Questioning decision
I dont know if this post will be moved to another forum but I thought that because I am newly diagnosed I would post here. I have an upcoming surgery on April 29th. I made my decision to have double mas. With TEs. That is what my ps does. He uses TEs. Yesterday was a nightmare for me, I cried and cried all day long. Last night I was on these boards reading everything I can about TEs and I must tell you there is a thread that really scared me. Are there many awful side effects to having TEs? Are they painful? Is it painful to have a bmx? Am I making the right decision for me? I thought I was. I am plenty scared of this surgery and would really appreciate whatever any of you could offer me. I am not as weepy as yesterday but still plenty scared. Don't want radiation want to get rid of this once and for all!
Thank you ever so much!
Comments
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of course you are scared, surgery is scary. When I had my Lx it was all I could do to stay in the waiting room before. It just felt wrong to me. I don't judge anyone for their treatment decisions, but I can tell you that radiation wasn't so bad, and very easy compared,to chemo. If you are so unsure of your decision, perhaps another talk with you doctor is in order. Did they recommend BMX for you? Mine did not. Also, when reading these boards, remember that more posts are about problems, not about the people for whom things are going well. There are plenty of women who do very well
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I chose bmx with DIEP recon and I am very happy with the results. I also wanted to avoid rads and I just didn't trust my breasts anymore. To me, keeping them was going to cause me more stress than losing them. Although many do fine with implants, I knew I wouldn't like them so DIEP was the right choice for me. It is a very personal decision. If you are questioning the choice you made there is still time to look into your options.
Most do fine with rads. Perhaps seeing an RO would help ease your fears and lx would suit you better.
If you are unhappy with the te's you may be able to have a flap surgery at a later date.
Of course it is surgery, so some fear is expected, but if your decision doesn't feel right take some time to look into your options and listen to that little voice inside you that tells you what.you can be comfortable with. Good luck to you.
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Hi Debann. Thanks formyourmpost. What is a DIEP
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Lmonelli, here is a link to information about the various types of reconstruction: http://www.breastcancer.org/treatment/surgery/reco...
I suggest spending some time on the main BCO site and doing a lot of research. Don't spend as much time on the boards, you need to get basic information before you start thinking about the experience of individual women. You have plenty of time. You have the least aggressive form of breast cancer, nothing much is going to happen in the next month or two that hasn't happened already. Have you had the oncotype test done yet? If you have a low oncotype, that may be more good news for you. *Take all the time you need to make an informed decision that you can be comfortable with.*
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You have a pretty small tumor. What is your doctor recommending? Do you have any + nodes? If I had a well defined small tumor with no + nodes, you better believe I would go for the lx first. Mx is a major surgery.
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I see you are not having your surgery until April 29. That gives you a little time to just think about and reconsider your decision. Just read on here and educate yourself. What does your doctor recommend? Is he/she telling you to have the mx? If so, why? Many doctors don't want to influence the decision one way or the other. My first BS told me to have lx with rads. But I have very small breasts and 30 year old implants. I didn't think that was a good choice. Also, when I went for a second opinion, the doctor did more imaging and found a + node and more cancer. So my first guy just had it wrong. So don't be shy about getting a second opinion. I saw 4 BSs, 2 MO's, and 2 PS's. I also got input from 2 radiologists. The second one flat out said, if you were in my family, I would say get the mx.
If you are nervous about rads, go spend some time on the rads boards and read about people's experiences. For every person who has a hard time, there is another who flies through it completely unaffected. Try not to fixate on your fear and keep an open mind. Quite honestly, every single treatment has a downside, so you have to consider which thing you are most comfortable or uncomfortable with. I think many woman hear they have cancer and freak out and rush to surgery. It took me over 8 weeks to make my decision, get second opinions and get started. I asked my first BS is time was a big factor and he said no. You have time.
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Lmonelli - Your diagnosis is early enough that you have lots of options. Take your time to explore them. My biopsy results were very similar to yours. IDC, 1cm, grade 2, ER+/PR+ and HER-. My first doctor recommended a lumpectomy/ 3 sentinel nodes/ 6 weeks of radiation then we will look further. Radiation had scared me. I considered mastectomy but was concerned about multiple surgeries to remove and reconstruct.
I got a second opinion from a National Cancer Institute Center, OHSU and found I was an ideal candidate for a Lumpectomy and Intraoperative Radiation with my diagnosis at one of the few centers that offered it. Radiation done during surgery (20 gray units of radiation rather than the normal 45 gray units during a six week treatment). I am now 2 weeks past surgery (lumpectomy/ 1 node/ IORT)and it is healing well. No side effects from the radiation and I am already done. My final pathology showed that my cancer is a rare mucinous type of IDC so is extremely slow growing and spreading. My grade was lowered to a 1 even though the size was increased to 2 cm. No chemo necessary since such a low low chance of spread or reoccurrence. Hormone therapy AI is optional. I am trying it to reduce my chances by 1%, but if side effects, the doctor would recommend dropping. I am following healthier lifestyle changes.
I imagined every possibility and treatment possible. (BMX with reconstruction, BMX with no reconstruction to be followed with decorative tattoos, standard lumpectomy with 3 nodes + 6 weeks radiation) I now have 2 3" incisions and am minus the tumor and one node. There are options available to you by your early diagnosis. Get a second opinion which was the key for me. Sometimes things turn out on the more favorable side.I just want to put some balance in from someone that was lucky. You may well be lucky too. My best to you in your decision and treatments.
