Hello lovely - sorry to hear you are so stressed out, understandably so. This part of the process is definitely the most distressing time. Lack of control is a big issue. You are correct that usually with multi-focal BC they prefer to do a mastectomy. I had 3 lumps in a patch of DCIS and originally had a lumpectomy, but a few months later had to have a mastectomy when they discovered another DCIS patch (not a recurrence, just a patch they didn’t spot the first time, ahem). I have had a DIEP reconstruction, which is the operation you want I think? My plastic surgeon was very hot on the BMI issue. If you saw me you probably would not describe me as fat but because i weigh 72 kg instead of 64 kg my BMI is about 28. Even this really concerned him. You have to understand that it is a hardcore operation and can take up to 10 hours. Therefore they have to weigh up the risks of giving someone that much anaesthetic and they are v cautious. Also bear in mind that DIEP is rarely one operation. My “foob” is not the right shape and my breasts don’t match at all. I have to go back to have the foob re-shaped and the other breast lifted and reduced to match. This is not a complaint but you need to know what you are letting yourself in for. An implant recon is a much simpler operation, and i think i would have had that given a choice but they wouldn’t give me an implant because i also needed radio! Are they now saying you only need a lumpectomy? Obviously that’s a much easier operation to recover from so that is why they try to avoid mx where possible. But if you have concerns, you can insist they explain to you why lumpectomy is being recommended and you can ask to record the consultation on your phone (you must get consent to make a recording) or for written advice so you can consider it carefully. Tamoxifen - don’t be scared of it. You can start taking it before surgery (I did) but you need to stop at least a week, maybe two weeks, beforehand. You can start taking it again once you are mobile after surgery. You won’t know what side effects it has for you until you take it yourself. There are various medications that can be prescribed that lessen side effects such as hot flushes. Also many people have success managing side effects using complementary therapies such as acupuncture and relaxation techniques (yoga, mindfulness, tai chi etc). So even if you have some issues, it might be that with the right medical advice and other help it is in fact all manageable for you. If you try taking it, then you have the option to stop if you decide that you can’t cope. But if you don’t take it you’ll never know and you won’t have given yourself the chance to benefit from the protection it gives. I was very upset indeed when first diagnosed and completely lost it when told i had to have the mx but now really I feel fine again, even with mis-matching breasts, a huge tummy scar, mild Lymphoedema and a slightly scary prognosis. You’re not self-pitying at all. All your reactions are completely normal and commonplace for people going through this ****. You will feel good again, I promise you, but it will take a little while. I found counselling enormously helpful. It’s also great to meet others at a support group. Is there a cancer support centre such as The Haven or Maggies near you - if so I highly recommend checking it out. Hang in there. We’re all here for you. Sending you all best wishes.
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