Don't know what to do, any advice?

Hi sweetie, second opinion is always a good idea, I had L mast, chemo and rads and 5 yrs on tamoxifen, (idc) and Praise GOD Iam a 20 yr Survivor) and just had L mast, everyone not the same.Hugs!!!!!!!!!!!!!! msphil

Hi TB, 

Really sorry to hear of your diagnosis, but I'm glad you have found this site early on as it can really make everything easier. 

I am going to tell you what my BS told me when I was first diagnosed - " Breast cancer that is confined to the breast can not kill you." Basically what this means is that the breasts don't do anything that is vital to your survival, so as long as the cancer doesn't 'move' to other parts of your body, you'll be 'okay' - treatments, yes, but the cancer won't kill you - it won't even really affect you at all other than needing to be prevented from spreading.. This means that the first line of 'attack' is to remove any cancer they can find in the breast. Get it out before it has a chance to spread. Usually if it does spread, the first place it goes is into your 'local' lymph nodes & they will likely do a biopsy of your lymph nodes during surgery and remove any that are cancerous. What happens during surgery will also likely determine the rest of your treatment. If you do have positive lymph nodes, then chemo becomes more likely (chemo attacks fast growing cells all over the body - but they only give it to people who reach a certain degree of risk that it has spread elsewhere in the body). Radiation is a possibility - that targets any cells that might have been left behind 'locally' after surgery. There are also hormone treatments depending on the type of cancer you have. The more info your docs get, the better they will be able to manage a treatment protocol. 

As to whether you should have a BMX or not; I had a UMX and I still don't know if that was the 'right' decision - and nobody can tell you what the right decision is for you. Have you always dreamed of nursing a child? Will you worry every time you go for a mammogram? How important is nipple sensation to you sexually? These things are different for everybody. Keep asking people - sometimes you will hear things that you didn't think to consider that might make your decision easier. 

Many hugs.  

I'm sorry to hear about your diagnosis td2005.

The type of surgery you opt for is a very personal choice. It sounds like a lumpectomy is out of the question? I had multifocal tumors and ended up having a lumpectomy and 3 re-excisions. But it sounds as though you are more concerned with whether to have a single or double mastectomy?

In that case, it's true that you may have a greater chance of developing breast cancer in both breasts due to your young age. It doesn't mean you will. If you have to take tamoxifen (if your tumor is estrogen positive you will probably take one tablet a day for 5 or 10 years) that can reduce the chances of developing a new cancer in the other breast. And of course, having a mastectomy doesn't guarantee that you will never have a local (in breast) recurrence or new breast cancer, there is a very small chance (like 1-3%) because they can never get all the breast cells. 

If you opt for a mastectomy then you will probably not have to do radiation. For me radiation was daily for 30 days, and was very easy. And like the girls who have been through bilateral mastectomies have said, it does actually reduce their risk of another breast cancer and psychologically that is a big thing.

Your oncologist will definitely recommend chemotherapy due to your young age and tumors. I 'only' did 4 cycles of TC chemo, which took 12 weeks from the first infusion to recovery from the last infusion. It's not pleasant, but as long as you avoid crowds (viruses and infections), most people do fine. 

The chemotherapy does damage fertility, and I don't know whether you have children as yet, or planned to in the future, but if you plan on children, you will need to take measures to protect your fertility. It would be very rare to be pushed into early menopause at 31 years old, but women who do chemo will most likely go into menopause earlier than they normally would have, and following chemo your fertility will be lowered. Many women your age do have children after breast cancer, but you should know that your fertility will most likely be affected. 

The fertility part is something women your age are not advised of during the early part of their treatment, and that is so unfair. I wasn't, and by the time I eventually got an appointment with my oncologist to talk about it, I was so annoyed that I just told them I was doing IVF. I ended up delaying chemotherapy by 6 weeks so I could do back to back IVF cycles and freeze embryos. But I was much older than you (40 yrs), already had a 5 year old and we were just about to start tying for our second child when I was diagnosed. You are much younger and will likely be able to do 5 years of hormonals and still conceive, but ask about zoladex injections which may help protect your ovaries from damage during chemotherapy. 

If it's important to you, make sure they talk about your fertility options.

Hi tb2005, so sorry you got dealt this blow

I was fortunate that mastectomy was the 'be all and end all' of my treatment, although I'd flat out refused radiation treatment up front, so it was never going to be offered if I'd needed it or not.

Now I don't regret choosing to have BMX, and if I had the chance to have a do-over, I would make the same choice, but I don't think going in to it I reallyknew what I was in for.
Ziggy mentioned about nipple sensation, but that's not all, the nerve damage from the mastectomy leaves you with no feeling in the 'breast skin' for quite some time, and sometimes you never get all the feeling back. (so my Plastic surgeon informs me...I'm still at the no feeling stage, 3 months post op).
That was a total shocker for me. I guess common sense should've told me that would happen, but honestly, I'd never had a mastectomy, didn't know anyone who'd had one and all I figured was the same skin sensation but with no nipples or areolae (spellcheck was pretty insistent the plural of areola was not areolas) 
I think, besides the scars, it's the one thing that really got to me the most.

I've actually been blogging about my BC journey, and I just did a post mastectomy update.
I'm not the greatest blogger, but you might find some of what to expect after mastectomy.

http://flyinthecoffeepot.wordpress.com/2014/03/22/post-mastectomy-3-months-on/