New here. Just diagnosed DCIS AND IDC
Hello,
This forum is amazing and I was hoping to get some guidance as making all these decisions is is so overwhelming. Lumpectomy vs mastectomy is the big question now. The good news is that it's small (4mm), grade 1. BUT because I have an autoimmune disorder of vasculitis I might not tolerate the radiation very well, nor be able to take tamoxifen or any of the others. So even though my BC would indicate lumpectomy as treatment of choice, I might still want a mastectomy.
Any thoughts, guidance, advice would be greatly appreciated.
Thank you!!!!
Comments
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Welcome, Lynn77! We're so sorry you find yourself here, but we hope this community can be a source of support and encouragement for you as you begin this journey. You may find some helpful information and feedback in our Surgery forum, lots of members there who can offer their insight in regards to the decision you're faced with: https://community.breastcancer.org/forum/91
The Mods
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Lynn77,
Do you have both IDC and DCIS? What is the size of each area? is IDC area 4mm? I had multi tumors in the same breast and decided to have mastectomy. But I still had to take Tamoxifen. Having a mastectomy does not eliminate taking Tamoxifen because there are still some breast tissues left after a mastectomy. Please read your report to see if DCIS and IDC are in two different areas in the same breast to figure out how much of the breast is involved. Also, is your tumor estrogen dependent? I hope this helps.
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Hi new2bc,
Thank you so much for your reply. Yes, the IDC area is 4mm, and it is estrogen dependent. And the DCIS is 1cm, and the report says it's admixed and away from the IDC. Before you decided upon mastectomy were you contemplating lumpectomy? Thank you again.
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lynn77 --- I know exactly what you are going through and it's a horrible decision to have to make. Take your time -- you probably don't have to rush into surgery --- ask your doctor about that. Mine was slow growing so it's taken me 3 months to decide. Finally decided on a single mastectomy with no reconstruction because I wanted as little surgery as possible. Decided against the lumpectomy because they were going to take out too much tissue and might even have to go back in if they didn't get it all plus 6 weeks of radiation. With the mastectomy everything is done with probably no further treatment. I just wanted it over. Good luck
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lynn77,
I am glad I chose mastectomy because after the surgery other smaller tumors were revealed that did not show up in the MRI. I decided to do double mastectomy even though only one breast was involved. You need to discuss this with your doctor since there are two different areas involved. For some reason, I did not even think about lumpectomy which ended up better for me. You will have more time discussing Tamoxifen with your oncologist after surgery.
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jessie123,
Wow. You bought up an excellent point. I feel like I have to rush and make a decision ASAP, and that causes even more anxiety. Did you ever contemplate a double mastectomy? Thank you!!
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Lynn77 - I was diagnosed with Pagets and DCIS a little over a year ago and decided on a BMX immediately. I wanted to be as aggressive as possible in the hopes of never having to revisit any of this again. MRI had indicated two other spots as well, one in the other breast, both were benign but all of that was very stressful. I also had implants as I was an A cup so my medical team were all in agreement that a lumpectomy was not an option, not enough tissue, no symmetry, etc...
I opted for direct to implant at the time of surgery and was able to avoid a second reconstructive surgery. Recovery was not as bad as I thought it would be and my breasts are very similar to what I previously had.
You definitely have time to make these decisions!
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I have Mixed Connective Tissue Disease that causes skin issues so my doctors recommended mastectomy for me. Some immune disorders are a contraindication for radiation, but there is a lot of discussion around it. The ROs I spoke to told me they wouldn't radiate me unless they had to. Here's an interesting study about the subject: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC42424...
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Yes Lynn77 - I have contemplated everything . In the beginning I wanted a double mx -- then it changed to lumpectomy - now I want a single mx. I keep changing my mind. I'll be sure one option is the best and very happy that I've finally made the decision and then a couple days later it changes. It's really weird. Sometimes I wonder if this diagnosis is causing mental problems. Maybe none of the options sound good because really I don't want to have breast cancer or anyone messing with my breast (-:
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hello sweetie this is what happened with me. Was planning our 2nd marriages when found lump under arm. Diagnosed with idc stage2 0/3nodes 3mo chemo before and after Lmast got married was 42 at time then 7wks rads then 5yrs on Tamoxifen. I am now this yr a 25yr Survivor Praise God Hope Faith and Positive thinking that I would get thru this. Hope this helped.
