Breast Cancer: Stage 3 & 4 Community
mastectomy or not - have posted before
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mastectomy or not - have posted before

My wifes surgeon says Femara has shrunk her breast cancer (right breast and lymph nodes) almost to nothing, and the swollen nodes under her arm are reduced by 3/4 in size. Scans show this. Nothing else has shown up in her body enywhere.
He still advises mastectomy and lymph node removal surgery but she is 74 and doesn't want to proceed. If she continue Femara and has six monthly checks (has been on it for 6 months since diagnosis) and doesn't have the mastectomy what are the chances of it remaining as is - no symptoms. Surgeon says who knows? Might live for 10 years, or it might flare up again. Her decision. Opinions will be greatly appreciated

thanks, Kev and Ursula
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Hi there,

I understand what you are wanting, a clear indication of what your wife should do in one of the most difficult decisions in a woman's life.
I understand the very emotions behind these choices as I am currently battling breast cancer and have had a left breast mastectomy late last year.

Unfortunately, if your wife's surgeon's answer is "who knows" then certainly we can't improve on that because it is, actually, the truth.
No one can predict the path of a cancer that is still left inside the body. At the moment, it is well contained with medication, but the surgeon knows as I do that a cancer can change rapidly at any time which is why he or she  is recommending a mastectomy.

The crux of the matter is likely to be your wifes age and the risks inherent in having an operation vs staying as she is with the tumor contained.

This will come down to a personal decision only she can make.

What I can tell you, is that having a mastectomy is quite a simple operation. I was in hospital for 2 nights, then went home with 2 drains that fed into one bag which was removed 4 days later.
My breast has not yet been reconstructed but I certainly feel no trauma at all looking at the scar as it is extremely clean and tidy.
The real impact for me, is the feeling of huge relief that the tumor has been removed and the freedom from the fear and anxiety it caused by its very existence.

My heart goes out to you both for having to make this choice, but often in the quietest moments, if she disregards everyone's  opinion but her own.....

She will know

My very best wishes to you both
Nylani's answer about this surgery being simple is correct.  I have had a bi- lateral mastectomy and lymph nodes removed also.  It's two days in the hospital and a recheck to remove a few drain tubes.  My family has a history
of breast cancer and my aunt had her breast removed at 75.  She didn't
want to either but removing the breast pretty much took care of her's and
our worries.  That was 7 years ago and she is cancer free.  I too have been cancer free for 13 years.
Best To You
thanks for your reply Nylani. I had a right radical mastectomy and lymph nodes removed last monday and it went OK. Home now, and saw the surgeon today. He said the full pathology report says that all has been removed and margins are clear but the cancer was 'POSITIVE" when they did the shish test. He originally said I wouldn't need anything after the op except Femara, but has now changed his mind
He said because of this he wants me to see an oncologist and maybe consider further treatment. I'm on Femara and it did shrink things apparently and I'm 75 and have a heart condition. He thinks chemo would be too severe for me...did you have any futher treatment, and how are you now?
All was fine after the mastectomy until last Thursday when the whole of the right side of my chest 'blew up' in a matter of a couple of hours and went the colour of a slight bruise. At midnight we went to the ER and the rest is a blur but what happened was an internal bleed (because I'm on Warfarin they said) which couldnt be controlled. I had emergency surgery early on Friday morning and multpile transfusions during the night and surgery.
They said at one stage my BP dropped to 47/27 and heart rate to 30 bpm. I spent 2 nights in critical care and now feel a lot better but it's sore where he went in again, and my right arm is puffy. Doctor says its fluid and I have a drain in which is slowing down now, and it's mainly fluid, not much blood.
A nightmare. They are going to see if they can adjust my Warfarin or substitute it with something else to avoid a re-occurance of this.

The margins of the cancer were clear, and all the cancer and lymph nodes that were involved have been removed. Surgeon and pathology report both confirm that.
The surgeon says he wants me to see an oncologist for an opinion as to whether I should have radiation therapy, but after this I've had enough.He originally said I wouldn't need any follow up therapy' and says it's all gone but he just wants reassurance from another scource.  I can't take anymore so we decided that I'll keep on taking Femara (which did have a good affect) and leave it at that

thanks for the good wishes, Ursula
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