DCIS , now LCIS in other breast

Options
justagirl
justagirl Member Posts: 730

DOES DCIS WITH HISTORY OF LYUMPECTOMY = DOUBLE MASTECTOMY? A year ago March I found a lump which was diagnosed as a DCIS + aggressive invasive carcinoma in my right breast resulting in a lumpectomy. Last month I had a breast reduction on the other breast and in the removed tissue they found LCIS.  My breast surgeon says a MRI, u/s and mammogram, with monthly checks by me is all that needs to be done.   If I get another carcinoma, at that time the breast surgeon will talk further with me.  I have little faith in a u/s and mammogram yearly as I had these last November and they were clear and it was ME who found the lump the following March.  I was diagnosed as stage III, had chemo and radiation.  THIS IS MAKING ME SO ANXIOUS, I am scared!   My oncologist has had me on Femora (hormone) since September and that's supposed to help keep cells from turning cancerous.  I want a double mastectomy now so I can stop worrying!

What if I find another lump and it's gone into the lymph nodes this time? 

I really want a double nipple sparing mastectomy.  

Have any of you had a similar diagnois and treatment?

Comments

  • justagirl
    justagirl Member Posts: 730
    edited January 2011

    Am I going to far by having a double mastectomy now?  My husband thinks it's radical and unnecessary if the breast surgeon says a mammogram and U/S every 6 months is enough for now!

  • takeadeepbreath
    takeadeepbreath Member Posts: 105
    edited January 2011

    I was even more extreme...I had LCIS, but BRCA negative and no fam history... and I had bilateral Nipple Sparing Mastectomy 3 weeks ago. I could not deal with a lifetime of "watch and wait" every 6 months---way too stressful for me. They founds lots more LCIS on BOTH sides (not just side that had 3 prior lumpectomies over past 4 years). My BS said what I did was" lifesaving". Procedure caused discomfort but no real pain or--thank God-complications thus far (I did tissue expanders as opposed to one step--they are certainly not pleasant, but what are ya gonna do...it's a work in progress!). Drains came out on Day 6, stitches 2 days later. I went in an A cup and came out the same size--will be upgrading to a full B, nipples totally fine (slight scabs like a sunburn that just washed off in shower around week 2)...I am going back to work this tues-3 weeks to the day. Still a bit stiff/sore, but I feel great and have had ZERO second thoughts. Trust your instincts.  

  • katp
    katp Member Posts: 10
    edited January 2011

    I had DCIS and atypical lobular hyperplasia in my right breast.  My sister had DCIS 10 years ago in her left breast.  She had one masectomy and radiation and chemo and reconstruction. She is doing well.  We had a great grandmother, two great aunts, and an aunt on mom's side with breast cancer.  They all had surgery and did well.  I decided to have  bilateral masectomy, skin sparing, nipple sparing surgery with immediate reconstruction in May 2010.  I had saline implants with Alloderm.  My cancer was 1.2 cm Stage 0, Grade 2 E+ PR+ Her- so I did not have chemo (my choice onc wanted me to have chemo or at least onctype test) but I didn't.  I am 59 years old post menapause so I take Arimidex (generic). Onc said I have 95% chance of living 10 years without chemo and taking Arimidex.  I am doing really well, so I recommend it to you.  My BRCA 1 and 2 were normal as well as my PTEN, but I am still convinced that it is genetic somewhere for so many of us to have had breast cancer and thyroid cancers in our family.  Genetic counselor told me to check next year to see if they have new tests for me to take.  I may or may not depending on if insurance will pay.  They were good to pay for tests I have already  taken, but DH is retiring and insurance may be different. Will just have to wait and see.

