Please help! Was my mastectomy necassary?

Cosmogirl
Cosmogirl Member Posts: 30

I am so confused. I had said I would have reconstruction from day 1 and was always very sure that this is what I wanted.

Whilst having chemo I fell ill with sepsis. Whilst in hospital being treated for sepsis the ward doctor did a CT scan, this was in February 2016. The CT scan showed metastases on my bones but the ward doctor never told me or my cancer care team.

A couple of months later in May 2016 I had a right mastectomy and axillary clearance. Obviously my lymph nodes were involved as the CT scan done earlier showed metastases on my bones.

I then opted to do a trial for primary breast cancer and when the trials nurse was checking my medical notes to make sure I was ok to do the trial, she came across my Ct scan from February showing that I had secondary cancer not primary cancer and she informed my oncologist.

They then called me in to tell me I had secondary cancer to the bones and that they hadn't known for 4 months because the ward doctor never made them aware of the CT scan result.

Today, I asked my breast care nurse when planning would start for reconstruction and she told me I am not eligible because my cancer is incurable.

Firstly, I didn't think they did a mastectomy for secondary cancer and I am now worried that the operated unnecessarily.

Secondly, when I was told I had secondary cancer why wasn't I told I couldn't have reconstruction.

I am so confused!

Comments

  • stagefree
    stagefree Member Posts: 2,780
    edited March 2017

    oh dear.. and you live in the USA, where healthcare is supposed to be good.

    Well, people make mistakes.. your med team made a dramatic mistake.

    Anyway, having read many articles, the entire bco stage 4 community threads right at dx in 2012.. I can say

    Even with a secondary cancer, some MOs prefer mastectomy to get rid of the cancer load. And even if that wasn't so, they could have dx'ed you as primary patient and do the mastectomy anyway.

    As far as I know, you may insist for reconstruction.. as you were mis dx'ed and operated on. Still, is it worth it?

    Quality of life is above everything else and many in fact don't end up happy with their reconstruction.. never is as good as orijinal.

    My aunt had it, after a couple of months of which they found c-buggers on the reconstructed breast and had it removed a second time.

    Each operation is to be considered carefully.. sometimes being stage 4 from the start is interestingly easier to deal with.. then start with earlier stages and and have recurrence..

    each of us have our own journey and noone is living forever.. having one boob less didn't effect my self confidence, my dh's love or etc.. hope you swallow the news asap and have a proper treatment plan with your med team..

    ı may sound a bit too taking-things-easily.. trust me my friend this is a very bumpy road, yet managable, if you accept the rules from day one. That is do whatever medicine offers and thank God each morning you are still alive :)

    Hugs

    Ebr

  • pajim
    pajim Member Posts: 2,785
    edited March 2017

    Cosmogirl, I'm not sure where you live?

    In the first question, physicians are divided over whether to do mastectomies in women with mets. Some think it's a good idea, some don't. No one can tell you whether it was "necessary".

    In the second question, if your insurance will pay for reconstruction you can still have it. You should contact your insurance company, be it government or private and ask them. A lot of insurances in the US will pay for this. This is your life to live and you can live it however you like. When I was first diagnosed my onc told me to think long-term and he has proven to be correct.

    Someone [obviously] dropped the ball on the CT and mets diagnosis. Mistakes do happen and this one is one of mis-communication. I'm not excusing them -- this was pretty stupid. BUT. It's not the end of the world. You aren't going to die sooner because they didn't diagnosis this on time. It's just that you may have made different decisions.

    Meantime please take several deep breaths. What's done is done. As Ebru says, you need to think of now and tomorrow, not of yesterday.

    Lastly. . .many hugs to you.

  • exbrnxgrl
    exbrnxgrl Member Posts: 12,424
    edited March 2017

    I am tempted to think that you may not live in the US as we don't, generally, refer to metastases as secondary cancer, but I may be wrong about your location. In the US reconstruction is covered for all mastectomies, whether it was prophylactic or due to presence of disease. As to whether the surgery was necessary, no one can say as there are varying opinions on whether it is a useful treatment ofr those who already have mets. Please let us know where you are.

  • susan_02143
    susan_02143 Member Posts: 7,209
    edited March 2017

    I am fairly sure that cosmogirl is not in the USA since we don't have ward doctors or secondary cancer as common words in our vocabulary. It seems that there are three things that went "wrong." The patient didn't get a copy of her scan reports and read them. The ward doctor didn't make sure that the treating doctor was alerted that s/he needed to read this report. And the treating doctor who didn't notice that a new scan report was part of the medical records and needed to be reviewed. However, the ward doctor did add the scan report to cosmo's records since the trial nurse found them, so they can't be considered truly at fault.

    It is not possible to know if your treatment plan would have been modified based on the existence of the new tumors outside the breast and no one will tell you that it was a mistake after the fact.

    It is so important that we all become our strongest advocates for ourselves and keep very good records since so many doctors are overworked, don't remember our history, or don't bother to completely review the information that was collected without them.

    Wish you the very best as you navigate this new world.