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Hi MBPooch,
That is so wonderful that you were so aggressive and took care of so much at the same time. - I have small breasts as well so will have limits with reconstruction options. Hope all continues to go great with you.
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Hi SummerAngel,
Thank you so much for that information!!
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Thank you so much for sharing msphil. Congratulations on your 25 years, and I'm sure there are many, many more great years to come!!
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Well Lynn I've changed my mind again. I posted my thoughts when you first wrote your post. I had decided on a mastectomy. Now I've changed back to a lumpectomy because someone on the board said " start small and go big later if you have to" That made sense to me. However, if you don't have the radiation the lumpectomy won't be as good as a mastectomy. I've decided that since the lumpectomy is such an easy out patient surgery and I get to keep my breast I'll try that first. If I can't tolerate the radiation I'll just get the mastectomy later. That shouldn't make us make these decisions ----- just too hard and stressful
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I did the exact same thing Jessie123. Just had my lumpectomy and sentinel node biopsy and all is clear!! The surgery was really easy. I'll meet with my oncologist this week and then start radiation soon. -- And yes, if I can't tolerate the radiation, or if something new crops up down the road, definitely I'll do the mastectomy.
Please let me know how everything goes with you.
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I found getting a second opinion helpful in making my decision. I get them wanting it to be up to us but it really is stressful wondering if you are making the right ones. It gets much easier once you have a plan.
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Hi Lynn77, I’m sorry that you are facing this decision. It is so so difficult. I had a very large area that had to be removed and in my surgeon’s words, I had a complicated case for a lumpectomy. I was facing a lot of pressure from my husband and friends to have a mastectomy, but I really wanted to at least try to save my breast. I also wanted to avoid such invasive surgery and risks that come with it unless the surgeon felt it would make a difference to my prognosis, in which case I would have been happy to have a mastectomy. My surgeon felt that from a medical perspective, he was indifferent between a mastectomy and lumpectomy and my plastic surgeon believed that she could save the breast with oncoplasty. I made the difficult decision to have a lumpectomy because I knew that it left the option open for a matectomy at a later date if necessary. The key for me was not to second guess my decision once it was made. There was no right or wrong answer, so I would have driven myself crazy if I kept revisiting it. It’s a personal and difficult decision; even though I was so unsure in making it, once it was made, I was at peace. I had surgery last week; I underestimated recovery and the cosmetic result, but I’m really just focused on the surgical pathology and hoping for positive results.
Good luck!
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Hello,
Just diagnosed with DCIS, met with surgeon. I have been given the option of lumpectomy with radiation for 6 weeks and taking Arimidex/Femarm daily for 10 years or mastectomy. I am torn on what to do and I am searching for information to help make this very difficult decision. Any feedback is greatly appreciated. TIA
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You sound like me ! I'm having another MRI in April and the surgeon says we can decide then if lumpectomy is possible. I have two small grade 3:triple positive, invasive ductal carcinoma.
I have already gotten through AC chemo andcstarting 12 weeks of Taxol had my second today.
Surgery in June 2019 so I spend alot of time thinking what is my best route. I do trust my surgeon and it would be great after all this chemo to just have the lumpectomy. So I am hopeful. Radiation will follow in July August for five weeks.
But trust I think maybe I should just do the double mastectomy but I have a hard time as I don't want to do more than necessary when no one really knows what will happen.
I'm also on Herceptin for a year and projeta four times because I'm Her2 positive.
Good luck
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Charlie1966, and Lynn77
Whoa! there're lots of approaches to your dx. I had DCIS in 1989 and had a lumpectomy period. Have never seen a recurrence in that breast. Did have a new primary in 2002 in Rt. breast with lumpectomy [nothing else] and again in 2005 [which I believe was just a continuation of 2002] also treated with just a lumpectomy. That was 13 yrs ago. This year unfortunately a new primary occurred, but I believe it is not related to prior tumors. Don't be overaggressive with treatment that may cause more side effects than benefits.
