Just Diagnosed and Weighing My Options
It was great to find this forum and I am learning so much from so many!
I was diagnosed with ILC and LCIS in my left after my annual mammogram this month at age 58. I have always had heterogeneously dense breasts. I had a 1.2cm speculated mass during my screening mammogram and then had an ultrasound guided biopsy that determined ILC and LCIS. Pathology showed ER+/PR+ and HER2 equivocal. FISH preformed and was classified as HER2-.
I met with with medical oncologist, breast surgeon, radiology oncologist about a week later. MO recommended that I have genetic testing due to diagnosis and death of mother (ovarian cancer at 50 and then pancreatic cancer at 71), father (hepatic metastasis - unknown origin at 58) and sister (pancreatic cancer age 58). We are waiting on the results before determining treatment. While waiting on the results I had a MRI of both breasts and another "spot" was detected on my left breast approximately 1cm from original. The pathology came back LCIS with stromal fibrosis and chronic inflammation.
I am struggling with which course of action I want to take. Unless something shows up with my genetic testing, the doctors feel that a lumpectomy with sentinel gland removal, radiation and hormones should do the trick. I know that there are no guarantees with anything but am just concerned about all of the cancer in my family that I would rather have mastectomy and not have to worry about this "sneaky cancer".
Did any of you have these thoughts and what did you decide to do?
Comments
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Hi DJay,
Yes, I agonized over having chemotherapy because the MO recommended it but said it was my choice. I had the oncotype test which I scored a 27 out of 100 so I wasn't quite in the middle but not at the lowest end either. My MO said having chemo would give me a few percent lower risk. I had a lumpectomy to remove a rather large lump (3.6 cm) which kind of popped up overnight so I was worried. I didn't want chemo because of the hair loss and the other side effects but I had my first treatment on Friday and it wasn't too bad.
I'd say think about it, talk about it with others, and do what your heart tells you. I went back and forth for awhile but now I feel I made the right decision. If the cancer comes back later, then I can say that I did all I could.
Good luck to you.
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Hi DJay,,, Welcome to the forum. I know you will find it both comforting and informative. The issue that comes to mind while reading your post is the fact that your dense breasts. The best tool for that is MRi. So I would be asking if that would be my primary screening tool moving forward. My breasts are also dense. I had an additional tumor that only showed up on a pre operative MRI. It was one of the factors that help me decide to have a BMX. However, difficulty in screening is only one of the considerations. Good luck with your decision.
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My BS is recommending BMX for my LCIS, ADH, and ILC on the left and LCIS on the right because my MRI lit up like a Christmas tree. Too many areas of enhancement to count. She has told me I cannot be monitored. I'm getting a second opinion but it will probably concur with the first. If your docs feel they can monitor you, lumpectomy might be a good option.
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Yes, I had these thoughts. I did not have the choice of lumpectomy. MX of righty was a given. I opted to get rid of lefty as well. My onc thought it was overkill, but my BS understood why I wanted it. I also had an ooph as part of my treatment, and again onc thought it was too much, but bs was highly in favor. No way to say what is right, but I am still here at least
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Hi DJay,
First off I'm am sorry to hear of your diagnosis but you will get thru it! I was also offered the lumpectomy route & I asked each of the doctors if it were them or their daughter what route would they take. I also had dense breast tissue & was offered treatment 1st then lumpectomy to remove it. However, I was found to have Chek2 mutation... My breast surgeon was VERY HONEST ( he's been in the business a long time) and said, if you do the lumpectomy because of your mutation you will get it again. No telling when but it will happen...that was it I said bi-lateral masectomy it is, because I refuse to go thru this again if I can help it. The day of my surgery they found 2 smaller tumors less than 1mm that wasn't even detected on my PEM scan, so I was very happy I decided to remove both & go with reconstructive. I didn't have a family history (which is crazy) but the mutation was what put me over the edge. If you don't have the mutation it is a tough call because if the history in your family. At the end if the day it was about the quality of life I was going to have...this summer was tough but I wouldn't change it for the world, one bad summer is better than having it reoccur multiple times. I spoke to a woman who had it 3 times ( yes 3) before having a BMX... There was no way I was letting that happen.
I recommend a second opinion from another hospital, and go from there. Know we are all behind you& support your decision, it's not about anyone else. Hugs to you
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I too went back and forth with what to do. I have (had) small dense breasts. I worried that a lumpectomy would leave me disfigured. I thought mastectomy on only the affected breast would leave me lopsided and I'd worry about the good breast following her sisters lead. So in the end I had bmx. I'm glad I made that choice. I ended up with 4 positive lymph nodes. Lefty had some precancerous stuff going on with her and now I feel I'm somewhat out of the woods with worrying about her. Think long. Think hard. Think about today, tomorrow and years down the road.
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Ware, yes my lefty also turned out to have pre-cancerous stuff going on. ILC is, unfortunately really sneaky and can evade all manner of detection methods. Not having the boobs gives me a degree of peace of mind, and having a flat, smooth chest makes it easier to notice any changes.
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Similar experience to many above. Dense breasts, ILC sneaky, not detected on 5 mammos over 5 years. I found it myself in during a self exam.
I opted for everything because of my + nodes. I wanted to avoid looking back and saying "damn, I wish I would have sucked it up and done chemo", or "damn, I wish I had decided on a BMX", or "shoot, I wish I had rads" if something came along later.
BTW, when the pathology came back from my BMX I had some pre-cancerous cells detected in my good lefty (to quote Momine!) that I never would have known about had I not had the dual surgery.
My MO reminded me a couple of times that the my risk was the same (LX/rads) as no rads and a BMX. But my choice was to throw everything at little "c" the first time. And hope for the best.
Claire
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Hi Claire,
Thank you so much for your input. I don't know anything on my nodes yet since they have not done anything. It seems that if you don't know about +/- nodes until after lumpectomy then it kind of like you made a decision without all the information present. I agree that i don't want t go through the "what ifs".
Donna
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Thank you all for your input. It makes it much easier to know that we all have many questions and options and that we can support each other. I didn't realize that I couldn't address each of you individually so I will address you here.
I am going for a second consultation in 2 weeks with some one not affiliated with my current group. I LOVE everyone that I have dealt with that I have seen so far and will probably use them for whenever I decide what I want to do. I have started a list of questions to ask during my second consultation because I have either learned more about breast cancer or I forgot to ask the first time through.
I am curious as to whether or not I will still have to have radiation or chemo if I have a MX since nothing will be there. I am guessing it will depend on node involvement??? Also would I have to take hormones afterwards or not?
I will post again once I decide what I am going to do.
Donna
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