Mastectomy or Tomoxifen

[DuneDust]

I just turned 47 & had 6th biopsy last week:  Lobular carcinoma in situ, sclerosing adenosis, calcification, apocrine metaplasia & epitheliosis.  Have VERY dense breasts with microcalcifications, simple cysts (quit counting at 30 on Right side alone), complicated cysts (largest two over 1" each), fibroids, fiboris tissue, scar tissue: i.e., they really cannot see in there. Prior to biopsy but after mammograph (which showed nothing) and ultrasound (which questioned area previously biopsied in 1999) I had a Gales score of 33%. After ultrasound I had an MRI which gave me a BIRAD rate of 4 (& questioned an area next to what the ultra. questioned).  Now the LCIS finding leaves me with option of Mast. or Tomoxifen 5yr treatment & pushs my cancer risk nearer to 45-50%.  Anyone else out there with similar history?  I'm thinking ************** doesn't make 'visual' any better.  I get a 2nd surgeon's opinion next Wed. Thoughts?

[Cleveland Clinic]

Dear Dune Dust, Deciding how to treat lobular carcinoma in situ (LCIS) can be
complicated because the condition itself is not cancerous and the majority of people with LCIS do not ever develop cancer; yet, it is known that they have a higher risk of developing cancer in the future.  Typically, people with LCIS are followed more closely, increasing surveillance for breast cancer in order to identify breast cancer at
the earliest, most treatable stage if it does occur.  Studies have also shown that taking the hormone tamoxifen reduces the risk of developing breast cancer in women who have been diagnosed with LCIS.  Bilateral prophylactic mastectomy without axillary node dissection is sometimes considered as an alternative approach for women at high risk for breast cancer. However, many breast surgeons now consider this to be an overly aggressive approach.  You may want to consider a second opinion with a breast oncologist as well  to discuss each of these options with you in more detail, and help to guide your treatment decision to the one most appropriate for your specific situation.

[SueYoung55]

Here are two cents added to this discussion. I had invasive lobular carcinoma and all the screening in the world didn't catch it. It was invisible on the mammogram.

Considerations... mastectomy? I had bilateral mastectomies with DIEP flap reconstruction. Reconstruction? You can have immediate reconstruction at the time of mastectomy thereby reducing your risk to maybe 1 percent and still waking up with both "breasts".

Tamoxifen? I'm on it and I wish I could just say no... but I did have cancer, 10 cm mass. The side effects are horrible in my opinion but hey.. everyone is different :)

Best wishes making your decisions.