  • Cosmogirl
    Cosmogirl Member Posts: 30
    edited March 2017

    I am in the UK.

    This would probably be harder to swallow if my original diagnosis was not delayed by nine months due to an incorrect biopsy. Meaning that I probably wouldn't of had secondaries if I had been treated at my initial referral.

    Thank you for your replies though.

  • pajim
    pajim Member Posts: 2,785
    edited March 2017

    So will the NHS approve a reconstruction? As exbmxgrl says, in the US they would have to have to pay for a recon if you wanted one. It doesn't feel like you should take the nurse's word for it. I don't know how the healthcare system works in the UK but hopefully someone from the UK will be along to help.

    [Meantime there should be an appeals process if your doctor will help]

  • zarovka
    zarovka Member Posts: 3,607
    edited March 2017

    Cosmo - It's not a bad thing to have a mastectomy. As you have heard, it is something we consider if the metastasis is not extensive. I've declined mastectomy so far, but it's on the table.

    However, given that multiple mistakes were made in your treatment, someone should pay for reconstruction. I would lawyer up if needed because those are pretty egregious errors. It takes a lot of nerve to tell someone whose boob was removed in ERROR that they cannot have reconstruction.

    And the idea that you won't live long enough to warrant having a full set with your diagnosis is both laughable and abusive. You are more than likely to outlive the nitwit who told you that.

    Sorry you are dealing with this. Like we don't have enough going on.

    >Z<

  • Cosmogirl
    Cosmogirl Member Posts: 30
    edited March 2017

    Zarovka... Yes, you see where I am coming from.

    I wasn't to sure anyone was seeing the enormity of what has occurred. It's crazy the situation I am in.

    I am grateful for my life and that my cancer is now stable, however, if I didn't need to lose a body part along the way then surely that is something to be concerned about.

    I mean, how would some one feel if a doctor came up to them and said "Hi, you are perfectly healthy but I am going to remove one of your legs, It's completely unnecessary but we just fancy taking it!"


  • stagefree
    stagefree Member Posts: 2,780
    edited March 2017

    Cosmogirl, even if you sue them, the law is so elastic that it would take very long to conclude you are right. And then what? But of course I feel and agree how devastating this is..

    as I mentioned before, getting rid of the cancer lıD is preferred by many MOs even if one is dx ed MBC from the start, and they remove the boob anyway. The operation helps the patient live longer, as examplified in various researches.

    It's still hard to swallow, I and eveybody else on stage 4 forum understand, trust me. Noone but we do. Because we all have our own bu ps down the road, if you read past the threads you'll see..

    new babies born with no cancer lose arms to wrong vaccines.. people get hit walking down the street.. that's life. It is when it happens to you, than you realise the devastation.

    You need good state of mind, positive mood among anything else. Do read scuttler's story I suggest. And Nancyh who we recently lost. There are so many rock star ladies here who look ahead..

    huge hugs,

    Ebru

  • Cosmogirl
    Cosmogirl Member Posts: 30
    edited March 2017

    Thanks Ebru

    I am positive in everything I do. My wife and I practise mindfulness in all that we do. We meditate daily. Live in the NOW. Enjoy a simplistic life in the country surrounded by nature, our only neighbours are wildlife, plants, flowers and trees. My wife is a life coach, psychic and counsellor. We are pagan. We embrace positivity to a high level. Our life is full of goodness. Reiki, Chi Gong, Chakras are all part of our life.

    I just feel that something is very wrong with my treatment.

    Where can I find these reads you suggest.

  • stagefree
    stagefree Member Posts: 2,780
    edited March 2017

    hi again..

    You see these hundreds of pages each having tens of pages of views, comments and real data.. read them all. I did. And it worked wonders. Btw please be careful practicing any exercice be it yoga etc.. which stimulates the lymphatic sustem, as it is the highway of these c-buggers.

    My MO, strictly forbid me do anything other than sswim and walk. And she is a teaching professor at a top notch reseach university.

    About the lost boob, I have no more cents left, I am sorry. Hope you find the solution fast.

    Best,

    Ebr

  • zarovka
    zarovka Member Posts: 3,607
    edited March 2017

    StageFree is the voice of reason. I do want to recognize the enormity of what occurred ... as you say.

    >Z<

  • indenial
    indenial Member Posts: 504
    edited March 2017

    No one can say for sure that your mastectomy was necessary but I have read recent studies that seem to suggest there is often a survival benefit to removing the primary tumor.

    I am sorry to hear that you are considered ineligible for reconstruction. Is that for health reasons or because of insurance coverage? In the US there is a law that women are entitled to reconstruction regardless of stage. I did not reconstruct but that was by choice - I'm sure I'd be pretty upset if I was led to believe I could, only to find out I couldn't. I would at least get a second opinion to see if it is an option, if it's something you really want.