  • justagirl
    justagirl Member Posts: 730
    edited January 2011

    THANK YOU for your input.  Two days ago I saw my oncologist for a 6 month followup about the Femora I am taking. I told her due to the new finding of LCIS in my other breast I was really wanting a nipple sparing double mastectomy to alleviate my daily fear of having another tumor, which could be a reality more than not after already having one in my other breast. She said I was being to drastic and hasty (it's not like I can run out tomorrow and have the surgery done!!!).  She said I was already in the'high risk' group so that is why I will have a MRI, U/S and Mammo every year, and that I should check myself monthy.  Ha!  A year ago, mid November 2009, I had a mammo and u/s and all was clear.....then when I checked myself  the following March, less than four months later, there it is - a grade III agressive-invasive DCIS 12mm in diameter....stuck right against my chest wall.  So, even if I had all the tests every 6 months I wouldn't feel better just watching and waiting.  WE all know cancers can grow and go wherever they want before we could detect then by palpation or tests.  I told the oncologist what if I get another tumor and it's gone to the lymph nodes and I'm a Grade IV?  Then they would surely jump in and do the double mastectomy on me and I could still more than likely die sooner rather than later!  Anyway, I have an appointment to see my breast surgeon 25th January and am telling her what I want - no more of this watching and waiting.  I'm not in love with my breasts but I do want to live beyond my 58 years, and be around for my 17 year old son, who, by the way, has been to hell and back with all this cancer stuff this year.  He almost didn't graduate from high school is how bad it got - from an A student to and C/D one.  He was diagnosed with anxiety and depression, had nightmares, became afraid of the dark and any sudden noises.  I won't put him through that again if having a double M will take care of it!  Thanks again for your input and support!!!

  • takeadeepbreath
    takeadeepbreath Member Posts: 105
    edited January 2011

    wow....follow your heart and instinct on this one--you articulated bout 10 good reasons above!.  If you want, take a look at the December Surgery board...45 women had mastectomies last month and to me it was astounding how many got surprise pathology reports after their surgeries...talk to another breast surgeon. I have an 18 year old son too and that part of your story is really sad and touching...poor kid...is he planning on college? 

  • justagirl
    justagirl Member Posts: 730
    edited January 2011

    Dear 'takeadeepbreath':  That's it - I don't want any more SUPRISE PATHOLOGY reports! Having my non- lymphectomy breast reduced in size was supposed to be the conclusion of this nightmare and a healing step...and back comes this pathology report which almost scared me as much as when I first found the tumor.  As a RN, I had never heard of this LCIS, nor had any of my nurse friends - it's quite a sleeper.  My son is planning now on going to college and living at home versus being 2 hours away.  He really isn't ready now to live away from his Dad and I so him not being accepted at the out-of-town college is no biggie.  My heart breaks for him as he never told any of his  school friends about my cancer.  Also, my husband is 18 years older than me, so I guess the three of us always thought if there was a major health issue in our family it would be my husband.  If my breast surgoen won't do it, I'll find one!

  • julie75
    julie75 Member Posts: 635
    edited January 2011

    justagirl:  I'm completely with you on getting a BMX (bilaterial mastectomy).  I had DCIS in my left breast only; that diagnosis came after two years of very stressful watching and waiting.  Had to wait over a weekend for my needle biopsy results and I swore Sunday night if the results came back as cancer, that I would get a BMX, period, even though my right breast had no indications of cancer.

    When I talked to my soft-tissue surgeon, I asked him if there would be any issues with the insurance covering a BMX, even though the cancer was only in my left breast.  He said that I definitely had a higher risk of developing cancer in the right breast, and told me he "would play with the numbers a bit" so that the insurance would cover it, if necessary.

    Well, I had my BMX on 09/17/10 with immediate reconstruction, and have no regrets.  The PS was able to save my right nipple.

    And, I'm sorry this has been so stressful for all of you; I'm glad your son will be living with you while going to college.

    Good luck with your search for a surgeon.  I think you're making a good decision.