Ask your surgeon or your med. oncologist "what if you just had a lumpectomy?" so long as you keep track it may not be necessary to be aggressive. They always want to be more aggressive than necessary to CYA.
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I preferred mastectomy in order to forego radiation (which can damage heart or lungs) and hormonal drugs (the side effects sound awful). I also did not get reconstruction, and removed my opposite breast. Recovery was easier than I expected. I'm glad I did not require additional treatment. However I only had DCIS.
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charlie--just chiming in to say the anti-hormonals depend on whether your tumor is hormone receptor positive, not on what kind of surgery you have. And long-term SEs from radiation are *extremely* rare. The equipment is so good these days--it's difficult to imagine the radiation going anywhere that wasn't intended.
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Hello, I’m newly diagnosed as well so can only offer good thoughts and wishes for you.
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Hi lynn77 and welcome to the club no one wants to join.
I opted for mastectomy over lumpectomy for peace of mind, it's a very personal decision and I wish you the best as you contemplate your options. My surgery is scheduled first week in March.
I'm doing dmx with no reconstruction due to the size of my breasts (rather than umx).I had a paternal aunt and first cousin with bc, and my mom died of female related cancer.
Another consideration was I didn’t want the radiation.
Trust your instincts, whatever decision you make is the right one for you.
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Well, now I really have no idea how to proceed. I had my lumpectomy and one doc wants to move forward with radiation and tamoxifen. But now after educating myself a lot more I do NOT want radiation, especially with my autoimmune disease. I've been reading such horror stories. And also the side effects of those pills are horrible.
So I spoke to my surgeon about mastectomy instead. She's very supportive of that choice. But my other two docs are not.
I honestly don't know what to do.
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Lynn77,
My RadOnc went on a rant to me about women who opt for mastectomies when they could have lumpectomies plus radiation. I was going for the lumpectomy so it was completely gratuitous and I found it kind of disrespectful. I wonder about the gender of your doctors. My RO was my only male doctor and I definitely didn't think he had any insight into the complexity or diversity relationships women can have to their breasts.
On the one hand, don't take the horror stories without a grain of salt. On the other hand, it's your body and your life and your mind and your breasts, and you have to make the decision you want to live with.
I wonder whether you could get a second opinion from a different medical oncologist? To see whether there's anything medical to the recommendation, to hear another perspective on it, to shore you up for going forward with your current one if you want to stay with her? Actually, I wonder if you could find a medical and or radiation oncologist with some actual background or expertise in comorbidity with your specific autoimmune condition? I feel like that would be by far the most useful and compelling.
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Lynn - it’s a tough call but you need to do what you think is best for you. Doctors advise and recommend but the ultimate choice is yours because it’s your body and your life.
Having said that I had radiation and had zero problems except for a bit of burning and fatigue. I also took Tamoxifen and except for joint pain the side effects were manageable. I took it until I hit the 5 year mark over 2 years ago. I’m just saying don’t let those stories be your reasons for skipping both. There are a lot of women who didn’t have horror stories to tell with either one.
At the end of the day it’s still your decision. Just be sure not to second guess yourself or look back and wonder what if..
Diane
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Lynn77 follow your instincts on this one. Consider the medical information you have been provided. Get second opinions if things aren't clear or you feel your concerns aren't being heard. I, too chose mastectomy partially because my tumor was on my left side close to my chest wall and I did not want radiation over my heart. And I knew going into surgery there was a slight risk that I would still get radiation if margins didn't come back clear. I also had dense breast tissue that was difficult to image. So for a few reasons I felt mastectomy was right for me. Was it the best choice? Only time will tell but I am at peace with it. I hope you find your peace in your decision as well.
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Double mastectomies have their risks too.
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Rachelcarter35 you are very correct in that. It isn't a decision to enter into lightly because it is a lot of surgery and a lot of recovery. You lose sensation almost everywhere on your foobs. None of our choices are easy. BC stinks.
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