    I can really relate to your diagnosis delays. My doctor ignored/dismissed the breast lump I found and wouldn't even do tests on it until many months later. It did turn out to be cancer but was considered "early stage" - however, they never did full body scans to see if it had spread. Then I finally got a full-body scan 2.5 years later due to pain, and I was told it was "all clear." However, several months later I found out that it was NOT all clear, that the scans had shown a bone met but no one told me and I wasn't officially diagnosed as metastatic until 6 months after that scan!! I can't help but wonder if things might have turned out differently or if I'd at least have made different decisions if there hadn't been so many diagnostic delays. It is incredibly frustrating and upsetting and I'm so sorry you've experienced something similar. HUGS

  • Heidihill
    Heidihill Member Posts: 5,476
    edited March 2017

    These crazy mistakes are so bad it's easy to say they are unforgiveable. I can't say I understand any healthcare system, not even my own, which is probably less complex than the US or British ones. I just wanted to interject here, in case it's any help in alleviating the mental anguish, that at diagnosis of Stage IV de novo (not recurrent) I spoke to several doctors,  general practicioners and two oncologists, and all told me I should have a mastectomy after chemo as part of a multimodal approach to treating a single bone lesion causing much pain and other symptoms. I spoke to a third U.S. oncologist after radiation therapy and was told the approach my doctors took was curative and would not necessarily have been the approach his institution would have taken. Who is to say then that a delay in diagnosis which allows someone to get treated curatively who is suitable for such an approach isn't an incredible stroke of luck? Maybe this is far-fetched but is it possible that given the constraints of the healthcare system some doctors might just "neglect" reporting facts they believe may be detrimental to a patient's getting the best care due to institutional policies?  Cancer treatment is more an art than a science and we don't fit into little boxes so doctor's automatically know what the best treatment for each one is.

    Cosmogirl, as for reconstruction, I would definitely fight for it if that's what you want. Our disease may be incurable, but it can also become as chronic as diabetes, also mostly incurable. So the distinction isn't relevant unless they would also not allow reconstruction for an early stage BC patient with diabetes.  I was told reconstruction was not advisable for me early in my treatment but was something I could consider at a later point. This made sense. Now I'm on my tenth year since diagnosis of mets and I still have not decided whether or not to reconstruct.


  • DivineMrsM
    DivineMrsM Member Posts: 9,620
    edited March 2017

    I second what zarovka says about lawyering up. Make sure to get copies of all your medical reports if you do not already have them. Do not be put off by how long this would take in the court system. You will gain some satisfaction that you are advocating for yourself and that you were wronged by several medical professionals dropping the ball when it comes to your case. At the very least, you should consult a lawyer about your situation, most will discuss the matter for free and then advise you whether you have a case that they are willing to take on. Many also work on contingency so they are paid only if you win.

    Don't be shy or meek about it. Stand your ground. It sounds like serious mistakes were made. By bringing legal action, these doctors and hospitals may put better measures into place for better communication among them so this type thing does not occur to others.

    I sought legal action after being turned down for disability payments. Yes, totally, completely different from what you are dealing with. Still, I wanted to share that with you. I had never consulted a lawyer before and was scared to do it, but I was angry enough that quack Dr. Denial said a scan report likely showed I only had arthritis and was probably only stage ii. After many months, I was notified that my disability was approved. I felt vindicated and glad I stuck up for myself.

    And even if I had not been approved, I would have been satisfied that I at least did what I could to leave no stone unturned.



  • Cosmogirl
    Cosmogirl Member Posts: 30
    edited March 2017

    Thank you all.

    Not for medical or insurance reasons.

    They simply say I am not eligible for reconstruction because I am incurable. When they thought I was stage 3 I was eligible. However, looking back over my scans it would appear I was actually never stage 3 and was in fact always stage 4.

    My GP has now written to my surgeon urging her to approach the CCG and consider me for reconstruction, especially due to my age and also due to all that I have endured with their mistakes.

    Hopefully I will hear back soon.

    Thank you all again.

  • Sue2009
    Sue2009 Member Posts: 228
    edited April 2017

    Cosmo girl, there is no reason to not do reconstruction. I was stage 4 at the get go too, w/bone mets in my spine. I did chemo for a large, misdiagnosed breast cancer. Bilateral mastectomy after chemo & then radiation. 6 months after radiation a PET scan showed spine was clean, but I had mets to the right intermammary chain of lymphnodes. More radiation and a few months later started reconstruction. I was 49. I had doubts that I wanted to go thru reconstruction, but my female surgeon convinced me I would feel better in the long run. I did saline implants, followed by nipple reconstruction, never did areolars, don't miss them either, but am glad to have cleavage. I am coming up on my 9th year anniversary of breast cancer Dx. Su

  • melmcbee
    melmcbee Member Posts: 1,119
    edited April 2017

    Cosmogirl I would be ticked but I wouldnt let that anger make a decision for me. I had chemo radiation bilat mastectomy with tissue expanders and finally gad the exchange surgery. Within a 6 months i was hospitalized twice for infection. I ended up losing the implant and basically went through all the pain for nothing. I have 1 implant and one caved in side. I wouldnt choose another surgery now for any reason. Hope you get what you want just think of any risk. Gentle hug

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