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Cancer Surgery (Expert Forum)
Preventative Bi-lat Mastectomy
Questions in the Cancer Surgery forum are answered by Dr. Denise L. Johnson of Stanford University School of Medicine. Topics covered include surgery for all types of cancers.
Preventative Bi-lat Mastectomy
by MomMomMaddie, Apr 16, 2008 03:49PM
After various diagnostice tests (mammorgram, MRI w/contrast, needle guided bx) and most recently, lumpectomy, I have been diagnosed with DCIS - multi focal (wide spread) - grade 0 - with A-typ and hyperplasia in my Left breast. I also am + for receptors and use of Tamoxifin. I am currently scheduling a mastectomy and reconstruction of my left breast. My question: the Right breast has indeterminate calcifications (this is how the affected breast started), and although my breast surgeon and oncologist seem to think I should just follow the right breast closely, my gut tells me to have the right breast removed as well (my GYN agrees with me) - still waiting the opinion of the Plastic Surgeon.
Diagnosis: Type of Cancer?
:
DCIS (left) breast
Date of Diagnosis
:
March 26, 2008
Type of Surgery
:
1st: needle guided bx - then, lumpectomy
Stage/Size of Tumor
:
various
Location of Tumor(s)
:
Multi-focal
Age of Patient/Pre or Post Menopause?
:
pre-menopause
Sex of Patient:
:
Female
General Geographic Location
:
southeastern PA
Age of First Pregnancy (If applicable)
:
20
Number of Pregnancies (If Applicable)
:
2
Have you received hormone replacement therapy?
:
No
Please list all of your current medications:
:
Caduet
Toprol XL
Benicar
Ctd Asp
Toprol XL
Benicar
Ctd Asp
Please describe your alcohol and/or smoking history:
:
no alcohol
35 yrs smoking
35 yrs smoking
Overall survival will not be improved with a prophylactic mastectomy of the right breast.
However, I would biopsy with core needle biopsy the calcifications of the right breast before your surgery on the left breast.
To my knowledge, there is no family history of breast cancer. My breast history began with my 1st biopsy ( neg ) of the left breast in 1999. I have dense breasts. Since then, I've had magnified view mammograms, scinti-mammograms, and last year a BSGI ... all due to calcifications.
One of my reasons for considering the bi-lat mastectomy is the fact that mentally and emotionally I'm ready and accepting of the diagnosis of the left breast and in actuality do not want to go through the months of biopsies and lumpectomies of the right breast. My surgeon would like to follow the right breast with a diagnostic mammogram in 6 months.
The second reason I have been considering having the right breast removed is due to a strong family history of adult-onset diabetes. Both my mother and maternal grandmother were insulin dependent and the rest of my family are treating their diabetes with medication. My brother and I are the only two that have not been diagnosed with DM to date.
I have worked in a family practice office for the past 15 yrs., and I know the secondary effects of diabetes such as cardiovascular, renal and circulatory disease.
Currently I am being treated for hypertension and hyperlipidemia ... and I know the state of my health right now ... I don't know what my health condition would be in the furture.
I appreciate your comments, thank you.
Donna