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Just a quick post--I had no problems with rads. A bit of skin reddening, and a bit of peeling, but no lasting effects and I sailed right through. I don't remember any pain at all. The advice to read the definitions about rads, different types of surgeries, etc. is right on. Many will post here because they have bad experiences and need support or are looking for information to see if others have had the same experience. I don't remember posting in the rads board saying I had a terrific experience, because I didn't need any help or support.
Claire in AZ
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I looked at your diagnosis, and you and are are really similar -- 1.5 to 2 cm, Grade 1 tumor with ER/PR+, HR neg.
Like you, my first reaction when I was diagnosed was just cut the damned thing off. But, I started talking to other docs, and other people.
I talked to the radiaiton oncologist, and came up with an alternate approach -- ended up with short-term radiation -- there are some paths that are 1 day, mine was 5. Many can be only 15. And my lump was located where they could angle the radiation so that it did not hit my heart or lungs.
But, what finally decided me was what someone said -- you can always go back and cut more off, if you are unhappy with your outcome, but you can never put an amputated boob back. My deal with myself was 2 years -- and, I'll tell you, it was a fine line. I was so frightened all the time.
But here I am 7 years out, and I am fine. And boob is fine. It still works, sexually. And that's nice. I see women who have had mastectomies struggle thru recovery and replacement, and all kinds of things, and I am glad that I still have the original equipment.
If you are grade 1, you have time. Talk to lots of people, and remember that those of us who have these early diagnoses are probably going to die of something else.
Big hug, this is all so hard. -
Lmonelli, I am a teeny bit concerned that you said you would have expanders because "that is what [your] ps does." You should have a consultation with someone who has more than one approach.
If I were having an mx (and I nearly did!), I'd have chosen to have a DIEP, with my tummy fat evicted and resettled as now boob/s. As I worked through all my options, and wrangled statistics from my doctors, I realized that, for me, lumpectomy plus rads would be at least as effective as a mastectomy (or two), without the risk of potential nasty recovery complications. Eventually, I chose the lx, with the thought in the back of my head that if I then felt I needed/wanted mx, I could just do it later, at my convenience, after having researched plastic surgeons and hospitals. As it happens, I am really, really happy that I had only the lx.
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lmonelli - I think it might be helpful for you to make a procs/cons list for surgical options. Sometimes writing it down helps clarify what's really important to YOU!
Some of the things I considered on my pros/cons list when I was presented with my choices (lumpectomy w/radiation, uni MX, bilateral BMX, tram flap & DIEP flap) were:
Whether or not radiation would be required
The length of hospital stay
Recovery time
Aesthetic result
How many surgeries
Anxiety level due to possible recurrence
Effect on intimacy
My diagnosis was similar to yours IDC, stage 1, <1cm, ER+/HR+, HER2- and no suspected nodes (after surgery we learned 0/5 nodes). My tumor was under the nipple so no matter what, I was going to lose it. When I made my list, I realized that for me even though a BMX w/expander was a lengthy recovery and painful it would produce the best aesthetic result and I could avoid radiation. I was only 39 and discovered during this journey that I am very vain. Symmetry and aesthetics became my main objective. So, with writing it out...it became very clear what route I wanted to go. I hope this helps.
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The link that Sjacobs posted will tell you about different types of recon options. It is true that a PS will usually only tell you about the ones they do. My first PS did only TRAM flaps, so he never told me about DIEP. I researched the TRAM and didn't want that, then learned about DIEP on my own. I searched till I found the only PS in my area who could do the DEIP and low and behold he was in the same practice as the first PS I saw. I chose a double mx over a uni because I wanted better symmetry.
Is your tumor in the left or the right breast? Many who fear radiation do so because the tumor is in the left breast and radiation will pass through the heart or the lungs, although often this can be avoided. A consult with an RO may be helpful to ease your fears if you would really prefer an lx.
Also, there are circumstances where rads are still necessary after an mx. For example if your final pathology shows the tumor margins are close to the chest wall or a positive node is found, rads will still be recommended.
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Thank you all for sharing your experiences with me along with your kind words of encouragement. I am doing much better now after seeing my PC. She put me at ease with my decision. I'm in good hands with all of my doctorsand I am going to be fine. Maybe even better..lol. I need to rest my mind and stop "researching".
Fondly,
Lori
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hello, i too had no problems with rads, also sailed right through,just peeling and a dark spot, that faded alot, hang in there sweetie, and come here often, we are here for U, this is coming to U for Inspiration, i am now a 21 yr Survivor(Praise GOD) all things are possible to those who beleive. msphil (idc, stage 2, 0/3 nodes, L mast, chemo and rads and 5 yrs on tamoxifen) -
No suggestion from me just a comment. I did a BMX and had TE's put in for reconstruction later. I was one who did BMX and needed the full course of rads But no boosts. Several months later because I had no apparent issues with the rads I chose to have a DEIP. I did have several complications with my reconstruction but it has nothing to do with rads. In fact the rads side had no problems.
Just another thing to consider. BMX does not always mean no rads, so don't do a BMX just to not have rads.
Good luck. Our prayers will be with you regardless of your surgical decisions.
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Anyone here have Oncotype or Mammaprint scores? Did that impact your chemo decision?
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