Just diagnosed with a question
I was just diagnosed with IDC last Thursday. This morning, I had my first appointment with my surgical oncologist.
I learned that my tumor is ER+/PR+ HER2 - (My tumor is small, less than 1cm, stage 1)
The surgical oncologist wants genetic testing done because my mother was diagnosed at age 42 and I am 41.
She said that if the genetic testing comes back positive, she suggests doing a double mastectomy with reconstruction surgery. (I would want reconstruction surgery.)
She said that if the genetic testing comes back negative, she suggests doing a lumpectomy with radiation therapy.
She also said that I would be on Tamoxifen for 5 years.
As of right now, I am to go in this week for a breast MRI since I've never had one and she wants to make sure that everything has been caught.
After that, it's a waiting game on the genetic testing, which she said can take up to 2 weeks. When we have the results of the genetic testing done, we can move forward with whatever surgery is needed.
My question is....I guess I'm looking for advice based on the info I have given.
Would you personally have a mastectomy regardless of the genetic testing? Or would you go with a lumpectomy only if the genetic testing is negative?
I know that everyone has different opinions and experiences and I'm just looking for advice based on what you know and on your own cancer journey. No right or wrong answers and I understand that I need to do what is right for me....I could just use some opinions to help me form my own, if that makes sense.
Thanks so much!
Comments
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FIrst of all, I am sorry you find yourself here and have to go through this. It stinks! To answer your question about surgery options - it is such a personal decision. I felt like it was about more than just what the test results said. I had a 4 year old son when I was diagnosed. I was in great health other than the BC and had good disability insurance through my employer. I also know my personality is very high strung and I knew I would be a worrier about all of this in the future. Because of these things, I chose Bilateral MX with reconstruction. I also had the added worry that my mammogram was clear 4 months before I found the lump. When I found out the tumor I had was slow growing and was there during the mammogram, I just didn't trust future testing. I was also stage 1 with a 1 cm lump and I had no family history. I tested negative for genetic factors but did not find out until after my bilateral mx. I know for me I don't regret the decision. I just knew I wanted to do everything I could because my son was so young. You need to wade through all the factors that are personal to you and add that to the information you get from your pathology and decide what is right for you. Just make a decision you can live with years from now. Best of luck!
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Hi ~ as mdg posted this is a very personal decision. I had just a single MX on my left breast with reconstruction to follow a year later (with a lift to right breast and areola and nipple recon 8 months later..). I could have done a BMX but given the discussion with my BS and MO I decided on a single for many reasons (having a BMX does not guarantee that the cancer won't come back) however, I am BRCA negative and I understand that if you are positive the cancer has a higher rate of recurrence and can be quite aggressive. I understand why they would ask you to wait on results of genetic testing.
Lumpectomy was not an option for me so MX was the choice. I chose to keep my right breast to maintain feeling in my chest...I wanted to retain sensitivity from an intimacy perspective. I had also seen a reconstruction done by my PS that was similar to my circumstances, single MX with recon to right breast to lift and match for symmetry. The results were amazing so I knew I was in good hands, that plus the discussion with my Docs sent me on the path I choose. I am very happy with the results.
Again, a very personal choice and you decide what is right for you; I rarely hear or read of any stories when someone regrets their surgery choices. Best of luck to you on this difficult journey.
Mary
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I'm so sorry that you're having to deal wlith all of this.
There's a thread titled "BMX vs. lumpectomy--please help me understand" which includes very thoughtful discussions of why one might choose one over the other. And lists of things you might want to consider as you make the decision that's right for you.
Personally, I considered the results of genetic testing. But only you can make the decision that will be right for you now and in the future.
Best wishes,
LisaAlissa
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etnasgirl, first off, I'm so sorry you are going through this! These boards have been an invaluable source of information and encouragement to me- I would have had a very different experience had I not found them. I'm so thankful.
