[Lani]

readings it would seem that any BRCA1 mutation carries with it problems with DNA repair which would make it more likely that you may develop another breast cancer in the same or the other breast. How much more likely and over what time, I don't know, but if there is a genetic counselling center at a medical school or cancer center near you, they could probably come up with some figures for inherited BRCA1 mutations at least.(won't necessarily hold for you, of course but closer to your situation than data for those without mutations)

The good news--it seems the North American and HERA herceptin adjuvant herceptin trials did not see an increase in recurrence in those treated by mastectomy vs lumpectomy as long as patients were treated according to the protocol ie, chemo and herceptin post-operatively.


Theoretically a larger surgery could stir up more angiogenic factors, but according to the adjuvant studies referred to above it doesn't clearly seem to be the case.

Don't believe there are any similar study results in those treated neoadjuvantly ie comparing large numbers of those treated with mastectomy vs lumpectomy but otherwise the same treatments with/without herceptin

Since your public profile includes no info on your previous treatment (whether your surgery,radiation therapy were long past, whether you had IDC vs inflammatory bc,etc) you may be in a different situation. If there any genetic counselors nearby--they are so used to advising those with inherited BRCA1 mutations they could probably give you some facts, figures on results with different surgical treatment options

Should I come across some papers which shed light on your dilemma, I will post them

Hope some of this helps