Multiple LCIS w/ family history - need recommendations
Just received results from wire guided biopsy which show multiple areas of LCIS. This finding, along with my family history (mother died of breast cancer when she was 40) and dense, fibrocystic, breasts, has my surgeon discussing bilateral prophylactic mastectomy. She also advised that tamoxifen and intense monitoring is also a fine option.
I don't like the side effects of tamoxifen nor the constant scares associated with monitoring (been down this road for 3 years already with alot of cysts first, then atypia, and now multiple locations of LCIS). I'm also not happy with prospect of a double mastectomy at age 40.
My surgeon also advised that there are techniques like nipple sparing mastectomy and techniques to improve the location and size of scarring, so I was leaning toward this solution. But, she quickly raised my concern by stating that the nipples may have to be removed if LCIS or Invasive ductal carcinoma is found close to the nipples during the operation. Furthermore, she advised the nipple(s) may have to be removed later if too much tissue was removed in the area close to the nipples during the mastectomy, damaging the blood vessels that bring blood to the nipples.
I'm still leaning toward mastectomy, provided I have the best chance at retaining a "normal" breast appearance. To that end I need advice on the best breast surgeon and plastic surgeon in the Philadelphia/New Jersey/New York region. By best, I mean the recognized best in doing the latest and best procedures. I don't care if their bedside manner is horrible. THANKS SO MUCH IN ADVANCE!
Comments
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Hi! I'm 40 also and recently diagnosed with LCIS. Two other pathology centers then downgraded it to atypical lobular hyperplasia, but it still doesn't change my risk. I tried taking tamoxifen for 2 months but recently stopped taking it due to the crazy side effects I was experiencing. My breasts are very dense and I have fibrocystic breast disease. I do not have a family history of BC. I have been going back to my breast care center every 3 weeks to have one or more new lumps ultrasounded. I just had 3 enormous cysts aspirated on Friday. I am a worrier and living with this diagnosis since October has driven me out of my mind. I met with my oncologist on Friday and she told me she'd do the PBMX if she were in my shoes. I really want to put this behind me and get on with my life. I have met with an amazing plastic surgeon at Hershey Medical Center in PA. I am going to have a nipple sparing mastectomy as well. I was very happy with the photos he shared with me of other women who had NSMX and were my breast and body size. I am totally terrified to do this surgery, but I've come to realize that I am more terrified of getting breast cancer. If I can't take tamoxifen to lower my chances, I have to do something. That something is surgery. I've heard that the University of Penn has an amazing team of breast doctors. If you are close to that area, you may want to look into that. I may even get a second PS opinion there too. Good luck!
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Thank you for the University of Penn recommendation. I will absolutely add them to the list I'm compiling. Thanks again!
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Your story sounds so much like mine! My mom died age 59 of bc and her aunts above her also got it. My breasts were dense, full of cysts, a true nightmare for the radiologists, my mammo and US took hours every year. Anyhow, we found LCIS and pleomorphic LCIS (an even more abnormal type) and I had enuf and did bilateral MX. I did not do recon.
Best decision I ever made. I am super happy like this, no problems at all, feel great and can do all the stuff I ever did, which is a very active lifestyle. My breasts were small before, so not a huge change. Like you, I was in my 40s.
I did have BRCA testing and it was negative. With your history it sounds like you are a candidate for BRCA testing - has this been suggested to you?
I hope all goes well for you. The surgery is not as bad as all that. (((hugs)))
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Hi Beacon! I just had the BRCA testing and await the results. The shock is starting to wear off a bit. Just very nervous going forward. Thanks for the well wishes!
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My team works at Penn Hospital and I cannot commend them enough. Dr. Dahlia Sataloff and Dr. Louis Bucky. I had a nipple sparing mastectomy last December and if you wanted to read about the process in a very candid blog, you can go to www.arleneflick.blogspot.com Those two are the BEST that Philadelphia has to offer. I look like I had an augmentation instead of a mastectomy and I cannot stress how good I feel.
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ArleneMarie your words are music to my ears. I grealy appreciate you taking the time to respond to my post. I will be heading there for a consultation.
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