I think to make this decision, you really have to know yourself and what makes you tick and what tends to freak you out:))
I had the advantage of having a close friend who chose a DBMX with TE reconstruction when she was diagnosed with DCIS (cancer in only one breast- she did both tho) and I saw first-hand how positive her results were, and how the whole experience became a "blip on her radar" (after she got through it, of course!) and she came out with lovely, symmetrical breasts in a few months. So, with my friend's positive experience in the back of my mind AND knowing that I was VERY concerned about having symmetrical breasts and not having to worry AS MUCH about cancer in the other breast, or for that matter, in another part of the first breast, I chose the same route. My situation played out very much like yours is- I was in my 40's- a reason to be more pro-active, my mom's sister had BC, and you and I have very similar stats. I, like my friend, did not wait on the results of genetic testing to make my decision. I figured, since I had BC that meant I "could" get it, so heck let's do this!
So, all that to say- what I knew about myself was that…
1. I wanted even, similar-looking breasts and
2. didn't want to worry as much about getting BC ever again so I chose the path I did. Had another friend who only had a single MX and she has had such a difficult time getting it to "look like" the other breast.
I had my DBMX in July and while it wasn't a walk in the park for a couple of weeks, it was very do-able. I go in for my exchange to implants on Wednesday- and since I was smallish pre-BC, my PS said I could be whatever size I wanted so I'm going a bit bigger! So that's my reward ha.
Just know that you are not alone and whatever you choose, there will be ladies there to encourage you! Sending prayers for wisdom and peace and a big hug to you:))
Freeland
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I so appreciate the replies, thank you!!!
Your answers have been wonderful, very informative. And that's just what I'm looking for. Just to hear from other women who have gone through this. I can learn from your experiences, thoughts, and opinions.
I'm so clueless, even though I thought I had educated myself on breast cancer!
Obviously, I will do what is right/best for me and my life.....but having your answers helps me so much to try to make sense of this crazy new world I have entered.
Please, keep the replies coming. It truly helps me to gather as much info as I possibly can. -
etnasgirl,, So sorry to hear , I am having the same problem as you , What do I do? I have pretty much all of the information in , seen all the doctors and have did all of the testing, I even got my results for the BRAC 1 and 2 Genetic testing which came back Negative but I like you are not sure what procedure is the best for myself. I really am leaning on doing the DBMX because I am so afraid of doing Radiation . I found out on friday that once you have radiation if the cancer returns any where near it you can no longer have Radiation- Which is a One Shot deal- to me that is Really Scary!! My mom was diagnosed at age 50 and passed away at age 57, I am 56 and I could not even imagine how my mom felt deep inside because I do not feel old at age 56!! I was so so sad , it happened over 20 years ago and sometimes it seems like it was yesterday. I want to be here to see my grandkids and be with my family and I honestly have never had to make a decision that is really life threatening and I still do not know what I want yet.
Good luck with your decision
Debbie
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I would have bilateral mastectomy. That is what I did. I will not say I never worry, but I do not worry about it coming back in my breast again. They say there is no difference, but that has not been the case in our support group.
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hi, sorry you have to be here but these boards are great for support and information. Our cases are almost exactly alike. I found out I had a 1.1cm IDC in left breast, I immediately did the genetic testing and my BS said if it was positive we would do BMX if not she would recommend lumpectomy plus radiation. My genetic results were negative so I then wrestled with this surgery decision for a while and it was really starting to drive me crazy going back and forth. What I can say is you can listen to people who have been there and your family but ultimately you have to go with what your gut tells you. What it came down to with me is my breasts were very dense and I had had biopsies before with one resulting in atypical cells being found in my right breast. I just knew that I would always be worrying about it coming back in the right and also I was worried about doing rads on my left side. So I decided on BMX. I had it on 10/27. Now just waiting again for my Oncotype to come back to determine treatment going forward. Good luck with your decision. I know I felt 100% better once I made my mind up and had a plan
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