what to do?

[dorkyD]

am 26 yrs old. Grandmother had breast cancer, 1 aunt had breast cancer, my cousin, my mother & my sister @ 26 years old. The strange part is that my September I went for a mamo and they found a complex cyst in my left breast. It was needle biospied Iand it came back not to be cancer. In December I went for another exam and nothing was found. 1 month ago I went for a mamogram and they found several cysts, 3 complex cysts and a mass in my right breast. I had a "surgical" biopsy 3 weeks ago and it came back negative. I don't know what to do. I have been talked to several times about having a double masectomy to reduce my risk. My Mother & sister feel that it would be best as well. In December I had two DR's, one which was saying let's see what happens and the other saying..you're going to keep going through this worry until you get it. This time around the DR seems to on both sides of the fence. She is not being too pursasive either way and thinks I should be the one too decide. I feel like I'm going to keep getting these "complex" cysts and masses on both sides, which will require a biopse each time...and that's no fun. Not to mention what my breast will look like when it's all done, if ever. If anybody had any advise or thoughts on the matter I would certainly appreciate it. --Thanks, dorkyD

[Cleveland Clinic]

Dear dorkyD:  Your extensive family history is a risk factor for developing breast cancer.  You may benefit from speaking with a genetic counselor as well as a breast specialist who can evaluate your risk (possibly including genetic testing) and discuss surveillance/treatment options as well as the pros and cons of these options.  

[Under Forty Pam]

The doctors generally put the decision back on your shoulders.  They don't want to take the blame for anything.  Basically all you can really do is continue looking for a doctor that you respect and can answer all your questions.  Then make the best decision you can and don't look back.  Each person is a bit different on how they decide to do such a drastic thing and it is a very personal decision that you and only you will live with.  Good luck.

[dorkyD]

I have had a genetic test and am a BRCA 2--whatever that means.  I guess I should have put that in my inital question.  Thank you both for you responses.  It is a very hard decision to make.  I was reading today something about having your ovaries removed as well?? What's up witht that?

[Under Forty Pam]

If you have your ovaries removed that will remove the production of estrogen which is what aids in causing the breast cancer.  Hormone drugs they put you on is meant to stop the estrogen production and do the same thing.  Having your ovaries out is a more efficient way except for the fact it will put you into premature menapause and the issue that might come with that.

[carme]

If you didn't learn enough from your genetic counselor when you were tested and found positive for BRCA2...find another genetic counselor.
My prayers are with you since you are so young.
My BRCA2 family members didn't develop breast cancer until they were 34 and older. My mother is the only one who made it 26 years from 1 breast, 2nd breast, colon cancer then finally dying of ovarian cancer.
My younger sister had stage 3 at 47, had bilateral mastectomies and total hysterectomy.
I chose to have bilaterals at 49, after an MRI showed something inconclusive. It was LCIS. 10 months later I had total hysterectomy.
I've seen 6 close family members die of this disease.
My sister and I do not regret doing bilateral and hysterectomy...we still have relatively young children and grandchildren.
Yesterday, I had my 6 month check with my oncologist and the day before with my gyno.
He commented on how some of these public figures who have had minimally invasive procedures have had their cancer come back. He also said women should ask their doctor, "If it was your wife or daughter, what would you do?"
Like I've said before in this forum (and I'm sure to read a few comments about this again), It's cancer, not warts, not wrinkles, not grey hair...
Now I'll sit back and read the comments...after all this is just my opinion.
I choose Life!

[Avidhiker]

My two cents:  If I had a STRONG family history of BC, I would definitely get tested for the BRCA  gene and darn it, if it tested positive, I would choose the same route as you did--give it no place to take root or fuel to grow.  MAKE NO MISTAKE ABOUT IT:  Cancer is very serious.  My opinion is that you do whatever it takes to get rid of it and reduce the risk of recurrence.  How could you NOT want to do that.

One year ago, I heard the words, "Unfortunately Elizabeth, yours is one of the ones that came back as cancer".  It totally blew me away.  Long story short: 2.4cm, node negative, ER/PR+, HER2+, lumpectomy, 4 rounds of AC, 34 radiation treatments, herceptin, and now Arimidex for 5 years. No one felt a lump.  Microcalcifications on my yearly mammo gave it away.  I am 52.

I did not disagree with my breast surgeon's recommendation for a lumpectomy vs. masectomy.  He has over 30 years experience and has trained at Sloan Kettering.  However, I researched BC and all the treatment options until I was blue in the face, books and internet.  I had a nurse friend who came along with me to a teaching hospital's library where we read JAMA articles, research statistics, research papers, etc.  I am comfortable with my decision, and I do not look back in regret.

As you must know, BC is very complicated and every woman's tumor is different.  I am not a physician, but I do know that you could have a small, perhaps .7mm size, tumor but it can be very aggressive.  It can be very small but has already infiltrated the lymph nodes.  To the contrary, you could have a larger, perhaps 3+cm size tumor that is non-aggressive or did not get into the nodes.  If the cancer has already spread to the nodes regardless of the size, the chance of recurrence is much higher (think Elizabeth Edwards-her initial diagnosis was node positive). That is why the pathology report is extremely important in determining the appropriate treatment.  The cancer community is all in agreement that having the most extreme aggressive treatment does not guarantee that the cancer will not return.  There is no guarantee, and oncologists, in particular, will tell you that the risk is ALWAYS THERE for recurrence no matter what the treatment. CANCER REALLY STINKS.

Can you please tell me what you mean by "minimally invasive procedures"?  Perhaps you mean just radiation for DCIS?

I wish you and your family a cancer-free life.  Stay well.  Peace.

[Montana girl 06]

Did your  clusters of calcifications appear in a years time, or did they follow your calcifications over a period of years?