and then annually if all is well.

    Mastectomy with reconstruction is certainly  a reasonable option, especially because you are so young and have a long time for possible recurrence.  It is much more extensive surgery than lumpectomy and takes longer to recover from; how long varies with the reconstruction technique.

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  • TJO92183
    TJO92183 Member Posts: 8
    edited February 2010
    I agree with RedSox, I spoke with several doctors before I made a decision. I went with a large margin lumpectomy. My plastic surgeon recommended removing tissue from my healthy breast to maintain cemetery which I did during the lumpectomy procedure. I'm left with two smaller breasts that match in size and I have full sensation in both. The difference between the two is a large flat area on the lumpectomy side. Even though I'm considering reconstruction surgery it's not absolutely necessary. I'm currently 2 weeks into my left side full breast radiation, 3 more weeks to go followed by 5 days of booster radiation (Localized radiation into the DCIS area). I was told that since I am ER/PR+ I should take the Tomoxifen for the next 5 years to decrease my chances of recurrence, which I'm going to do. This would be a good question for you to ask your Oncologist, if your not ER or PR positive do you need to take the Tamoxifen? Before you make any decision make sure all your questions are answered and that you fill comfortable and confident in the doctors your talking to. My advise, ask lots of questions, write questions and answers down, perform lots of research and only then make an informed decision. Good luck... 
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  • Kyta
    Kyta Member Posts: 713
    edited February 2010

    I didn't have the choice between lumpectomy or mx (I was multicentric and small breasted, so mx was needed), but if I had had a choice, I would have chosen lumpectomy.

     If your Dr thinks the biopsy removed the cancer (assuming the MRI results are accurate), then the mass must have been very small....that's great news. Good luck with your decision.

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  • Fidelia
    Fidelia Member Posts: 397
    edited February 2010

    Before making a decision - definitely find out about your ER status -  you are ER/PR+/Her2 - your options are very different from if you do not have these receptors. Although this is very early stage - thankfully!!!! - you are young and want a family - you NEED to see an oncologist who will explain in detail the role of receptors - the reasons for the various treatments and the best sort of approach in your case - surgeons only deal with the physical side of this disease - you now need a talented chemist (onco) AND a fertility specialist. You are in a very special category - young and life about to take off - the complexity introduced by BC needs serious analysis and the best possible response.

    Redsox & TJO - good work - this disease deserves a very thorough response!!!

    Fidelia

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  • KC71579
    KC71579 Member Posts: 73
    edited February 2010

    Thanks for all of your replies ladies :)  I am definitely calling the oncologist tomorrow.  I do know my tumor was small 4mm, and the other area was 1.5mm.  He got it all in the duct excision and density excision according to the MRI, so the wider margins and the radiation is what we are looking at.  And, I have lots to consider so hearing from all of you is very helpful.  Of course, if this failed there would still be Mx.  I am not sure the ER, PR, H status yet because the final report wasn't back.  As for Tamoxifen, does that hurt fertility from what you guys know?  Naturally, I have a nice long list of questions for all of these specialists before I decide.  Thanks again ladies!  :)

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