Aromasin, BRCA, Mastectomy v. Reduction...

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msm_in_SC
msm_in_SC Member Posts: 2
edited June 2014 in High Risk for Breast Cancer

I have a strong family history. My mother and one of her sisters died from metastatic breast cancer. I am post-menopausal and have very large and dense breasts. Also, I have a lupus-like auto-immune issue. I am 50. Here are my questions:

Do I need a specialist to discuss taking Aromasin?

Do I have enough "qualifiers" for BRCA testing?

Breast reduction has been considered due to shoulder, upper back, and neck pain. I've considered prophylactic mastectomy instead. Any experience or opinions?

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  • JanetinVirginia
    JanetinVirginia Member Posts: 1,516
    edited June 2011

    Hi msm.   If relatives on either side of your family had 'early-onset' breast cancer (pre-menopause) then a BRCA test is a good idea and can help with your decision making.  With all the news this week on Aromasin, you could start with your gyn but they may not be as up to date as a breast specialist in a NCI center.  Certainly anything you can do to PREVENT it in the first place is smart idea.  Also you should discuss an MRI for screening as mammograms are famous for missing tumors in dense breasts.

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  • msm_in_SC
    msm_in_SC Member Posts: 2
    edited June 2011

    Thank you so much for your reply! I only have a GP group because my insurance charges a co-pay 4 times higher to see a specialist whether you're referred or not. I will try to find a breast specialist. I love the MRI screening and I hope it becomes more available for more women. Unfortunately, I have a Vagus Nerve Stimulator in my chest and can't have an MRI. MAybe the prophylactic mastectomy is worth further investigation. My insurance doesn't cover it, but they will cover breast reduction. It doesn't specify how "reduced" so maybe there's a loophole. Again, I am very appreciative of any and all info and suggestions. Reading the forums is so helpful. I am so glad I know where I can come to find answers and learn from those who have been there. 

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  • Kathy044
    Kathy044 Member Posts: 433
    edited June 2011

    Regarding Aromasin for high risk post menopause women, I saw a story about  a new  study on the news last night. 

    Drug exemestane can cut risk of breast cancer among high-risk women: study

    http://www.theglobeandmail.com/life/health/new-health/andre-picard/drug-exemestane-can-cut-risk-of-breast-cancer-among-high-risk-women-study/article2047548/

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited June 2011

    msm_in_SC- Some states have made it a federal law that insurance companies have to cover prophylactic mastectomies.  To find out if yours does you can go to-

    http://www.scld-nci.net/ 

    To find out if it makes sense to have the BRCA testing done the CDC has some good information.  You can find it at-

    http://www.cdc.gov/Features/BRCATesting/index.html 

    I would only do the testing if you knew you would decide on surgery if positive or if you have children and want to know if there is a possibility you may have the gene that you passed on.  Otherwise, there's really no point in doing it because you could have the gene and never develop breast cancer.  Or you could be negative and still get breast cancer.  The test itself is extremely expensive, too, and they will require you to have genetic counseling prior to taking it.  Also, they always recommend that the first person tested in a family is someone who already has breast cancer.  If the first person tested has no symptoms the results may be uncertain.  If some other member in your family has had the test, and it was positive, they will discount your test because they already know what mutation to look for.  Here is another great site about deciding to test or not-

    https://atlantichealth.dnadirect.com/grc/patient-site/brca/pros-and-cons.html 

    I would definitely research a lot of different threads on here before deciding on mastectomy.  It is permanent, disfiguring and there's always the risk of complications.  Although I had BC and didn't have a choice since my DCIS was multi-focal I miss my old breasts.  Reconstructed breasts will never feel or look exactly like natural breasts.  After researching you may still decide you want mastectomy but you'll go into it knowing exactly what to expect after surgery and the years beyond.  Good luck to you. 

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  • emanresu
    emanresu Member Posts: 60
    edited June 2011

    I posted on the other Aromasin but thought I would also post here.I

    I had breast cancer in 1992, chemo, radiation, evista, tamoxifen.

    In 2003 I had breast cancer in the other breast. chemo, rad, Arimidex which is an aromatase inhibitior. After my time was up on the Arimidex I begged the oncologist to keep me on the drug. She refused, not in her protocol, I suspect I was in a group that was being folowed for recur.

     Anyway, now the new thing is to give this drug to people like me. I told her I wanted it because I am estrogen receptor positive both tumors, post menopausal and that drug was a security  for me.  I have no oncologist now, I walked away and left my chart on the floor. ... this is my life I would like to keep...

    I simply could not understand WHY I was not able to stay on the aromatase inhibitor?? Now, I will go to my internal medicine doctor and discuss with him again, about going on this drug and if it would be beneficial now.

    I do not have BRCA's. I do not have a family history of bc. I was 42 with the first diagnosis. And I was 53 years old with the second breast cancer. A mammogram did not show either breast cancer. I also beg for an MRI because of scar tissue and failure of the mammograms to show tumors on me.

    So, I would like to know if women like me in my situation would go on Aromasin, Arimidex or Femara?

    Thanks.

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