Deciding on surgery after genetics came out negative
I was diagnosed with IDC E/P+ HER2- on 05/12. I'm feeling very overwhelmed right now. I'm looking at what options are ahead of me. After the biopsy, just yesterday for my genetics results came in and they ALL came back negative. No mutations. Honestly during the wait period I was sure that I was going to go for double mastectomy, just to be sure that I was going to get a once and done procedure. Now, even if the genetics results came out good, it still does not provide any clues on why I got this tumor in the first place. With the results I'm sure my doctor is going to suggest that lumpectomy is a better option, but honestly I think that double mastectomy would be a more definitive option, with less chance of recurrence. I know recovery will be longer, but I don't want to go through this again after the initial surgery and the oncotype results come back.
My question is, am I being too drastic by choosing mastectomy, even if my genetic indicators are negative? Please help.
Comments
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Hi Anette. I think it's a personal decision to choose mastectomy if the surgeon thinks that a lumpectomy is enough. I can see why you would want one. Apparently, the research shows that lumpectomy with radiation offers the same survival rate as mastectomy. I have seen women on this forum who got a lumpectomy and ended up with a recurrence in the breast and were shortly thereafter diagnosed with stage IV. Not trying to scare you, I'm just saying I've seen that. It must be very uncommon or else doctors wouldn't offer lumpectomy to anyone.
I had to get a mastectomy because I had too much DCIS throughout my breast to get a lumpectomy. I have implants that look and feel really different than natural breasts, and the implants have to be exchanged once every ten years or so. Some people who get reconstruction have complications and need further surgeries, and other people have no issues. Just something to keep in mind. I'm sorry you're going through this.
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Anette77, I am wondering how old you are, your stage/grade, nodes involved, and how your oncotype score would impact the surgery you want. I just don't think you have enough facts to make this decision. You haven't sat down with your breast surgeon and discussed this yet. I know it is a lot to take in. Make a decision after you have more information. There are some great post on this subject if you do a search. Best wishes.
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Hi Annette,
You are focused on the fact that your tests turned up no known genetic mutations, however genetic mutations are the exception! Only about 15-20% of bc cases test are positive for bc mutations. As to why any of us develop bc? We have breasts! The vast, vast majority of us will never know why we developed bc. Doctors and researchers do not even know why in most cases. Despite advances in treatment of bc what causes the development of bc and what cures it are still unknowns. Take care.
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hi Annette,
I’m so sorry about your recent diagnosis. I’m just a little further ahead from you. I was diagnosed 3/11.
I just wanted to share with you that I do have a genetic mutation- chek2. Which I’ve known about for several years. It was why I had that MRI and why it was caught so early. I decided to have a bilateral mastectomy. My tumor was 5.5 mm. So very tiny. No dr tried to talk me out of that decision. I’m telling you this because I still have moments when I doubt this decision for me. I think because this is just very hard. I loved my breasts. I know deep down this what the correct decision because of my mutation but also so because of my history. I’ve had an excisional biopsy years ago. And the final pathology revealed other conditions in my breast never picked up on any imaging modality which eventually would have required more surgery.
This is hard. Rarely is the decision easy to make and and easy to live with. Im three weeks out from surgery and physically feeling better and emotionally im coming to terms with all of this. To be honest I feel quite proud of myself that I did this and im learning to love my new body, scars and all.
Good luck and take cad
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This is such a personal decision. What's right for one person might be completely wrong for someone else. The only person who can tell you if a BMX is too drastic for you, is you.
I'd suggest you read the following thread. There is lots of information that can help you with your decision.
Topic: Considerations: Lumpectomy w/Rads vs. UMX vs. BMX
And these charts, which I recently posted in that thread, are very helpful: (They are hard to read here but you can find them on the webpage I linked below.)
Source: Lumpectomy vs Mastectomy: How to Choose http://www.melbournebreastcancersurgery.com.au/lum...
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Thank you very much for the reply and the referral to the previous post. This has helped me to understand the factors I need to consider, and while I still need more time to think, this has given me clarity. Thank you so much.
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Hi Anette,
It is overwhelming especially in the first month or two. I remember that my eyes were burning every day from all of the sudden research. These wise women are so right; it's a very personal decision.
While I did have a genetic mutation, I'm learning that other factors can play a role, like having dense breast tissue or not having breastfed. There is a lot to be said for epigenetics (life decisions, foods, stress levels, sleep, exercise, vitamins, minerals, etc., the "software" you put in your body to run your "hardware.") My integrative doctor is convinced it was probably not my genetic mutation but my blood type (A) which doesn't digest nutrients well or clear out cellular debris. She says she's seen it a lot in 40 years of her med practice. We'll never know, but at least now I'm taking digestive enzymes to nip that in the bud from now on.
I chose a lumpectomy, even though I have a few involved lymph nodes. I am not going to let myself worry about a recurrence (as much as I can). I decided to change my lifestyle and diet (low carb, no sugar because it feeds the insulin receptors on the cancer cells), intermittent fasting (not eating early am or late pm) getting the right level of vitamins and minerals (I had very low iodine and vitamin D wihich is common with bc, and lower stress. My doctor has my levels back to normal, and I've started taking Vitality C, a better multivitamin, magnesium, selenium (two forms) and Juice Plus to keep my fructosamine level down and boost my pure fruits and veggies. I do struggle with sleeping. I haven't slept well since my diagnosis, and while melatonin is helpful with bc, I don't like how groggy it makes me feel.
I guess what I'm saying is that there are so many other factors than genetics which can really make a difference. I have surgery coming up in five days and feel like the past few months have helped me get ready for it, or at least, as ready as I'll ever be.
I know it's overwhelming right now, but when the time comes, you'll be able to make the best decision for you.
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