    Julie

  • justagirl
    justagirl Member Posts: 730
    edited January 2011

    Julie75:  Thank you for making me feel like I'm not crazy for wanting a BMX.  Since I had a DCIS in my right breast and 6 months later found LCIS in my left breast I would think an insurance company would agree a BMX is the most economical, logical, health-smart decision.  I think health insurance in the US is better than here (Australia).  In Australia, all citizens have medicare but if you rely on them completely you get placed on waiting lists for everything: surgery, appointment to get appointment to see surgeon or any doctor.  We also pay for private health insurance but it sure hasn't been taking care of it all - like our private health insurance wouldn't pay for any of my radiation treatment because it wasn't given to me as a day patient in the hospital (waiting list was months long)....so, to make a long story short, this has been a very expensive past year for us... 

    I'm happy to hear your surgeon agreed to your thinking and have no regrets.  Sounds like we think alone the same line.

    Thanks Julie

  • julie75
    julie75 Member Posts: 635
    edited January 2011

    justagirl:  You are very, very welcome.  I'm sorry the health insurance isn't as good in Australia and that 2010 was quite expensive for you. 

    No reason you shouldn't be able to find a surgeon there who would agree to your thinking as well.  My surgeon did tell me (as you indicate above) that a BMX is less expensive for insurance companies in the long run (no more lumpectomies, etc.).

    If you want to PM me, that's fine.  I'll be checking back to see how you are doing.

    Julie

  • Stanzie
    Stanzie Member Posts: 1,971
    edited January 2011

    I have a question. I was diagnosed with DCIS and LCIS at the same time. I ended up with a double MX and reconstruction. I was told I would not need rads or chemo but when I think back ( I am foggy with everything that happened ) everyone always only talked about me having the DCIS. What impact does the LCIS have - any of you know? Still very confused by that. Thanks.

  • justagirl
    justagirl Member Posts: 730
    edited January 2011

    Dear Julie75

    I just  might take you up on your offer to PM you.  I see the BS on the 27th of this month.

    Stanzie, for me with my original DCIS the oncologist said removing the tumor, since it hadn't gone to the lymph nodes gave me a 70% of living past 5 years (5 years isn't much!), then 20% better chance with having radiation and 8% more if I had chemo.  I wanted the best chance I could get to keep on living, so had both chemo and radiation.  Maybe with your preexisting medical hx your drs. thought chemo and radiation not worth the risk to your overall health.  My understanding of LCIS is it increases the chance of potentially having up to bc in both breasts by 25%.  Supposedly, I think, one out of every eight women will be diagnosed at some time in their life with bc.  So, you and I are the 1 in every 8.  

  • Stanzie
    Stanzie Member Posts: 1,971
    edited January 2011

    justagirl - Thanks. I hadn't heard it put like that before.

     Does LCIS just increase your chance of getting either another or a new cancer in your breasts or can it show up other places. I wish I could remember exactly what my BS said but I was so shocked by it all when I saw him I can't remember. But when he told me I had both kinds he said that made it more complicated because something like when as an embryo being formed your breast tissues become breast tissues and if you get LCIS then it will go where ever those same type tissues are. I just also know having BC puts us at higher risk for uterine and ovarian and then I guess it can spread to bone, lung and brain, if I remember correctly. It is funny it just seems like no one talked to me about the LCIS after diagnois and now I'm wondering did they miss something? Not a great feeling to have.

    So sorry your insurance is so difficult. Ours here certainly is expensive but I think we do have more options and a quicker responce. Thanks so much

  • justagirl
    justagirl Member Posts: 730
    edited January 2011

    Stanzie:  As far as I have learned, LCIS only shows in the breast tissue.  Sorry, can't follow you on the embryo becoming breast tissue. Just because we have had bc doesn't mean it spreads on everyone to other areas of the body.

    LCIS I guess takes 2nd place to other types of bc, as LCIS is considered a Stage 0 bc.

