Terrified for my friend

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arkansaslou
arkansaslou Member Posts: 1
edited June 2014 in High Risk for Breast Cancer

I have a friend who was diagnosed with bc fairly recently.  She is a friend, but we're not close buddies.  On the advise of her surgeon, she had a double mastectomy and he didn't advise any further treatment, no chemo and no radiation.  She didn't have any lymph node involvement so she is convinced she is healed and will never have to worry about it again.  I had another acquaintence who is now dead after a lumpectomy and no further treatment.   I am wondering if I should be worried at all.  My oncologist told me there's always a possibility that one little cell escaped when I had my lumpectomy.  Suppose a mastectomy would be that much different from a lumpectory? 

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  • NancyD
    NancyD Member Posts: 3,562
    edited May 2010

    I believe the current protocols say no radiation after a mastectomy if no nodes are involved. The belief is that removing all of the breast tissue removes the possibility of leaving a cell or two behind, as can happen with a lumpectomy.

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  • leaf
    leaf Member Posts: 8,188
    edited May 2010

    But they can't remove ALL breast cells in a double mastectomy.  If no bc cells have escaped the breast, I've seen figures that there still is a ~2-10% incidence of bc (for example for women with a BRCA mutation.)

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  • Beesie
    Beesie Member Posts: 12,240
    edited May 2010

    It is true that after a mastectomy there is always a small risk (1% - 2%, possibly higher for those who are BRCA+) that there will be a local recurrence (in the breast area) or the development of a new breast cancer.  For those who have invasive cancer, even if the lymph nodes are clear, there is also a very small risk that prior to surgery, a cancer cell might have moved into the body undetected and at some point this rogue cell could develop into mets.  These risks exist but they are small - and generally for women who have pre-invasive cancer (DCIS) or small invasive tumors and no nodal involvement, these risks are not considered to be high enough to warrant any treatments after a bilateral mastectomy.  On the other other hand, for women who had larger tumors, usually additional treatment - either hormone therapy and/or chemo - will be recommended, even if the nodes are clear.  So whether "no further treatment" is appropriate for your friend all depends on her exact pathology.  Certainly there are many cases where "no further treatment" after a bilateral is the accepted standard of care, but that's not always the case.

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