Nearly finished chemo - thinking about MX now

Next week I have my second dose of taxotere, being my fifth of 6 neo-adjuvant chemo cycles (FEC-T). I went straight into chemo 11 days after diagnosis in December, and will be having a mastectomy and lymph node clearance approx 4 weeks after my chemo finishes.


So, final chemo session is Wed 2nd April, then I’ll be having a mammogram, ultrasound and another CT scan to see the end results, followed by an appointment with the breast surgeon. I worked out that I will be seeing him probably about 2 weeks before the op, but until that point I won’t get to discuss it at all.


It’s playing on my mind now, and looking through the forums, I can see that it worries a lot of people. I am obviously worried about my cancer returning, and asked my oncologist about a double mastectomy, but she assured me that a double mx would offer no medical benefits at all, as my cancer would not return in breast tissue - if it comes back, it will be secondary, elsewhere in the body, apparently.


Then I started worrying about how I will look afterwards. Provisionally they have told me that I’ll have a single mastectomy in May, then 15 sessions of radiotherapy in the autumn, then a reconstruction at some point in 2015. I will also need hormone treatment, but they haven’t told me anything about that yet. However, I have been reading about natural fat being used instead of implants. I’ve got plenty of that - and as I understand it, if you go for that option, you can have an immediate recon as it won’t be damaged by the radiotherapy. Am I right? If that is the case, why have they not mentioned that to me yet? If natural fat looks more realistic than artificial implants, I’d far rather go for that option. I also think that cosmetically I would look more natural if both breasts were done. I’m 48 and have quite large saggy breasts. I dread to think how odd it would look if only one were replaced.


But how on earth am I meant to get my head round all of this when I won’t get a chance to talk it through with the surgeon until so close to the operation date? Why don’t they allow us more time to discuss the options and consider them?


If anyone can offer any realistic advice about the options and the pro’s and cons, I’d be very grateful. I really am worried that I’ll walkm into his office unprepared and get talked into doing the wrong thing.

I can’t really offer any advice re the mx and recon as I didn’t go down that route.

I was dx 4 years ago and like you had chemo first and was told that I would have a mx following this as my tumour was huge.  However, by the time I had finished my chemo when I had a scan at the end it was found that there was hardly anything left, so when I met up with my surgeon again he said that he was able to perform a lumpectomy. 

Like you I was concerned about recurrence so I asked him if I should still go down the mx route and whether a double was better than a single and my husband also asked him straight out what he would recommend if it was his own wife.

My surgeon was adament that a double mx does not cut down the risk of recurrence and he said bluntly that having a double mastectomy was in a lot of cases just about the pyschological aspect.

The reason I mention this is are you still sure you will be having a mastectomy or might you have enough shrinkage for the lump to be removed on its own.

Something to think about, hopefully others will come along with their experience of reconstruction.