Multi-Focal DCIS

[bayla511]

Multi-Focal DCIS
by bayla511, 2 hours ago
I had a lumpectomy for DCIS which was located on the side of my breast and under the nipple.  My surgeon did not get large enough margins and my follow-up mammography showed another suspicous calcification cluster along with a lot of calcification in between the two original malignant sites. Both the radiologist and the surgeon have suggested mastectomy since my mammography is difficult to read and no guarantees can be made about the remaining calcifications.  But, if I so choose, my surgeon will try to a re-excision, but I will have to lose my nipple because that lesion was micro-invasive.
I'm torn, because I do not want to lose my breast.  However, I know I have a higher than normal chance of re-occurance because of all the calcification in my breast.  I also know that implant reconstruction after radiation is very difficult.
Part of my wants a biopsy of the last suspicous cluster before I have a mastectomy.  Am I just resisting the inevitable?

[bayla511]

Do you mean questions or doubts?
Bayla

[BhumikaMD]

Hi,

Do keep us posted and also let us know if you have any doubts.

Regards.

[bayla511]

Thanks for your advice.  I'll try to ease her into it.
Best,
Bayla

[BhumikaMD]

Hi,

It would be best to talk about it with your mother slowly, gradually over a period of few days to weeks - so that she is acclimatised and is not in a sudden shock on hearing the news.

You could start by telling about your symptoms etc.

It is great to hear about the strong support you have from family and friends.

Keep us posted.

Regards.

[bayla511]

Hi, Dr. B
I'm blessed to have a lot of support from family, friends, and co-workers.  I'm also going to see a psychiatrist at NYP who deals only with cancer patients.  My next hurdle is telling my 92 year old mother about all this when she gets back from her annual sojourn to Florida.  I hate to cause her this kind of pain at this stage in her life.
Where are you located, if you don't mind my asking?
Best,
Bayla

[BhumikaMD]

Hi,

You could talk to someone in your family or one of your friends about all your anxiety. Also schedule an appointment with your surgeon and anesthesiologist and clear out any doubts about the procedure and pain relief that you have.

This would help to a certain extent with your apprehension. You can always post us if you have any doubts or queries.

Do update us on how you are doing.

Regards.

[bayla511]

Hi,
I'm doing okay, thanks.  The surgery is scheduled for either May 9 or May 15 dependent upon the coordination of the breast surgeon's and plastic surgeon's schedules.  I'm apprehensive/slightly depressed, but coping. Thanks so much for your concern.
Best,
Bayla

[BhumikaMD]

Hi,

How are you doing now?

Keep us posted on your health and also let us know about what your doctor advises.

Regards.

[bayla511]

Hi,
Can I impose on you to take a look at my posting and weigh in with an opinion?
Thanks.
Bayla

[BhumikaMD]

Hi,

I would also vote for the mastectomy and i think you are doing right in trusting the judgement of your specialists and friends.

You could in addition talk to your breast specialist about getting a breast reconstruction done and talk to a plastic surgeon about this.

Let us know if you have any other doubts and post us about what your doctor advises.

Regards.

[bayla511]

My breast surgeon and radiologist both said if it were their sister, they would recommend mastectomy.  My case was also presented at the department's weekly conference and all the other members of the department asked why I hadn't had a mastectomy already.  Since I'm being treated by the acting head of a major academic center in NYC (NYP), I trust their judgment and have decided to have the mastectomy.
It's the hardest decision I've ever made and hope to ever make.  I've also asked a number of my friends who are also physicians hoping they'll talk me out of it, but they also agree that this is the way to go.
I've also been told that this is a better choice cosmetically since we're not sure what I'll be left with after a second incision, removal of the nipple and radiation.
I welcome any additional thoughts.
Best,
Barbara

[BhumikaMD]

Hi,

How are you doing now? Keep us posted on your health and also let us know about what your doctor advises.

Do you have any other doubts?

And, yes , i am a physician.

Regards.

[bayla511]

You seem to be responding to a lot of questions and know your stuff.  Are you a physician?

[BhumikaMD]

Hi,

This is a very difficult decision and your choice should be based on what your breast specialist advises and thinks would be best for you.

Your breast specialist is the best person to consult regarding this because he/she has a complete understanding of your case including the case history and the investigations and surgical findings.

Let us know about what he/she advises and if you have any more doubts.

Keep us posted on how you are doing.

Regards.