    Sounds like your mind was boggled when you saw your dr.  If I can make a suggestion, keep a pad with you and write down questions you want to ask you dr at your next appointment (and if you don't have a next appointment soon, make one).  Ask the receptionist to make it a double time appointment as you have LOTS of questions to ask the dr.  Take you pad with notes with you to your visit and tell the dr you have a list of questions you would like to ask. The dr may not let  you, but you could ask if you could tape his/her answers as you just have trouble remembering.  When I see my bs she writes a brief outline of what we discuss and she tells me and she give it to me.  She is always happy to see me with my list and thinks it is a good way to make sure all my questions are answered.

      Mind you, you and I may not like all the anwers the drs. give us! 

    Yes, our insurance company is not compatible with having breast cancer, and it's not inexpensive.  It's been almost 20 years since I left the US but I have kept up with what's going on and up, and I know health insurance continues to rise while the values of real estate decline.  Our government medicare health plan here in Australia is good and free if you can wait until the system decides you should see a specialist or have procedures.  A sad example is now the dr.s are talking about me having a MRI, U/S and mammogram every six months - costing me at least $1,000 for the 3.

    Anyway, I've got to go - we are having major flooding here in the south-eastern part of Australia!

  • takeadeepbreath
    takeadeepbreath Member Posts: 105
    edited January 2011

    Stanzie--LCIS is just a "marker", placing you at a higher risk for BC...if all you had was LCIS, they usually just monitor very closely (Mammo/US/MRI combos every 6 mos) and often have you take tamoxifin for 5 years to reduce the odds. Someone gave me the analogy it is like having high cholesterol...it puts you at higher risk for a heart attack, but it does not mean you will get a heart attack. If LCIS is discovered on one side, should BC develop, it is almost as likely  to be on the opposite side, thus it's status as a marker, not an early cancer. As you will see, LCIS is a really grey area. There is a member on these boards named Leaf...look up her posts...she has tons of great links/studies re LCIS. I was an "LCIS only" person and I opted for a bi-lateral mx last month as I could not deal with the stress of constant monitoring. Given the fact you had a mx, seems like the LCIS is no longer a significant issue. The L in LCIS is for Lobular, it is atypical proliferation of cells confined in situ (in place) to the lobes of the breast.

  • Stanzie
    Stanzie Member Posts: 1,971
    edited January 2011

    Thank you both so much. That helps tremendously!!!! Thanks!

  • justagirl
    justagirl Member Posts: 730
    edited February 2011

    Hello Everyone,

    I am having  on the 5th of March a double nipple sparing (I hope) masectomy using at least one LD muscle for a flap, and maybe both plus silicone implants (tiny ones).  I just am tired from freaking out every day thinking that know I have LCIS tissue in one breast with having just had a year ago a lumpectomy for an invasive agressive form of breast cancer.  I did chemo and 30 rads.  I am on the 5 years of femara (and my knees ache so bad I can't run anymore - I used to do triathlons).  Anyway,  I just decided I was tired of waiting for the LCIS tissue to maybe morph into cancer and having mamograms every 6 months doesn't reassure me as I found the lump with a self exam 3 1/2 months after having a clear mamogram.  I don't need my breasts to live and that's what I want to do - live without fear of breast cancer.  If people don't like my decision, that's their problem.  My husband is supportive of my decision, just is worried I will be upset about the scars.  Scars won't kill me.  Cancer can.  Much of this is a mind game and if one more person tells me how lucky I am to be alive or to be positive as that determines so much of my medical outcome I will scream.  Being a RN all I know is cancer is devious and not a friend!  Now all I have to face is hours of surgery, recovery and another pathology report on the removed breast tissue - NOW THAT MAKES ME ANXIOUS I haven't had a mammogram, U/S or MRI since my initial diagnosis a year ago due to the surgeries, chemo and radiation.  They scheduled all of that for March but now having the double M. rules it all out. I think I'll look up what Leaf has had to say about LCIS.  Amazing, none of my friends who are RN;s like me have ever heard of LCIS before!

Categories