Prophalactic Mastectomy, am I being too extreme?
My sister had breast cancer at 26, my cousin was diagnosed about a year ago at 42. My Dr. With my breast tissue and history and we have found benign masses before so I'm at a 25% risk over my lifetime and my sister who had cancer thinks I'm being extreme. But I'm not interested in the yearly Mam and MRI 's which will increase my chances with radiation cancer.
Comments
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I guess there's a few parts to this. One of which is whether insurance will pay for it given your risk profile. If they won't pay for it, are you willing to pay yourself? Can you find a breast surgeon willing to do it?
I think it makes sense for you to explore and see if you can find a doctor willing to counsel you about it and do it if you decide, and to wrangle with your insurance and see whether they'll pay for it.
Maybe you've already done all that, and you're all set to go except the final decision. So I assume you know that a mastectomy greatly reduces but does not eliminate risk. In that case, I think it doesn't really matter what anyone else thinks. You're the one who lives in your body, you're the one who understands your risk tolerance and quality of life concerns best. The most important thing is that you make a free and informed decision that you feel good about.
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Thank you for spending the time to reply, I have been doing a lot of research especially the issues I could possibly have after and found out that my insurance will cover PMX for anyone with a 20% over lifetime or greater. I am only 30 but have two children and just by the numbers it makes more sense to me, then do the tamoxifen for 5 years and the rotating yearly exams. I still want to have my next MRI because I just finished breastfeeding and the mass they found and had a vaccum biopsy but didnt show cancer cells did show growth while I was pregnant, I struggle with anxiety and always thinking worst case scenarios, so I just feel that even for my mental health instead of having the what will they find now every six months.
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MRIs do not emit ionizing radiation and do not cause cancer. However sometimes the MRIs use a gadolinium based contract agent that can cause problems in people who can't excrete is fast enough
If you feel a BMX is right for you then that is your choice but there are both pros and cons.
The pros are, you significantly refuce your risk of developing breast cancer, and if you go flat or get the right type of implants, you will not need to wear a bra.
The cons are, the risks of surgery themselves, you will lose sensation, you might not be able to reconstruct as planned, you will not be able to breast feed future children, and your partner or future partners may find the results of the surgery, a turn off.
But if you are at a significan risk for breast cancer, the cons might be worth it.
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Hi WisconsinMom,
Do you know if you sister had genetic testing? If she did, and they found the genetic mutation responsible, you can get genetic testing to see if you carry the same mutation as your sister. Did you Dr. discuss genetic testing?
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my sister and cousin both had the genetic testing and it came back negative however, 10 years ago they only tested two Gene's the BRACA1 and 2 and now it is over a panel of 20, and previous people with negative results for BRACA 1 and 2 are now showing up with positives for the new found gene types, my surgeon and Dr. Are pretty confident that with the expanding education and information they are still learning about breast cancer it will not a matter of IF it is genetic but WHEN will they discover the gene.
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Genetic testing has come a long way in 10 years! I agree - your sister likely is a carrier of some mutation, but the testing wasn't advanced enough to find it 10 years ago. Has she considered testing again?
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Yes, they test her when a new mutation is found, she has a really great genetic counselor.
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Actually, the Ambry panel tests for 33 or 34 mutations! I’d had BRCA 1 & 2 testing eight years ago but did the Ambry panel last summer. All the best to you
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Hi Wisconsinmom88,
I don’t know if this will be any help to you but I’ll tell you the story anyway. My sister had a prophylactic BMX 20 years ago because she had cysts that her Dr.’s couldn’t agree on whether they were pre cancerous or not. After being told she could carry on but get a mammo every 3 months and do daily breast checks she decided she didn’t want to live her life like that so she had the surgery. Having just spoken to her about my situation she said she has never regretted the decision and given my situation actually reinforced her decision.
Good luck whichever way you go
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Following this post because I am considering same due to family history and adh/alh diagnosis (and not done yet-I have one more core needle biopsy to go before surgicial excision for the other area of adh/alh). So far from conclusive results yet....hoping second area not cancer.
Even if there are all just “high risk" results on my biopsies right now, all this has made me realize how tenuous these prelim results really are when you have known risk factors. My mother was getting 6 mo screenings for years when she was diagnosed with IDC stage IV. I do realize this is the “best we have" and definitely better than nothing though.
My dilemma is as much as Id like to drop my lifetime risk from 40-50% down to 10% or less by prophy bmx, all the cons listed above...they matter to me. The scars, getting prematurely rid of possibly currently healthy breasts....my self image....how my husband would react.
Also its hard bc Im 5'6 1/2" tall, 38DDD about 165 (currently 20 pounds overweight but havent been smaller than a DD at 20 pounds lighter weight) Im naturally very dense and with reconstruction I honestly worry about the result. I would look very strange with anything smaller than a D cup due to my frame bc I also have hips..I realize that size is not very realistic with reconstruction due to shape and projection issues. (My mom had this issue and we have similar frames) I guess I worry I wont feel like myself. I feel like I might trade cancer worries (which will be reduced risk not eliminated) for possible body image issues. My mom was greatly impacted by the changes for years. I am 12 years younger than she was then..
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Hi Wisconsinmom88,
I'm glad to hear your sister has a good genetic counselor. You would be surprised how many people get stuck with Drs. that have no clue about genetics...
I can see where your sister might think you are too extreme if your goal is ONLY to avoid the extra exams etc., but if you are worried about getting breast cancer and/or not catching it soon enough - then I don't see why your choice is extreme.
Good luck with whatever decision you make!
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WisconsinMom88, Perhaps I've missed it, but have you personally had any testing such as an Oncotype DX Test and genetic testing before you decide what to do?
Both my sister and I had genetic testing: I have no mutations, she's BRCA! She also found out that she was triple negative. Based on her test results, my sister is having a double mastectomy, and ovaries and Fillopian tubes removed. Such a difficult decision but her tests pointed to this direction.
I wish you all the best.
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I am 43 and genetic testing was negative for BRCA genes but I did test positive on several partial genes for the possibility of breast cancer. My mother was dx at 49 and a grandmother in her fifties. I have very dense breast and am having biopsies formlunps and bumps. I cannot handle all the anxiety and still feel like I have any quality of life. My insurance hasn’t already approved the surgery. My problem is that do I I love the ps- I hate the OS. One the oS won’t do o the surf surgery
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I have not had the genetic testing yet, my breast dr. Decided not to do the testing since my sister was still negative with the most recent panel....but now that all of my milk has cleared up from breastfeeding, I have a dimple on my right breast OUQ, and have a consult with my breast surgeon on Aug 22nd, so I guess I'll just wait and see what shows it from that, plus my nipple is s darker color than my left.....
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Glad to see your post as I am considering the same. 3 sisters, mother, and niece with BC. I’ve taken Tamoxifen for 5 years as a preventative, and am kinda freaked out that my Dr took me off. She suggested PMX, said that insurance would pay considering the strong family history. Weighing the pros and cons, and doing my research. Has anyone else done this? How did yours go?
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