Is treatment my choice?

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marilyn113
marilyn113 Member Posts: 118
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

After repeat ultrasounds to the same area of my right breast over the last few years, my general surgeon told me this time the cysts were complex.  He gave me the option of needle biopsy or lumpectomy to remove the cysts.  I opted for surgery and they discovered DCIS.  (The cysts were benign.)   Both times I have met with the surgeon (to get the path results and then the MRI results), he told me I need another lumpectomy to get clear margins, radiation and 5 yrs of hormone therapy.  Mastectomy was never presented as an option. 

I have a 2nd opinion appointment on 10/10 at a major hospital which is further away, but they have sugeons which do only breast surgery.  Reading their website it says their goal is breast conservation whenever possible. As a married, 52-year-old, what I look like naked is not a priority.  I have fibromyalgia so I'm very concerned with how I my body will handle the radiation and HT when I already struggle with fatigue and muscle and joint pain.  My preference would be to remove both breasts and ovaries and be done with it (ideally).  Do they have to allow me to do BMX or MX if that is my preference?

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  • Leah_S
    Leah_S Member Posts: 8,458
    edited October 2011

    Marilyn, treatment is your choice. Docs tend to offer lumpectomy first since most women (at least in theory) prefer it.

    You should realize, though, that  having a mx doesn't guarantee that you won't need rads. If the margins are very close to the chest wall it might be recommended. You should discuss your concerns with your 2nd-opinion doc and also with a rad onc.

    Hormone therapy (or, to be more accurate, anti-hormone therapy) is something you should also discuss. Usually it is not necessary if a woman has only DCIS and opts for a BMX but this is something else you need to discuss.

    You really do need to speak to an oncologist so it's good you're going to the larger facility. No matter how good a surgeon you have, his specialty is surgery, not oncology.

    Best of luck.

    Leah

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  • marilyn113
    marilyn113 Member Posts: 118
    edited October 2011

    Thanks for the info, Leah.  My local surgeon wasn't going to refer me to an oncologist until after I was done with radiation.  I think I will be seeing one on Monday, but if not, I'll definitely ask about that.

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  • cinnamonsmiles
    cinnamonsmiles Member Posts: 779
    edited October 2011

    My surgeon presented me the information about my cancer, drew a picture, and answered all my questions. She presented me with both options, lumpectomy plus rads or mastectomy (but no guarantee that I wouldn't need rads, although in my case it was extremey unlikely.)

    One of our local cancer centers has medical oncologists and radiology oncologists. I wasn't happy with either, so I went to a different clinic.

    I had a BMX with SNB and ALND dissection. My breast surgeon treats all cancers on the more aggressive sides and even with DCIS and BMX, she wanted me to take tamoxifen, a type of  medicine your dr. was talking about to stop the body from using estrogen. The oncologist told me the negatives outweigh the benefits. But that is for my particular case with my other health issues.

    Best of advice is to ask a lot of questions, do a little research on reputable websites, books, or literatures, find out the positives and negatives and hopefully the answers will come to you. Best wishes

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  • mom3band1g
    mom3band1g Member Posts: 817
    edited October 2011

    Please know a mast is major surgery.  It is very hard physically and emotionally.  It's a decision you would have to live with the rest of your life....it can't be undone.

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  • CTMOM1234
    CTMOM1234 Member Posts: 633
    edited October 2011

    The right to choose the best surgery for your personal mental and physical situation is yours. If a doctor doesn't give you options, and assuming your insurance company is flexible with whom you see, then go with your heart and seek out another doctor. 

    It is sad that we are faced with having to educate ourselves, but I do truly believe that we are our own best advocates and it can actually feel a little empowering in the face of such shocking news.

    That being said, I completely agree with mom3band1g. Mast. is a major irreversible surgery and bmx is double that and add . While body image may not a priority (it wasn't for me either, not at all!), there are risks and complications with any major surgery -- plus no guarantees that you won't still need rads. Most of us first just want to "hack 'em off 'cuz we don't want to ever worry about bc again" -- I know that's what I thought when I was at the stage you are in -- but now that the lump+rads are behind me, I'm very glad I chose the path I did! Every day I'm very glad. 

    Please take the time now so that you won't have regrets later. 

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  • Hindsfeet
    Hindsfeet Member Posts: 2,456
    edited October 2011

    Marilyn, I agree with the above comments. None of the options are perfect. In the end, it's what can I live with? Each time I am dx, I pretty much go over the pro's and con's for mx, lumpectomy and other bc treatments. Nothing is fool proof. Like what was said, do your homework or research. If you are considering a mx, I would suggest you first read the threads here on reconstruction.

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