I need to fight for the right surgery for me.

Hi bigshirley, and welcome to the forum.

I'm sorry you had to come looking for us, but very glad you found us.

It sounds like you got your question about the insurance authorization of a larger surgery answered, so I won't address that.

What I can tell you is that I was diagnosed with multifocal (in more than one place) DCIS over a year ago, and chose a double mastectomy because of my history (Mom had BC) and my Original Girls were HUGE - heavy, droopy, fibrocystic, and hung nearly to my waist.

Like Beesie and others have said, often there is more going on than DCIS, and you want your surgeon to be able to diagnose that.

I had seven different procedures before my BMX, and during the last two, they found Invasive Ductal Cancer. It was considered to be a microinvasion from the DCIS.

I understood exactly what would happen during the mastectomy, because I dogged my surgeon every time I saw her. I always went in with a two-page list of questions, and I wouldn't let her leave til she answered them.

Like SpecialK, I had my radioactive isotope injection in my left (cancer side) breast the morning of my surgery. During the mastectomy, the breast surgeon uses a small tool like a geiger counter to locate the Sentinel Node. Since there is no big sign on a specific node saying "SENTINEL NODE", they remove only the ones that are "hot" or "light up" with the tool. In my case, they removed three nodes, all of which showed no sign of cancer. There was no need for additional removal of any axillary nodes.

The cancer also had very clear margins, meaning no radiation, and the final pathology report (the one everyone holds their breath for; the one that shows a detailed explanation of EVERYTHING that was removed from the breast tissue and remaining SNB) showed there was no lymph node involvement.

Before I joined this forum, I had very little idea about what breast cancer involved. I assumed the worst, having heard all the horror stories and watched all the scary movies on TV.

Here, I learned that's just not always the case. Every day, women are being diagnosed with BC (a tragedy, but that's another story) and every day, women are pursuing treatments and getting better. There are some incredibly inspiring stories here. 

It totally changed the way I thought about how I would proceed if I found out the cancer had spread. It removed the fear.

Today, it's been over a year. I am done with my reconstruction, I've lost weight and gotten healthier, and my only treatment is five years on a drug that removes estrogen from my body. I don't regret a single choice I've made.

I'm so sorry your husband is having a hard time dealing with this. Many men do. And losing your son at the age of three...I can't begin to imagine the sorrow. Now you are faced with a scary situation once more...

We're not doctors here, nor are we therapists. But in one way or another, someone here has walked in your shoes. And the best thing is, we are always here to listen!!!

I hope by now you have been able to have a better conversation with the person you need to see about your upcoming surgery.

Keeping you in my prayers....

bigshirley - sometimes the SNB is done as a separate procedure, it is actually a good thing as they may have time to complete the pathology prior to your procedure the next day.  I did not have too difficult time with the injections - kind of a bee sting feeling.  See if you can get a prescription or sample of a cream called EMLA - it is a lidocaine cream that numbs, but it takes about an hour to really work.

bigshirley - I have read that they don't like to inject the lidocaine because it may interfere with the tracer injections, but this is a question you can ask.  As I said, for me personally, I did not have any lidocaine - even the EMLA cream, and it was a stinging that was brief, short lived, no problems.  Do you have a pre-op appointment in advance of your SNB, where they do vitals, draw some blood, do an EKG, etc?  That would be a good time for those kinds of questions. 

When they did my node mapping, it was about an hour or so prior to surgery.   They did do lidocaine injections first (quite a few of them).  I didn't feel the tracer dye, but the lidocaine injections were not painless, either.

Radical mastectomies are not the usual these days even for invasive cancers. Radical mx involves taking all the muscle and nodes. More often only as many nodes as needed are taken and the muscle is not taken unless there is a compelling reason to do so. Radical mx are very old school and most surgeons , who are up to date, don't do them unless there is good reason,