It's cancer- where to start
I had a biopsy 2 weeks ago and got results back, it's cancer with some precancerous cells around it. They believe it is 2cm long but feel it is growing. My Breast is very dense with other areas that could be just milk drying up from finishing Breast feeding a few months ago or could be unknown all over my Breast.
My decision is to figure out if I should go with a Lumpsectony or mastectomy? How to decide. If I go with lumpectomy there would be radiation afterwards.
Has anyone else had to make this decision, if so what factors did you take into consideration.
I'm not looking for you to decide for me but just what things were in your pro/con list for each.
So far;
Mastectomy
Pro
It should be over. ( this is Huge!!)
No more guessing. I have a daughter I want to be around for.
Con
Loss of whole Breast.
How much will I morn it?
What are the costs for a prosthesis?
Will I regret it, if I find out after it was minimal and could have gone with a lumpectomy
It's a long time to be out of commission
Lumpectomy
Pro
Smaller procedure
Potentially that this is all I need
Cons
Radiation- this terrifies me... Who has been through this and what can I expect.
Higher risk that it isn't gone. Potential to still have to go for surgery again and potential that St some point I would have to go for a mastectomy anyways.
Thanks for any info you can provide
Comments
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Jenga60,
I am very sorry about your recent diagnosis. The first weeks are the hardest but it will get better as you start your treatment plan. I saw someone else debate over the same decision a few days ago so I am going to refer you to that link since a long list of pros and cons is discussed in that forum. Please refer to this link:
https://community.breastcancer.org/forum/5/topic/8...
under the title:
Lumpectomy or Mastectomy Decision Time
Please come back if you have any more questions or concerns.
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Hi Jenga, one thing I never considered when opting for a lumpectomy and radiation nine years ago was that once you've had radiation, it is very likely you can never have radiation in that area again. I had DCIS stage 0 and was recently dagnosed with Inflammatory BC, stage IV. Treatment includes chemo, then surgery, then radiation. I was told they may be able to work around it. I'm also a very rare case in that I have another completely new and different BC in the other breast, so I'm note the best case study! iTS just another thing for you to consider. Hope this helps I truly wish you the bes
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Welcome to BCO Jenga60, we're sorry you have this problem but glad you found this forum.
By either detailing your actual diagnosis or filling in details of Diagnosis (Dx) in you profile, you will enable people to assist better in making your decisions, as to which path you should follow. We can't just assume from your limited info what your Dx is and are therefore limited as to where to best to direct you. Your biopsy results should give other details that are pertinent to advice too, so if you are willing to release that info too, that would be of help.
For any assistance, please feel free to contact us.
We wish you the best for surgery on 24 March.
The Mods
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Jenga, did they biopsy your sentinel node
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ok sweetie, ill just tell u my story, was preparing for our 2nd marriage, making wedding plans when i found the lump,worked at city clinic here in Philly at the time, went to work next day doctor friend of mine did needle biosy and he and my nurse friend looked at each other, and i knew, that was September, got biopsy October, then started chemo three months before surgery, L mastectomy is what i chose, didnt want to always worry bout coming back, thats my decision and my Faincee, hubby now agreed, he said he rather i have one breast then to have Anxiety for yrs. I am now a 21 yr Survivor(Praise GOD) and wear prothesis also, so weigh Your options. msphil(idc, stage2, 0/3 nodes, L mast, chemo and rads and 5 yrs on tamoxifen) -
I felt like I was missing info, that my Dr went over but didn't remember, so I got a copy of the report and added the diagnosis to my profile.
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Jenga 60
I am sorry you have to endure this diagnosis.
First advice is....breathe.
I listened to the local MO recommendation, then I got a second opinion from a big wig institution. . I did not want mastectomy if not needed, I didnt want to risk reinsurance. either.
In my case, I was told that lumpectomy,rads and hormone therapy would have the same survival rate as mastectomy. I recovered from the surgery easily ( a week off work) . I have some interesting scars,
Rads were not difficult for me. I got a bit pink skin and tender and fatigued but that was all. Hormone therapy has been harder. In the beginning I had nuclear, turbo charged night sweats and flushes. MO resolved that with Megace 40mg a day. , I am dealing only with severe fatigue. Oh well, it could be worse.
I was told that chemo would change my survival rate by only 4% .I had an Oncotype DX test that indicated this. Considering the negative effects chemo was not recommended unless those 4% were important to me. I passed.
I don't know what country you live in but in the USA insurance MUST pay for reconstruction of either lumpectomy or mastectomy. They also must pay for any cosmetic surgery on the opposite breast to maintain symmetry
Insurance must also pay for prosthetic although policies limit how many per year. .
Insurance must also pay for a second opinion Its law. So listen to your local MO and then go to the biggest , best oncology center and check if his recommendation is right. Mine was point on with the big cancer center.
As for mastectomy (MX) ending the cancer...not true. Cancer can return on any skin or muscle anywhere on your body. You would be spared regular mammograms. A close friend of mine had a recurrence on the muscle behind the cosmetic implant. Surgery all over again.
Mastectomy is a must if tumor margins cant be clear, or simply there is too much to remove by lumpectomy and other reasons too.
I personally am extremely grateful that MX was not recommended. I just couldn't wrap my mind around that severe an alternation to my body. I do know that if this cancer recurs, I will have to have MX because I have had the maximum radiation allowed in a lifetime on that breast.
So my friend, you really can't make any decisions until you know more.
I wish you all the best that can be.
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Jenga - first of all, I am sorry that you have had to join us and understand where you are in the decision making progress.
I chose a bilateral mastectomy because I just wanted them gone. Even if you go with a mastectomy, it doesn't mean that it won't recur, the changes are pretty similar to lumpectomy, but I just didn't want to have to go through this again. It is good that I went with the BMS because final pathology came back with precancerous changes in the good breast.
Insurance paid for the BMS and reconstruction.
The surgery was a breeze. I was home the next day. Drains were out within two weeks and I was back at work in 2 1/2 weeks.
Based on my Oncotype score, I did have chemo, but will be done on 4/10/2015.
All I can say, is do your research. Get a second opinion if you want to. Take someone with you to your appointments. They hear what we don't.
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Quote from above:
"I don't know what country you live in but in the USA insurance MUST pay for reconstruction of either lumpectomy or mastectomy. They also must pay for any cosmetic surgery on the opposite breast to maintain symmetry"
I don't believe this is true--I don't think the law requires insurance companies to pay for reconstruction for a lumpectomy. Most insurance companies will cover it, but not all do.
Just wanted you to have all of the info.
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Jenga60
RaiderGirl reflects my thoughts perfectly. I chose to go with LX and SNB. What my doctors said, Mayo Clinic book said, and Susan Love Breast book said, that long term survival rates are equal led me to my decision. I know that I have a greater chance of reoccurrence, but am willing to take the lesser surgery now knowing there is a 10% chance I need to address localized cancer again. My surgery went surprisingly well yesterday and I am feeling good today. I chose to have IORT, intraoperative radiation therapy. If radiation is an issue, you should talk to a radiologist about all your options. As RaiderGirl said, visit a bigwig hospital for your second opinion. I went to OHSU, one of the National Cancer Institute hospitals and was given lots of options to address my treatment fears and needs. OHSU also negotiated with my insurance company to cover as if in-network since I was an ideal patient for an alternate procedures that my local hospital didn't offer. Take the time to look at all your options until you are comfortable with your plan.
Joanne
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