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Not sure what to do about surgery
am having surgery in a couple of weeks for early stage IDC right breast. PS said I am too old and too many underling health conditions for reconstruction.(age 77) Now I am having trouble deciding on how much surgery to have. Lumpectomy with possibility of mastectomy down the road. or R breast mastectomy and feel lopsided or bilateral mastectomy and just enjoy not worrying about bras. Anybody out there have a suggestion. I am really concerned about reoccurrence and then having more surgery at an even older age.
P.S. I doubt that any one will ever again see me with out my clothes excepting medical personnel and the undertaker. |
Re: Not sure what to do about surgery
Everybody is different and someone else's experience doesn't mean it is the right answer for you. I was 62 and married when I choose a double mastectomy. I had very large breasts & the surgeon recommended bi- to prevent back issues. My husband wanted both gone to lower the risk of recurrence although I think statistics show there is no difference in risk with either option. Normally you have to have radiation if you choose a lumpectomy. If you don't need radiation otherwise that would certainly be a consideration. I am thrilled to never have to buy another bra, never hike up another strap, never get heat rash or skin rot again. It was the right choice for me. However, getting clothes to fit is an issue. Maybe someone out there designs clothes for large women with no breasts but the closest I have found are full tank tops (again, strappy things and I don't get along) with a shirt or sweater over it works better than anything else. My husband hasn't minded the way my chest looks and my daughter finally saw me when she was helping me pick out clothes. It didn't bother her either. It sure won't bother an undertaker considering the shape some folks are in after they pass on. It certainly doesn't bother the medical staff either. Just do what feels right to you and don't spend time on regrets afterwards.
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Re: Not sure what to do about surgery
Forgot to say there are lots of prosthesis choices if you want to look like you match or to cover both sides. I just don't want to do that.
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Re: Not sure what to do about surgery
Good questions, Mama Bexar. And I like your sense of humor, especially that you are able to summon it up at a hard time like this!
This is such a personal decision. There are no right or wrong answers for a straightforward diagnosis of early breast cancer -- only your OWN right answers. As I'm sure your providers have said, for a basic early stage breast cancer, there is no difference to survival between lumpectomy vs. mastectomy. You didn't mention the plans for the axillary lymph nodes -- will they do a sentinal node biopsy? Lumpectomy is the simplest/easiest surgery, although simple mastectomy (without reconstruction) is quite straightforward, also. As Pat94 mentioned, some people (with negative lymph nodes) choose mastectomy specifically to avoid radiation, either because of fears about that part of treatment, or for convenience (avoiding the drudgery, cost, travel, and/or loss of work involved in daily treatments for weeks). There have also been studies questioning the need for radiation after lumpectomy in older women, but that decision probably depends more upon general health (life expectancy) than upon any specific age. It's true there's a very slightly-higher risk of a recurrence in the breast after lumpectomy (vs. mastectomy) but it's quite small -- your surgeon or oncologist should be able to give you some numbers to describe that risk. Keep in mind that it's the (unlikely) distant (metastatic) recurrence that would threaten your life, not a local (in the breast one). But I do hear (and get) your concern about avoiding the need for further surgery at a later date. If it were me, as I said above, I'd want to get some numbers about how likely it would be that more surgery would ever be needed, before making the lumpectomy/mastectomy decision. If you choose mastectomy, whether to do just one or both is again a personal decision. Symmetry (whether flat or reconstructed) appeals to some and drives their decisions. Another driver of the choice for bilaterals is that no further screening (mammography/MRI) is needed. Others value having one functioning breast over other factors. Sometimes it helps clarify your thinking and feeling to write it out -- how you feel about each option, the pros and cons (in your mind) of each. If all of us on this list shared with you what we decided, and why -- you'd see that there were many different "right" choices, and that most are satisfied with what they chose, for many different reasons. Have you gotten a second opinion about your surgery options? It's always a good idea to do that (and if at all possible, at an NCI-designated Comprehensive Cancer Center). You may not hear anything different from what has already been discussed, but you will gain peace of mind and prevent later regret, knowing that you based your decisions on the best information and advice you could gather. Good luck, keep us posted. This time of gathering information and making treatment decisions can be the hardest part of the breast cancer experience. Debbie Laxague |
Re: Not sure what to do about surgery
Thanks so much Pat94 and Debbie L. I haven't gotten a 2nd opinion since my case was presented at a cancer conference and the only thing for sure is I can't do reconstruction at the same time as the first surgery. I will start Herceptin 3 wks post op. I am er/pr neg so no hormone therapy.Ki67 only 3-5% so n o chemo. I guess these are the reasons I am so concerned about recurrence.
Your messages were a comfort so thank you again. MB |
Re: Not sure what to do about surgery
Saw the surgeon yesterday. She pretty much insisted on doing a lumpectomy. The overall opinion at the cancer conference was that my general health was not good enough to do a mastectomy. She will also do a sentinel node. I will have some type of intense radiation device implanted a few days after surgery. Five days with that.
We all know that things could change after the pathology reports come in so I will keep you posted. |
Re: Not sure what to do about surgery
Good to hear your update, MamaBexar. It sounds like a reasonable plan. Are you okay with it? Do you have a date set yet?
All good thoughts to you. Report in when you can. Debbie Laxague PS: It's interesting that your providers are willing to give you Herceptin alone (although given the details you've included, it makes good sense to me). |
Re: Not sure what to do about surgery
There has been more research article covering lumpectomy and recurrence that have been posted here. From what I have skimmed over there is no increase in recurrence with lumpectomy. You may try to find those on the site.
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Re: Not sure what to do about surgery
I had the lumpectomy yesterday with three nodes checked. Looked like clean margins and neg. nodes in the OR . Final path report in next few days. I guess they were right about my inability to withstand much anesthesia. Had to be put on ventilator during the surgery.
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Re: Not sure what to do about surgery
Hi Mama Bexar,
Glad you have that behind you. Clear margins and negative nodes are very good news. It seems to me that you have an excellent chance of never having to deal with breast cancer again. jacqueline |
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