What is the experience of the surgery for mastectomy?

Good luck with your decision infobabe. From what you describe you are in your 70s with a small amount of DCIS and no invasive component yet found. Unless there were other factors, such as strong family history of bc or dense hard to read breasts, I would strongly consider doing the lumpectomy plus rads. From what I read the rate of survival is identical as for doing a MX.



Ask your radilogist about how easy your breasts are to see on mammo. In your age range they should be able to easily see anything that might come up in the future and if it does, well, then you can do a bigger surgery,



My case, totally different, I did a bilateral for prevention, but if I were in your shoes I think I would strongly consider breast conserving therapy. What is your doctor recommending?



Oh as for your original question, for me, BMX was very easy literally painless (as in I never took any of the pain meds they gave me) and I am at 100% of normal activity. For me it worked great but surgery is always a gamble, even small surgery. Good luck to you ((hugs))

For me, I think my BS screwed up. I had 2 surgeries prior to the MX and no lymph nodes were taken. A sentinel node was never taken. When I went to surgery it was supposed to be a simple mastectomy. He said my lymph nodes were swollen so he took a "few". I was told 5-6. When I went back for post op the path report said 22 nodes. The BS was surprised. Not happy about it because now I have to take precautions about lymphadema, but what's done is done. Had I been on this board on this board sooner and know what I have learned, I would have asked more questions.

Infobabe,

You do have a lot to consider and as you've read, there is a wide range of experiences among those who have had mastectomies . As Erica noted, Anastrozole is the generic name for Arimidex, one of the aromatase inhibitors. I am post menopausal and this is my first AI, not Femara. I have had very few and easily managed se's. As for the Oncotype dx test, you must fit a specific profile to take it. It will determine how efficacious chemo would be for you but it presumes you will take Tamoxifen after chemo.You can find specifics on the Genomics Health website. Good luck with your decisions.

Caryn

Infobabe - your surgeon may take nodes with a lumpectomy. My biopsy showed invasive from the start so I knew he would. You may want to ask, just so you are prepared. I have a BMX scheduled in June and I'm appreciating everyone's response. If you do choose a lumpectomy - the breast incision caused me very minimal pain.

Bilateral mastectomies - easy peasy compared to other surgeries/hospitalizations I've had.

To me it sounds like you will not have to  have a sentinel node biopsy on  your revision lumpectomy.  This is because if they obtain clear margins on this surgery and find no invasive cancer during pathology, they will have had no reason to take nodes.  If, once they do the pathology, they determine that there is invasive cancer they will go back and do a sentinel node biopsy to stage it.

in the interest of efficiency some doctors might want to do a sentinel node bx along with your lumpectomy, but if it were me (and it's been me) I would not let them do this.  Doing it as I outlined above is better for you as in the event they find no invasive cancer they will not have done an unecessary sentinel node biopsy on you.

Mastectomy often calls for a sentinel node biopsy as once the mastectomy is complete, they have difficulty identifying the sentinel node and therefore have to take many more.  In short words, the breast must be intact to perform a sentinel node biopsy. 

In your case, with a grade one smallish area of DCIS you might get away without a sentinel node bx even with mastectomy but that is very much up to your surgeon.  For the record I took the gamble and did bilateral MX, no sentinel node and that worked out for me, but I have seen it go the other way too.  Have you had an MRI to determine if the rest of your breast (s) look normal?

infobabe -  i am just two weeks out from BMX.  for me, the surgery and recovery so far has been much easier than i anticipated.  pain was well managed in hospital.  i was off pain meds and just on tylenol after 4 days.  I'm stiff and sore and definitely have road in front of me re: reconstruction, but my pathology came back clean and for me, i can deal with the pain better then i can deal with recurrance.  it's a very personal decision-- with no right answer.  for me, the BMX was the right answer and i don't have any regrets.  best of luck to you!

Hi

I had BMX for dcis grade 3. I opted for the bilateral after my lumpectomy did not get clear margins and because my MRI lite up on both sides and even after 2 biopsies on the opposite side that were negative my surgeon was concerned there was cancer on both sides. My dcis did not show on mammo it appeared as a lump so I was also concerned that if I did get it in the opposite breast it would not get caught timely.



I stayed in hospital 2 nights I could of gone home next day but I asked to stay an additional day. I got great care in my hospital and was comfortable there. I had setinal node done on side that was positive for cancer. My final pathology luckily did not show cancer on opposite side but showed a lot of pre cancerous cells so glad I made the decision I did. I took pain pills or muscle relaxants off and on for 2 weeks. I did not have any previous surgeries to compare it to but felt the pain was much less than I expected. In fact the 2 nd week I was out Xmas shopping several times. I did notice I was more tired tho. By opting for the BMX I was able to not have radiation or have to take any hormonals.



My advice is to see more than 1 doctor and get a few opinions based on your personal risk factors. Wishing you all the best! Take care

Cindy

Infobabe have you consulted with a RO yet?  I had a lump and rads and had a pretty hard time with rads.  With your type 2 diabetes I would be concerned about wound healing as whole breast radiation is very hard on the skin, but then again you would have wound healing with the MX.  I ended up having another issue with my other breast so ended up with a BMX with reconstruction.  I do not think the BMX was any harder on me than the rads were.  I think most of my longer pain from BMX was actually from the reconstruction side of it.

I had a BMX in September, so it has been almost 8 months at this point. It is major surgery, so itmakes you tired. The pain was not too bad, but there was a lot of annoying discomfort, the drains, the creepy crawly feeling in the incision area, the tightness and so on. None of it was too horrible, but it dragged out recovery over a very long period, for me anyway.



As for the drains, here in Greece they do not send you home with drains. Instead I was in the hospital for 5 days, the drains were removed and then I went home.

I'm always surprised that you guys have to suffer with a general surgeon doing mastectomies in the US. I had a radical mastectomy with level 1 and 2 axillary node clearance 3 months ago; one drain removed after 9 hours.  Home after 20 hours. Paracetamol for 2 days only; no pain at all after 3 days.  Full shoulder mobility within 2 weeks; full chest stretch at about 6 weeks.  some minor cording for about 3 weeks. Weighted prosthesis after 5 weeks, running etc then too. No signs of lympodema (yet!) Getting more chemo now but will get radiation in about 7 weeks time - need to keep stretching while that goes on apparently.

Hi Erica,

your post makes me feel better for you guys... in Europe we hear so many negative reports about the US medical system that I have had a nagging little worry about how you cope financially etc.  Same as I worry about the women in developing countries who have no access to any treatment..... sigh