Cancer on opposite breast before surgery??

Scared, you can ask for whatever you want!

I had BMX June 2015. I had multi-focal(7 foci), multi-centric BC in my left breast. I had sentinel nodes done on both breasts. My surgeon said he felt that was the best thing to do. Once you have your breast removed, and if by chance they find something in your good breast after they do the pathology they would have to go in and remove all the lymph nodes. I would take my chances on only having Sentinel nodes removed. That is just my opinion though. I have not had any issues with Lymphadema 1 1/2 years out.

Breast tumors don't (or at least almost never) spread from breast to breast. If they spread, it's within a breast (i.e., growth), from breast to sentinel nodes (same side), and then to (worst case scenario) distant organs. Contralateral tumors mean the conditions favorable to formation of the first tumor were also present in the other breast. If you have no evidence of cancer in the other breast, the only reasons to have it removed are either personal preference or a genetic mutation that puts you at risk of developing another breast cancer. Even women with two healthy breasts are advised to have BMX if they test positive for such a mutation. (And the test is run on a blood sample drawn, not a breast tissue specimen). But as to “peace of mind," unless you have such a mutation, you should know that a BMX (both breasts removed) confers no overall survival benefit over UMX (one breast), and UMX doesn't have a better survival rate than LX (lumpectomy) + rads.

And here in the U.S., it is absolutely not true that one positive sentinel node means all nodes will or even should be removed. The new std. of care suggested by UCLA calls for leaving even other positive nodes in place—reasoning that if there was one positive node, micrometastases are definitely present and so long as adjuvant systemic treatment (chemo &/or endocrine) is timely administered, removing the other positive nodes is like locking the barn door after the horse has been stolen. Moreover, surgeons are beginning to realize that the more nodes removed (especially more than one level), the higher the risk of lymphedema; and that even with sentinel node biopsy, the risk is much higher and lymphedema is more common than conventional wisdom taught. Some surgeons advocate even skipping SNB altogether, reasoning that with IDC, micromets are usually present in the bloodstream even with all-negative nodes and that adjuvant treatment should be administered. What kind of adjuvant treatment (chemo, endocrine, targeted) should be determined by the tumor's biology on surgical pathology (hormone-receptor and HER2 status, grade, size once clear margins have been achieved, mitotic rate), genetic assay of tumor sample should the pathology be inconclusive as to risk factors (OncotypeDX) and further gene assay (Mammaprint or Prosigna) should OncotypeDX fall into the low-end (18-24%) of the intermediate risk range (18-30%).

Mets are a possibility at any Stage/Type (DCIS/IDC/ILC/IBC . Unlikely at lower Stages but possible. You should be being scheduled for full body CT/MRI with contrast and a bone scan. Possibly a PET Scan. Heart function tests are also a probability before any chemo.

Talk with your Dr about your concerns!