recently diagnosed

moodyblues. Surgery went good. I haven't had too much pain. Took my last pain pill about midnight. Just really tired and weak today. The surgery didn't take as long as she expected. She thinks she got the entire mass. Now the waiting begins for the results. It just feels like a weight is off my shoulder just getting the mass taken out. Then I will deal with what they find. Thanks for asking.

Hi Moodyblues i found out I had BC Nov 7th 2016 biopsy dcis in the left breast only and I decided to do a bilateral mastectomy with reconstruction at the same time. My final report came back with 98% dcis and idc.

Moody, both my BS and the decision-tree video and materials she had me read (as part of a patient-decision study) said that all other things being equal the recurrence rate with mastectomy was 2-3% and with lumpectomy & radiation 4-6%. I chose the latter because I have large breasts and a small not-very-aggressive tumor located in a spot that would minimize the visual effect of lumpectomy. I have as much peace of mind as anyone else my age with the same type, stage, & grade of bc.

And overall survival (life expectancy before death from any & all causes) is the same for both surgical options.

But if you’re looking for true “peace of mind,” I hate to tell you that’s an illusion once we get diagnosed. We have many patients here on bco who got mastectomy, even bilateral (double) mastectomy and still had a recurrence and/or needed radiation—tumor cells can hide out in skin, axillary tail & nodes, chest wall, etc.—all of which usually remain after mastectomy. I know that I will need a mammo every 6 months, and I’m okay with that. Not having had positive nodes, as well as having had clean margins, and a small Luminal A tumor, improves my chances, but the chance of recurrence is never zero. There are no guarantees. Don’t do anything irrevocable for the wrong reason.

Moody - I had DCIS in one breast and no known in the other. I had a BMX (double mastectomy) I'm so glad I did because the so-called "uneffected breast" had many tumors.

Unlike Sandy, I am REALLY glad that I had the BMX. Yes, I did have a recurrence in the lymph nodes, but that was again the luck of the draw.

You have some hard decisions in front of you. I wish you the best of luck.

Dear DebjR,

We welcome you here although we are sorry about your breast cancer diagnosis. Know that you have reached out to a supportive and informed group who can walk with you as you move forward. Please stay connected here. Keep us posted and let us know how you make out on Tuesday. We are here for you. The Mods

I have posted this link in other threads but I believe it is also relevant here.

Summary or article discussing rising rates of bilateral mastectomy following MRI: https://www.ncbi.nlm.nih.gov/pubmed/25159548

Moodyblues, what do you want to do? What, deep down in your heart seems like the right answer to you? That's the only answer that matters. Make the decision and then never look back because you know you made the best decision for you

Yes - I had an MRI before BMX. Very dense breasts. Even with the MRI, they found issues w/DCIS and tumors in the 'good' breast. Personally I wanted it all done so I didn't have to have mammos & worry going forward. Also I did not want to live with one breast.

It's such an individual decision. Good luck with your choices.

Moody Blues, make sure to ask what effect on treatment this decision on surgery will have. You will need radiation with a lumpectomy, probably not with a mastectomy. People do hormonal treatments longer when one breast remains. Etc.

My surgeon wanted me to do one at a time, so she could see how my body handled the first, due to some health issues. Both went fine and I am "flat," One piece of advice is to have a paravertebral block with a mastectomy, which lessens anesthesia potentially and totally avoids pain meds in the OR and hospital stay.

I would find out ER and PR and HER2 before deciding. Have all the information in hand.

ps my health breast felt "funny" to me which influenced my decision too...turns out it was chock full of cysts...also I hated having one breast!

moodyblues - if your tumor is 2.2cm, and triple positive (ER+/PR+/Her2+) you should have a consult with a medical oncologist about receiving chemo and targeted therapy (Herceptin and Perjeta) prior to surgery. You qualify for Perjeta based on the size and Her2+ characteristic of the tumor and doping this may offer you an excellent chance for eradication of the larger tumor and create additional surgical options once chemo is done.

ruby - some will, some won't - same for surgeons, some will and some won't. Generally speaking, the legislation passed during the Clinton administration (the WHCRA Act of 1998) that offers insurance protection that guarantees coverage for reconstruction after mastectomy, offers surgical symmetry as part of that. For many symmetry means a BMX so that either you are bi-laterally flat, or bi-laterally reconstructed even if your contralateral breast has no disease. Reconstruction is guaranteed if your insurance covers your mastectomy, but whether they are mandated to approve removal of a "healthy" breast is somewhat subject to interpretation as they may insist that symmetry can be achieved without mastectomy and recon. FYI - lumpectomy and symmetry correction is not currently covered by this legislation, although oncoplasty during lumpectomy has been paid for by some insurance companies, as has fat grafting after lumpectomy. That seems to be a case by case basis at the moment. I self-elected BMX even though I had cancer in one breast only for a number of reasons - I wanted to minimize my risk, I had a 20 year history of very dense and fibrocystic breasts (I had at least 4 simple and complex cysts in each breast at the time of surgery), mammography failed to "see" my 2.6cm palpable cancer so I could not count on it in the future, my non-cancer breast had been more heavily surveilled in the couple of years leading up to surgery, and I wanted to achieve symmetry surgically. My oncological breast surgeon has no qualms about doing a BMX despite no evidence that there were any issues with the left breast. The post-op pathology revealed ADH and ALH that were previously unknown in the non-cancer side, DCIS and IDC in both ducts and lobules, and a positive SNB. Additional surgery revealed a large positive node that was missed on pre-surgical MRI. I have had many breast cysts, many ovarian cysts, numerous uterine fibroids, a 3cm pre-malignant ovarian mass, a 3cm nerve sheath tumor in my calf - all prior to diagnosis of breast cancer. Although I was unaware at the time of surgery I had cancer that had spread regionally outside of the breast - I felt pretty sure my body could make cancer in the other breast - it appears that was a distinct possibility based on the pathology report at the time of my BMX.