I had stage 2, grade 3 IDC tumour/ surrounded by DCIS, with clear nodes, and also had the choice of a MX or WLE + Rads, as im quite large breasted 36E i chose to have a WLE + Rads as i was still able to get quite good cosmetic results.
Usealy unless an area of DCIS is very extensive and they cant get clear margins, or a WLE wouldnt give you a good cosmetic result then a MX would proberly be advised for you, though if you have been given a choice then it might be worth bearing in mind that both options a MX or a WLE + Rads are comparable and provide the same clinical survival outcome,the chance of survival is not affected by the choice of surgery, and a woman’s life expectancy is the same no matter which surgical choice she makes.
Some women sometimes wrongly assume that breast cancer won't return if the whole breast is removed,but this isnt always the case as there is always "some" breast tissue left behind (approx 5%)this is because breast tissue extends to the underarm and clavicle area and cancer can recur in that tissue or on the nearby chest wall.
A MX will though greatly reduce the risk of recurrence as will a WLE + Rads, but there are no gaurentees unfortunately with either of the Ops .
Re the opposite breast,there is a slight risk of a new cancer in the opposite breast ,"The risk of a primary breast cancer in the contralateral breast is approximately 1% per year. Patient age younger than 55 years at the time of diagnosis or lobular tumor histology appear to increase this risk to 1.5%."but if you are er+? Tamox or an AI will greatly help in reducing the risk of a recurrence in either the same or the opposite breast.
Its very often a personal decision about how you feel about both surgery options,but i would say have a proper chat with your med team or maybe give the helpline a ring here on BCC to try to help you come to the best decision for you.
Good Luck and all the best to you,
yeah think your right about doctors having different opinions.Not surprised your confused on what to do. I had to make the decision on having a mastectomy or lumpectomy I chose lumpectomy but got something in the middle, half a max lol.Suppose a bilat/max will ease any worries and give peace of mind,it's a hard decision to make.
I also think it depends on each doctor too. I was told there was a higher percentage in it coming back in the other breast than someone who had not had cancer.
I am so confused what to do!!!! lol
Least I have time on my hands. The Marsden are brilliant arent they, I am under the Chelsea one in London. Will ask them if I can have my radiotherapy at Sutton as will be easier every day than going on the train.
I had grade 3 DCIS and 17mm invasive grade 2 and had a central mastectomy so still got a bit of a boob left but is much smaller than the other one lol.I also had a node involved so had to have chemo.I was also treated at the Marsden in Sutton. I was told that there was no greater risk of getting it in the other breast,this was nearly 4 years ago so perhaps things have changed.
Wishing you all the best with your decision and treatment
Below is a link to the breast cancer care information about DCIS. One of the main ways to treat DCIS if its in a large area is mastectomy. The leaflet below from breast cancer care explains that in more detail.
I know there is more chance of it coming back in the other breast than someone who has not had breast cancer, so if I am going to have one, I decided that I would play safe and have both. The Marsden who I am under are quite happy to do that for me.
My DCIS was quite a large area, but the invasive was luckily only a small area.
Hi stargazerlilly, hope you don't mind me asking but I was wondering why you are considering bilat/max.I know with lobular cancer there is a risk of getting it in other breast but not with ductal cancer.I had invasive and DCIS and bilat/max was never mentioned.
Sorry if i'm being nosey.
Hi yes thats more or less the same as me Sheil. I had a large area of DCIS as well as two small invasive tumours. My nodes were clear too. I am going to see if I get clear margins this time, and then have a long hard think. Three males doctors have told me to have a mastectomy but one lady has told me that Breast preservation is a good idea!
I am terrified of the operation as it sounds horrendous, but will see how I go.
I keep reading on here ladies say if only they had etc. etc. which does kinda push me towards the bilateral!
Yes, great news SGL. You are in a similar - but not same - boat as me. I have 2 small, one tiny, invasives with some LCIS, and was 'recommended' a Bil Mx by docs, except for the professor who did my MRI-guided biopsy. I just kept feeling that I've got clear nodes, and hormone responsive type, and this lady just really saw it from my point of view. She really seemed to think I've got a bit of wiggle room - so I had the WLE's with radiotherapy, and if there's any sign of anything still hanging around in a year then I'll seriously reconsider then. I just thought they can't stick them back on, but they can always take them later. I didn't realise how 'attached' I was to them there boobs.
I did go as far as going to see the plastic surgeon about bilateral reconstruction but to be honest it seemed so drastic. He seemed to only consider the LD flaps and to me that meant I'd have neither a front or back bit left untouched. I'm going on the more recent research I've read and a bit load of gut instinct. Just hope it doesn't come back to bite me.
But I really hope you can come to a decision and be happy with it. Let us know what you decide.
Thanks Andie and EL Katrano, it is good news, but I am so unsure what to do. I don't want the cancer coming back, but the surgery is so drastic. Will definitely think long and hard about it.
