Big Decisions

[kymelody]

Beginning in October, I had surgical biopsy to remove a 5 cm tumor from my right breast. I had lumpectomy with 13+ of 26 lymph nodes removed in November. Two weeks later I had additional tissue removed, which still did not produce clean margins. Team of doctors did not want to delay chemo, so I had four dose dense AC treatments, and am now 6 weeks into my 12 weeks of Taxol/Herceptin. I will continue Herceptin for one year. I will also have radiation for 5-6 weeks following my decision on additional surgery, since I did have positive nodes.
I will meet with a plastic surgeon and my breast surgeon on the day of my last treatment to discuss mastectomy. I will be 35 yrs old this year and just have so many questions about my options. I just cannot wrap my mind around losing my breast vs losing my life. I'm only a size 36B - even if they take alot more tissue and it leaves bad cosmetic results, what is more cosmetically bad than a mastectomy ? I have researched reconstruction - I would only be candidate for implants.
My surgeon stated at one time that "We like to do breast conservation as much as possible, because if it does reoccur, its easier to detect". I have not actually talked with her since my lumpectomy, so I am anxious to discuss all options withher, however, I won't have alot of time to make my ultimate decision. If it is surgery, I will have only two weeks. I am just trying to get a jump start. Any comments/thoughts would be greatly appreciated.

[MGordon]

In her case she opted for full hysterectomy and no reconstruction. I know that this is an extremely personal decision, but as a spouse I have to say that no reconstruction is an option and you are still beautiful!

Just a thought - you may be facing a lot of "procedures" from here on out and if this is one that you do not HAVE to have it may be worth not doing it.

It is your experiences that make you unique and beautiful.

Love and Light
Mel

[tousled1]

Since you have positive lymph nodes you will require radiation. I had a large tumor and had neoadjunct chemo (before surgery) to shrink the tumor. It did shrink the tumor but I opted for a bilateral mastectomy for many reasons. It was a personal decision that I thought long and hard about. I was told that since I would require radiation that reconstruction would have to wait until about six months after mastectomy. I have no regrets and will probably not have reconstruction. You are still very young and according to statistics, there is no significant overal survival difference in mastectomy vs lumpectomy and radiation. With your chemo regime you should have good results. Talk to your surgeon and oncologist at length about your diagnosis and what they would recommend. Whatever you decide to do, make sure you feel good with your decision.

[lu ann]

I was dx. 09/25/1991 with stage 1 BC, 1 cm tumor, no positive nodes. Lumpectomy with rad. therapy and chemo was the origional treatment plan.

The Doctor could not get clean margins so I had a mod. rad. mast. with immediate tram flap reconstruction, followed with 6 months of chemo. (cytoxin, methotrexate, and 5-fu).

Adriamyacine was used if there were positive nodes, larger tumors, or metastisis.

Three years ago I was dx. with stage 4 to my mediastynime (area between breasts), spine, pelvic bones, and other various bones.

I believe the type of reconstruction I had, masked the reocurrance. I also did not get radiation, which I think would have cleaned up the area left with disease.

Hind site is always 20, 20, but looking back and having the option of making different decisions, I think a double mastectomy with rad. tx. and the option of having reconstruction later would have been a better option for my situation.

[Jeanette]

I also had my tumor shrunk before surgery, though I was a lot older than most of you. I am waiting results of another biopsy and will know tomorrow what they are, I had an MRM of the left breast with no reconstruction. I figured at my age at the time 65 there was no need. Hindsite being what it is, If I had known what I know today I would have had both breasts removed at the same time. it is an indivual decision though. Bless you all, Jeanette

[vickie h]

Melody, I had a mrm in july of 04 and opted not to have a reconstruction (which is good, because after 2 rounds of radiation I wasn't a candidate anyway). I am 58 and my husband and I are satisfied that I am here and doing so well. At your age I know that reconstruction is a huge decision, and yours alone to make. I would do as much research in the little time you have to make that decision, but whatever you decide, always know how truly beautiful you are and that we are all here to support you. Sending you much love and prayers, Vickie

[jessica]

Hey Melody~
Just sitting here doing one of the few things I'm allowed to do (typing on my laptop) since I just had the next stage of my reconstruction 4 daysys ago (the swap out the tissue expander, post skin sparing mastectomy 10 weeks ago).
I was 33 was I was dx'd & small breasted (34B)too. After a L lumpectomy in 5/02, then an excisional biopsy in the same quadrant of the same breast in 2/06, my L breast had become pretty asymmetrical. I finally had a Skin Sparing Mastectomy 10 weeks ago (12/06), not b/c of asymmetry, but because of lots of high grade dcis and yet another 1cm malignancy.
Last Friday, I had surgery to swap out the temporary expander for a permanent implant + augmentation of the R side for symmetry.

It is SO HARD to make such difficult, yet important decisions under such incredibly stressful circumstances. And Fear, especially Fear of the Unknown -and there are many unknowns on the journey with this disease-is truly the one of the most challenging things we encounter.
Just know, if you get educated about all your options, you will make the best decision for you. Take all the time you think you need to get comfortable to make a decision. It's your life, your body, YOUR DECISION.

I was dx'd in May 2002, with IDC, 3x3cm malignancy, NO DCIS WHATSOEVER, 12/12 positive nodes, BUT a single, 2x2cm liver met. I've had 81 weeks of chemo, not to mention the many weeks of Herceptin solo when I was NED. I could have chosen a mastectomy when I was 1st dx'd, but I didn't & I've never regretted that decision. But then my disease changed & my circumstances changed, so I had to make another choice.

Get educated (so many great folks here to help you), take your time & make peace with the decision.

Best of luck & Keep the Faith~
Jml

ps-if you decide on surgery, why will you only have two weeks?

[kymelody]

Thanks so much for your input -- I have found that no matter the different "phases" you go through while in this battle -- this website has ALWAYS been a great source of information. I will keep researching and reading everything I can get -- I truly believe you can never be too informed about this dreadful disease.

I do have some major decisions in the next few weeks and appreciate everyone keeping me in their thoughts and prayers. THANKS !!!

[TheresaM]

Melody: My impression, after 3.5 yrs on the her2+ bandwagon, and extensive research and interaction with other Her2+ folks, is that if you respond to Herceptin you may not re-occur. However, if you do not respond to Herceptin your chances of re-occurring, no matter the stage at initial dx, are quite high. So.....my impression is that lumpectomy vs mastectomy is not the vital question to ask when worrying about survival. It's a cosmetic issue and you choose the one that makes you most comfortable.

Remember, this is only my impression, you might bounce it off your docs if you are interested,

Theresa

[kymelody]

I kind of have a weird arrangement ..... I am having my treatments (Taxol and Herceptin weekly) using a local oncologist (we live in a smaller town in KY).... my original team would mean traveling over 5 1/2 hours round trip (in TN), which I did during my A/C treatments. I just couldn't do it EVERY week for the 12 weeks of Taxol - did not want my family or myself to have to make that trip. I am just fortunate to be able to only be 5 minutes away from my local treatment facility and the oncologists were gracious enough to work together for me. I will return to Nashville to see the plastic surgeon on April 19th and my breast surgeon April 20th, which is also the date of my last treatment. My oncologist indicated they could do surgery as soon as two weeks after the last Taxol treatment.
I guess everyone wishes they had a crystal ball to show our future to make those "big decisions" easier and to know that we made the right ones.
Some days I am like "take it off - who cares" ..... then there are the days the lingerie catalog comes, and I just want to forget I have to even think about it .... I am such a girlie girl ~ and a sucker for the vanity of society !