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Breast Cancer (Expert Forum)
Bilateral
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Bilateral
by Orneville, Jan 15, 2003 12:00AM
Hi, after 4 years of montoring both breasts with mamograms and ultrasounds, I was diagnosed with invasive DCIS on the right breast. Tumor is aprx 6mm. The doctor who did the biopsy wanted me to have an MRI done for both breasts as they are extremely dense and the MRI showed "suspicious areas" on the left breast.
I had more biopsies done on both breasts at a major breast center and was diagonosed again with invasive LCIS on the left breast,aprx 6mm in addition to the original right breast diagnosis. The 2 doctors that did the biopsies recommended bi lateral mastectomy, as have 2 surgeons. I have no real issues with losing both breasts if it means I can forget about the cancer after this treatment is done. The doctor who is doing the surgery says I have an excellent chance of a cure, since the best guess is stage 1. Of course I under stand there is no guarantee about stages until they do a complete pathology, but I would like some feed back. Tamoxifen has been suggested since both tumors are receptor positve. I am 50 years old, and have no
other health issues and don't drink and haven't smoked in 14 years. Should I have chemo instead? How about radiation?
I had more biopsies done on both breasts at a major breast center and was diagonosed again with invasive LCIS on the left breast,aprx 6mm in addition to the original right breast diagnosis. The 2 doctors that did the biopsies recommended bi lateral mastectomy, as have 2 surgeons. I have no real issues with losing both breasts if it means I can forget about the cancer after this treatment is done. The doctor who is doing the surgery says I have an excellent chance of a cure, since the best guess is stage 1. Of course I under stand there is no guarantee about stages until they do a complete pathology, but I would like some feed back. Tamoxifen has been suggested since both tumors are receptor positve. I am 50 years old, and have no
other health issues and don't drink and haven't smoked in 14 years. Should I have chemo instead? How about radiation?
Doctor's Answer
by CCF-RN,MSN-rf, Jan 15, 2003 12:00AM
Dear orneville: Bilateral mastectomy is a reasonable option if both problems are invasive, although it is not necessary. The choice to do a mastectomy on the breast with lobular cancer may make more sense, since lobular cancer often has projectiles making a successful lumpectomy more difficult. You could do a lumpectomy in the ductal breast - if you went this route, you would need radiation therapy. The final pathology, along with lymph node dissections ,if these are invasive, will determine the stage. The stage, in turn, will help determine the followup treatment. If in fact, these are both stage 1. They are different primary cancers, neither chemotherapy nor radiation therapy may be necessary. In general terms, consider this, you have 2 primary cancers, they can be treated as individual problems. Overall, treatment would be designed based on the one that is worse. In any case, you should see an expert breast oncologist who can help advise you. Hormone therapy will likely be recommended.
