Hi TTM,
So sorry that you have had to join us here. I was in a similar situation as you re given the option of a mastectomy, but that was only after my WLE and SNB, I’m 39 as well so I know what it’s like to be diagnosed at this age.
My diagnosis originally was a 20mm grade 2 invasive ductal carcinoma, ER and PR+, HER2- and node negative. I had the tumour taken out and at my follow-up appointment my surgeon told me the lump was bigger than originally thought at 34mm, and because of that I would need chemo as well as radiation, but that I also had the option of a mastectomy (mx) to possibly avoid rads and it was my decision to make. That absolutely blew me away as originally I was told WLE, SNB and six weeks of rads plus five years of tamoxifen!
I didn’t really take in what the surgeon said at that appointment so I spoke to my BCN and she arranged another meeting with her and I took a friend along that time to take notes and she explained things better and put my mind at ease. Since then I’ve come to New Zealand (my home country) for my chemo treatment and I’ve seen the top breast cancer surgeon here at a private appointment, and she’s also explained more to me about my diagnosis and how that suggested the mx option. I’m right on the edge as far as age, size of the lump and it’s location, I had really close margins with extensive lymphovascular invasion and pre-cancerous cells in the area as well, so all these things combined add up to slightly higer risk of recurrance apparently.
I was really against further surgery until I saw the surgeon here in Auckland, but after seeing some examples of her reconstructions I’m feeling like I’ll go with that option now as my risk of recurrance will be a lot lower, she said 2%, and I’ll get a new breast out of it to replace my rather ugly post-WLE boob!
It is a very personal decision, and you will have to weigh up the options based on what your surgeon, oncologist and radiation oncologist tell you based on your own diagnosis - we are all different in what is specifically happening to us, but whatever you decide you will have our support and the resources of this site to help you through it all.
I started writing this reply a while ago and see you have posted since with questions. Is it a WLE (lumpectomy) you’re having? If it is, this is what I had and I found it to be a lot less horrible than I was expecting. Mine was done as day surgery and I was up and about very quickly after coming round and going to the ward to recover. I only had pain when I came round from the anesthetic, they asked me how bad it was on a scale of one to ten, I said seven so they gave me three pumps of morphine and after that I only had a tiny bit of discomfort.
Even though it’s a day surgery you should take an overnight bag with pjs that do up at the front, and preferably that you don’t have to put over your head as you will have restricted movement of the arm on your affected boob side. You should only have to stay in if your surgery is done late afternoon as they don’t usually discharge after about 8pm I think, and they always want you to go home with someone as well. Take a book, magazines, iPad, iPod with you as well as there is always a bit of waiting around to do on the day.
Post-op you will need to start doing exercises that your BCN or ward nurse will give you (it’s a booklet and dvd supplied by the good folks here at BCC) pretty much straight away, you should also keep taking whatever pain meds you are given as they will help in your recovery. I was pretty much back to normal the day after, and didn’t feel any sickness from the anasthetic.
Re your lymph node question, I had my lymph nodes checked at the same time as my ultrasound scan after the mammogram. They also took a biopsy of my lump but not of the lymph nodes. In my case they did a sentinal node biopsy at the same time as the lumpectomy, which is when they take just those nodes that are linked to the breast lump and send them off for checking, if they are found to have any cancer cells they will go back in for a full clearance I think. They locate the sentinal nodes by giving you a pre-op injection in your affected boob of radioactive tracer, and also injecting blue dye either before or during the op. The tracer injection is just a tiny scratch (mine was painless as the doctor giving the injection was rather lovely to look at! :-)) and the blue dye will probably leave your boob with a blue stain on the skin for a while after (mine still has a blue patch on it and I’m now two months post-op).
Re your question about tablets, if your lump is responsive to hormones (oestrogen and progesterone I think they are) they are referred to as ER and PR positive, and these cancers can be treated by hormone therapies, the most common you will see is Tamoxifen and that is what you take for five years, and in most ladies it will force you into menopause. This will impact on fertility, so you should speak to your surgeon and BCN about a referal to a fertility clinic if you think you want to harvest eggs for future IVF treatment. I was given this option but didn’t go ahead with it as I will be 45 by the time the Tamoxifen finishes. The fertility thing is an extra added shock on top of everything else for those of our age, I think I was more upset about that than the cancer in the early days after my diagnosis because I don’t have children and desperately wanted them, but in the end I just wanted to get my treatment underway so have pushed that to the side for now.
One thing I would say is if you can take someone with you to your appointments this is a good idea as it is such a lot to take in and your brain gets overloaded, a second pair of ears makes sure you have all the information but also don’t be afraid to call your BCN and ask questions or ask for another meeting with your surgeon. You can also ring the BCC helpline (Jo posted the number in an earlier post) and they can answer questions or just listen if you need to offload emotionally.
Good luck for your op on the 30th and keep asking questions here if you need to.
All the best,
Tracey
