Options, options? Young & Newly Diagnosed

I'm so sorry that you are going through this at a young age. I know I've seen a couple of other ladies in there 20s on the boards recently. It seems that most women are going for the mastectomies right now. I opted for a lumpectomy with reductions on both breasts. I had plenty for the doctors to take. My opinion would be to go for the mastectomy since you are diagnosed so young. You can have reconstructive surgery and hopefully have less treatments that might effect your fertility. Only you can make make the decision that is right for you. It looks like we you are doing your research and asking good questions.

Pinks - I answered on your other thread.

hi pinks. First off, I'm sorry you are here so young!

I just wanted to say that I am as fair as they come. And I had no reaction to rads. None. I wasn't even pink. My RO said fair people often fair better, for reasons they can't explain. So it's not a given rads will be a problem.

Best,

Pamela

I'm with Poodles on this one. Having a cardiologist for a husband, who's dealt with many patients who had major surgery gives me a different perspective on surgery in general. Any time you have a surgery requiring general anesthesia, you are at risk for major complications and death—especially the longer you have to be “under" and on the table. Now, I am not advocating against having surgery—as bc patients, it's absolutely necessary, and sometimes more extensive than we'd prefer. But I would opt for the least invasive and shortest procedure that will get the job done. Survivorship stats are identical for lumpectomy + radiation and for mastectomy (uni-or-bilateral). You are statistically nearly no more likely to develop another cancer in the same breast (“ipsilateral") with lumpectomy + radiation than you were to develop the one you do have, and no more likely to develop a contralateral one (other breast). Lumpectomy is major surgery, but mastectomy is more major—longer time under anesthesia (even longer if you opt to reconstruct immediately after), requires a hospital stay, and a longer recovery time, with drains to manage. And a mastectomy has no effect either way on whether you will need chemo or hormone (more correctly “endocrine") therapy.

As for radiation, I am so fair that I never got a tan that didn't come from a bottle and wash off after one good sweat and a shower—I have had many second-degree sunburns, going back to childhood. But I practically sailed through radiation—just some pinkness and breast enlargement (with the only “tan" of my life being over my lumpectomy scar). No redness. No skin breaks. Not even irritation. Was able to wear my underwire bras throughout.

Everyone's experience is different. Because you're young, they'd want to do more aggressive adjuvant therapy especially if your tumor turns out to be higher grade 2 or 3, is over 1cm, PR-, and/or you have positive lymph nodes—in which case, if you have 3 or fewer positive nodes, they'd send out a post-op tumor sample for OncotypeDX testing to determine the need for (based on probable effectiveness vs. risks & side effects) chemo. On the risk side, you're younger and without the maladies (“co-morbidities") we oldsters get that makes chemo riskier; and if your tumor turns out after surgery to have been 1 cm or less, grade 1 or lower-grade 2, PR+ and you were node-negative with clean margins, they won't even bother to send out for the OncotypeDX because the score would likely be so low as to make chemo unnecessary and infeffective (not to mention socking your insurance company with an extra $4500 tab for the test). But youth has nothing to do with the decision for extent of surgery (except to preserve nipple and lactation function to make bilateral nursing possible, since you are intent upon starting a family). Once a breast is gone, it's gone, and not even the best-looking reconstruction that goes off without a hitch will bring back sensation and function. But if you ever do end up needing a mastectomy, that's always an option. Your options are pretty much foreclosed, however, if you go for the mastectomy first.

If I hear one more person suggesting someone with neither a genetic mutation or close family history of bc get a mastectomy or even bilateral mastectomy for “piece of mind," I will haul off and give them a piece of my mind. (The expression is “peace" of mind, BTW). The fact is that there are patients here who have thrown everything in the book, including bilateral mastectomy, at their cancers, with the goal of “peace of mind"--only to have a recurrence or new primary tumor in the chest wall, underarm, etc. Once you have breast cancer, get used to the fact that recurrence will always be in the back of your mind, and absolute “peace of mind" will be illusory. I weighed the pros and cons and realized that for me, getting a mammo & checkup every 6 months was not enough of a stress to deprive me of “peace of mind." I am at relative peace that I have done and am doing all that I should (as opposed to “can") to never have breast cancer again, and to get back to as normal a life as possible for as long as possible.

Look, there are several ways to kill a cockroach. You can run over it with a Sherman tank, but you can just as effectively kill it by stomping on it. If you have an average-sized block of natural cheese and there's one small spot of mold, just cut off the moldy part (with a margin around it) instead of tossing the entire block. Absent family history or genetic risk, all things being equal for me it's the same with my tumor and my breast. Of course, if you have precancerous areas of concern or several tumors and a very small breast, than things are obviously not “equal" for you.

ChiSandy and Poodles, your posts should be required reading for all newly diagnosed ladies.

Please listen to ChiSandy, Pinkskies. Your posts are overflowing with words like "scared" "struggling" "paranoid" and you are worried sick by excessive tests and waiting times.

You are stressed, and that's not the position you want to be in to make important health decisions. Choosing the most drastic treatment is a choice made from fear, not strength.

You can make the right decision. Expect to have doubts about your decision; you are new at this. You will learn to stand up to the doubts, and keep moving.

Nobody ENJOYS cancer treatment. I don't know anyone who doesn't suffer from anxiety over blood and needles. You CAN move forward and you can make good decisions that make you feel in control. We did, we who once stood where you are now. We were scared, too. We made it through, and so will you.

Face it, this breast cancer experience will shape the person you are, and the mother you will be. Whether or not your cancer recurs, you will be forever changed. As you start your family and on through to the time you are a grandmother, how you handle this will help you feel stronger in the face of other adversities. If it helps you feel calmer, think of how you will tell your children how you initially were terrified of breast cancer, but you did your research and made strong decisions.

Surround yourself with strong people, not just family and friends who are freaked out about your diagnosis, and leaning on you for support. Seek out the friendship of wise, calm people. Wishing you peace, goodhealth and happiness.

Hi!!

I am Cari. I was diagnosed 3 weeks prior to my 32nd birthday, so a "young survivor" like yourself. As a Nurse, I have worked with individuals that have had RADS therapy and chemotherapy for a variety of cancers. This experience definitely affected my treatment choices.

I chose a double mastectomy due to my unwillingness to have radiation therapy. My tumor was on my left side, and possible heart damage was a deal breaker for me. I do not want to live another 20 years only to find out my heart health is poor. I am all about quality over quantity, I will be willing to live fewer years to be comfortable. My physician and surgeon knew that I would not have RADS under any circumstances, so my best choice was a double mastectomy. I had reconstruction and I am really happy with my results. I had a nipple sparing MX, so I still have my nipples. I discontinued chemo due to extreme sickness and poor quality of life.

I chose what was best for *me*, not necessarily what was best for my cancer or what was 'recommended'. I am not afraid of death, I am afraid of not living well.

I encourage everyone to explore how they feel about different choices and outcomes, because only YOU are qualified to determine what is best for you.

DCISinAZ -

We have similar DX. I've followed along with the January board although I'll have surgery this month. I was going to PM you regarding your procedure. Would you be okay with that?

My sentinel nodes were clear and my margins were clean and my tumor was less than 1 cm. And yet, the cancer later was found in my lungs, bones and lymph nodes. But not in either breast. To this day, no additional cancer has entered either breast. This seems illogical but that's how it is. I bring this up to show that removing both breasts doesn't guarantee no further breast cancer. Neither does developing metastatic cancer necessarily mean the breasts must be removed eventually. Crazy cancer