Recurrence after mastectomy???

Annie, the first bs I saw told me horror stories about breast cancer recurring after mastectomy and all the scarring and pain after mastectomy. I got a 2nd opinion from another bs working with a different hospital. She told me bc can come back in the minimal amount of breast tissue left, but it was very rare for that to happen.  The stories about all the scarring and pain were about the mastectomies done 30 years ago. On March 26, I had bilat mastectomies (2nd surgeon). So far, no problems.

Hi Annie (nice humps BTW) --

BC can recur after a mastectomy because it's impossible to remove all breast tissue.  Skin-sparing (fairly common) and nipple-sparing (less common) mastectomies likely increase the amount of breast tissue left behind following surgery (I have no data on this though).  I suppose if I'd been diagnosed Stage 0 or 1, I would've spent more time weighing the benefits and risks of my treatment options.  As it was, Stage II something, triple negative, 50 years old, I went for all the chemo I could get, the bilateral mastectomy and radiation.  I know the stats don't support my approach (i.e. lumpectomy / rads vs. mastectomy) but, as everybody keeps telling me, I'm not a statistic.  That applies to survival as well as treatment effectiveness. As each new tidbit of info was presented to me along this journey (i.e. you have 3 nodes positive for micro mets), I evaluated the choices presented and went with the most aggressive option.  Here's hopping that I don't have to deal with recurrence but if I do, I won't regret my treatment choices.  I may, on the other hand, regret this glass of wine or the fact that I didn't work out (again) today.

Hugs Annie.

t

Yes, there's a chance, even with bilateral mastectomies, but it's very, very small. One can have recurrence locally at the chest wall, in the epidermal junction, etc. But it is the very best way to minimize the risk - down to about 1%. That's why as a very high risk individual (not only premenopausal triple neg., but also BRCA-1 positive) it was a no-brainer to get rid of 'em for me. I know for others there are many complicating considerations. No, I had no indication for radiation as I had clear nodes and my path was clean from the mastx2. I very much wanted to avoid the extra risk from rads (lymphedema, organ exposure, etc.) if I could.

The very best result you can have is a Pathologic Complete Response after neoadjuvant chemo (no evidence of tumor cells macro- or microscopically) but even then you will not get any guarantees out of anyone. We get our Damoclean accessories for life.

Lisa

Woohoo!  Texas .. Here I come!  I should be settled in the new homestead by July.

Hey, Annie, good news about the wine!

I was complaining to my onco yesterday about the terrible indigestion I had after chemo tx #1.  We were discussing other options to treat the indigestion, and she was listing some common-sense things to do to reduce the risk of acid reflux. You know, stuff like not eating right before bedtime, and sleeping in a more upright position, and ... not drinking alcohol late in the evening.

I said my dh and I used to have a glass of wine with dinner, but I'd cut out the wine for the duration of my chemo treatments.  My onco said there was no problem having a glass of wine with dinner--I just needed to be careful it wasn't too close to bedtime because of the acid reflux/indigestion.

The issue of alcohol as a risk factor for BC never even came up in the conversation.  I really like my (new) onco.

otter 

Otter, I was taking Ranitidine for acid reflux, but my onc switched me to omeprazole which she says is much better. PCP was treating my chronic cough with the Ranitidine.

Just wish to know I think of you Annie, and follow along on your posts. All has been well said above. One's choice of surgery is so individual: minimal removal is the current dogma, yet many of us choose otherwise, I think most commonly to avoid staying on a bc treadmill with studies, biopsies, etc. I did choose a prophylactic contralateral mastectomy, yet needed an ipselateral mastectomy due to disease involvement. I have noticed many less office visits and no tests other than my own exam and an occasional clinical exam as a consequence of this (I have silicone implants). This has lessened the feeling of a Damocles sword in terms of local recurrence and contralateral, not to 0%, but 1 or 2%, which has done well by me.



Distant threat of recurrence is omnipresent. I have hope that here too, perhaps with circulating tumor cell blood checks (doubt bone marrow checks would ever catch on, unless done with radioactive tracer/surface tumor cell marker) a different view towards the value of early microscopic detection of disease will occur. Such would buoy breast cancer patients much, to know they may change or re-introduce treatment sooner than later. In this way too, the dream of breast cancer being changed to a chronic illness would be realized for researchers/clinicians and patients alike.



Soon you'll start Adriamycin/Cytoxan, a tried and true cytotoxic regimen which should greatly add to shrinkage of your tumor. Have a good discussion with your oncologist about Neupogin etc to help keep your white count up, and review food avoidances (fresh foods, non-cooked foods).



All the best to you as you continue with your treatments and to all others undergoing them too,

Tender

The statement that bc can come back after a mastectomy is true but very misleading. My MO told me that its about 2 percent. Obviously the more breast tissue you have the greater the chance you have of recurrence. Also the more skilled the surgeon the better chance that there is less breast tissue left. Another reason to be very careful how you chose your doc! Good luck to all....