Should I get second opinion?

I was diagnosed with bilateral BC in April, had SMX in May and WLE. Have just found out that low Oncotype DX score means no chemo which is a huge relief. WLE margins not clear so next stage is reexcision followed by radiotherapy. I wanted DMX from start but surgeon said not NHS guidelines I think. I do not want more operations than necessary so do not want reconstruction- want symmetry and am quite comfortable flat. What I would like now is a second SMX rather than reexcision which would limit number of operations overall and possibly remove need for radiotherapy as well. Is this a feasible/reasonable request and is there any point in asking for a second opinion if surgeon says no?

Hi Emma , the nurses may not be able to get back to you for a couple of days as changes going on with the forum mean people may not be able to post for a day or so from tomorrow am . You can ring them to talk it through though if you would like , I know there are others on the forum who’ve been through this  so you could also post on the surgery section to chat once we are able to do so .

Nurses contactable on 08088006000 

Hello Emma42 

Thank you for posting. It’s understandable that you have questions about the possibility of having a mastectomy rather than re-excision for your upcoming surgery. 

When faced with needing further surgery, some people choose to have a mastectomy instead of a re-excision. This may be for many different reasons, such as how the breast may look after surgery, wishing to avoid further surgery if the margins are still involved or for better symmetry, as you mention. Sometimes people will consider a mastectomy as they want to avoid radiotherapy. Although it is important to remember that, in some cases, radiotherapy may still be needed after a mastectomy. 

We would always recommend talking to your breast care nurse or breast surgeon about all of the options available for you. You can ask about the option of having a mastectomy and if this is feasible for your individual situation. Do let your treatment team know how you are feeling about the surgery. They can advise on the risks and benefits of each option and help you make a decision about the most suitable surgery for you.  

You may find our information about body changes after surgery helpful, and the website Flat Friends has lots of information for people who have had a mastectomy without breast reconstruction.  

You ask about getting a second opinion if the surgeon says you are not able to have a mastectomy. Some people do request a second opinion to help them feel they are getting the most appropriate treatment and care. If you decide you would like to get a second opinion, then this information from Macmillan Cancer Support may be helpful.  

Having a second opinion doesn’t necessarily mean that the second specialist or treatment team will offer different treatment options or take over your care. If you would like the doctor who has given the second opinion to treat you, this will need to be agreed by your GP and the hospital where you had your second opinion.  

You may want to search in this section of the Forum, or post a question, to find out other’s experiences of having a double mastectomy.  

Talking to someone who has had a similar experience can often be helpful. Our Someone Like Me service can match you with a trained volunteer who’s had a similar experience to you.  You can be in touch with your volunteer by phone or email for them to answer your questions, offer support or simply listen. You can ring the Someone Like Me team on 0114 263 6490 or email them at someone.likeme@breastcancernow.org, so they can then match you to your volunteer.  

We are currently evaluating this service and would appreciate your feedback. Please click here to the survey. It should take approximately 10 minutes to complete.  

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen to your concerns, talk things through and signpost you to more support and information. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001). 

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Best wishes 

Cassie 

Breast Care Nurse 

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