Hope you are both ok.
Great news on the MRI ! Sorry about the rest of it, theres so many tough decisions to make SGL.
SGL so glad that the MRI news is good. Your surgeon sounds brilliant. When I was DX I had 6 months of chemo before my surgery which gave me plenty of time to consider what surgery I would be happy with and like yours my surgeon agreed to go with my choice. No one can make that choice for you so take the time to be happy with what you decide.
Locket although I only had one breast and it's nodes affected by cancer I opted to ask for a bi lateral MX. I am a much older lady than you ,and I knew that I would cope better being flat and even.I also opted for no recon because after 6 months of chemo and then surgery I felt that I had had enough and wanted to move on (because I was to have rads my surgeon would not do the MX and recon at the same time) The decision whether to have the healthy breast removed at this stage is yours to make. We all worry about the BC coming back would your worry be less If you opted for that surgery now.
Why don't you talk it over with your BCN or the helpline here, but don't make a snap decision ,be as sure as you can that you are making the right choice.
Locket, BRILLIANT news about your nodes, what a great relief! I didn't have a mastectomy but am also Er+, Pr+ and HER2+, so have the same extra treatments as you, with the addition of radiotherapy.
Hiya,finally got my results today,just wanted to share them with u ladies n if anyone has any info that would be much appreciated.Brief catch up i'm 32 had a mx & lymph nodes biopsy nearly 3 weeks ago Results today are all 4 nodes taken are clear, Grade 3 26mm ductal carcinoma oestrogen/progesterone+ with full clear margins because of mx.Treatment chemo,Herceptin and tamoxiflen (not sure if that spelling is right),just waiting 3-4 weeks to fully recover from my op then starting chemo.Im relieved about the nodes being clear,i'm still worried cos it was Grade 3 (aggressive) even though its gone from the mx dont know why!! and i'm terrified about starting my chemo and other treatment.Also whats your views on other healthy breast? because im thinking what are the chances of it returning in the healthy one and would mx on other side not be beneficial???
Sorry to go on but basically im terrified about everything
Thanks guys, well the MRI did not show up any more disease, but the histology has shown that there is defo cancer in the margins, she did say this could keep happening and there would be no choice but a full mastectomy. At the moment the decision is ultimately mine, but the consultant suggested going in again and seeing if they can get clear margins and if they can radiotherapy, but she cant guarantee there is not microscopic disease else where in the breast, so its really my decision what to do.
I am having my surgery on the 1st of July and then going back ten days after to discuss what has been found.
The surgeon is brilliant and really understanding of how I feel, and has told me in no uncertain terms that if I decide to go for a bilateral mastectomy at any time she will go along with my wishes and do that for, whether its a few months or a year down the line, so at least I feel I have time to think things through!
Hope you didn't have to wait too much longer to be seen! Also really hope the news was as good as could be. Thinking of you, Julie x
Hope you had some positive news! xxx
Hope things have gone well today SGL
thinking of you
i arrived for my 1.20 results appointment, supposed to be first in the afternoon, to be told the morning clinic had not finnished and there would be another hour before the afternoon appointments would start. People were offered pagers so that they could go to the local shops and cafe's and would be beeped 15 mins before they were to be seen.
for some reason that did not apply to me. I was told to wait and was seen at 1.30.
At the previous appointment we were all told they were running late and kept giving updates on how far behind they were.
frustrating, but at least we were not in the dark, and could ring and text friends to let them know about the delay.
Still waiting - god that's awful, it's bad enough as it is.
I remember the day I had to find out the biopsy results to see if it was cancer or not and they were 3 hours late!!! The BCN said that its because they dont know how people will react and how long they will need to discuss it. And I was thinking that the delay was because they were telling all the people with cancer first or something. It was agony, then I was angry with them for it taking so long as my family/friends knew when I was getting the results and were worrying and I knew they would be, couldnt' get a signal in the hospital at all either to let them know I'd not been in!
Still waiting!! appoitment was at 4.20!!!!!!
Wishing you only the best of results today.
I'm not a big fan of MRI's for this disease though. There's still a lot of controversy over false positives and 'spotting' bits that would most likely be mopped up by radiotherapy and this leading to overtreatment. I had one which spotted another 'highly suspicious' area, and had to push for it to be biopsied (there are not a lot of health board areas who can do this yet), and it turned out to be non-invasive after all.
thank you ladies. xxxx
Good luck, SGL, and everyone else who's getting results today.
SGL here's hoping your results are the best. Come back and let us know
good luck SGL! thinking of u, keep smilin! love alex xxx
Hope it goes well Stargazerlily. Warm hug. Adi x
good luck hope you get the results you want xxx gaynor
everything crossed for you - best wishes
I go back to the hospital today to get my MRI results, just hoping that there is no more invasive cancer. They have said that no matter what the results are I will still need the same surgery, as there could be microscopic disease. Decisions will be made today on alot of things!
Wish me luck ladies.