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Avatar universal

mastectomy/reconstruction

I am a 46 yr old woman with a family history of breast cancer (mother 5 year survivor invasive lobular). In the past 2 years I have had 3 abnormal mammograms followed by sterotactic biopsy/surgical biopsy that have shown ADH once in each breast and now DCIS in the right.  My surgeon is suggesting bilateral mastectomy with reconstruction. is this a good decision? I feel that over time the risks of invasive Breast cancer will catch up with me.
8 Responses
242527 tn?1292452740
MEDICAL PROFESSIONAL
Dear lvtwoqlt:  ADH is a risk factor for developing breast cancer.  DCIS will need to be definitively treated, either with lumpectomy or mastectomy.  Your mother's history may further increase your risk although it may not indicate a genetic form of breast cancer (genetic forms often occur early).  The decision to do prophylactic bilateral mastectomies is a very personal one and must be considered with risks and benefits.  You might benefit from seeing a genetic counselor and/or medical breast specialist who can discuss your risk, specifically, and make recommendations that may help you in making this decision.  There is no absolute right or wrong decision.  It depends, in part, on your comfort level.
25201 tn?1255584436
Such a personal decision; I doubt anyone can really answer your question. Have you considered a second opinion ..... just to get another view of your situation. I wish you the best and the strength to arrive at a decision and follow thru without regrets.
Avatar universal
I think it is an excellent decision.
Avatar universal
It is a good decision if it is the one you are comfortable with!!  Bottom line is you have to choose what will give you peace of mind and how much uncertainty you are comfortable with day-to-day.  Every person is different, and has different priorities - for some it is breast conservation, for others is risk-minimization.

For what it is worth, I am in a similar situation - just diagnosed DCIS with some significant family history and I am 40.  I am having the genetic testing and a bilateral w/reconstruction (regardless of genetic results).  If I was older, or didn't have young kids, I might choose differently, but this is what feels right for me at this stage in my life.  Once I decided what to do, and made peace with my choice, the whole thing became a lot easier to deal with, mentally!

Weigh your options, go check out bc.org discussion boards, discuss with spouse/so and you will be led in the right direction.

Good luck!
Avatar universal
I have discussed this with my spouse and he said that whatever I felt comfortable doing he would go along with.  My family history is more than bc with my mother. Her sister died at age 37 with ovarian cancer.  My mother had the genetic test but she was negative.  Every 6 months when I have my mammogram I anxiously wait to see what will show up this time.  January of 2005 I had adh in the left breast, July 2006 I had adh in the right breast and was put on Tamoxifen. This year I had DCIS in the right.  I have been going to the local Breast Cancer support group with my mother for close to 2 years and the survivors have helped me to make the decision so I am going in with plenty of first hand knowledge. I know that they can keep taking out tissue a little at a time but each time there is a problem why not get rid of the problem. My doctor recommended thinking about surgery 6 months ago if the problem occured again.
127512 tn?1193745816
It sounds to me like you know in your heart what you need to do. breastcancer.org is a wonderful site. Join the discussion board there after you read all the other info. I often recommend this site. They also have pictrures of reconstructed breast. Remember this is about saving your life.I wish you well.
Avatar universal
I was 36, newlywed and pregnant when my mom discovered breast cancer in her remaining breast. 13 years had elapsed from the first mastectomy, but during that time, she had a tumor on her thyroid and colon cancer. (I also lost another aunt (her sister) and my grandmother, (her mother) to cancer in 1971, 2 weeks apart.) I declared to my husband then, that if I ever developed breast cancer that I would have them both removed...I also told him I would stay on top of everything I could learn etc. to be able to fight this horrible disease. He backed me then, he backed me when I joined the Tamoxifen trial in 1992 and he didn't flinch when I elected to have prophylactic mastectomies in 2003 after my mother finally died of ovarian cancer. The surgery was a bit urgent, since there was something that showed on the MRI, that turned out to be LCIS. But, I knew going in, that even if that something had turned out to be nothing...I was making the right decision, at least for my peace of mind, FINALLY.
I lost a 40 year cousin to it last August, my younger sister had stage 3 breast cancer and had bilateral mastectomies with tram flap recon. We are all unfortunate to have the BRCA2 mutation and between us have 6 more kids to test...(2 have tested, they don't have it).
I am now 54, had total hysterectomy in 2004 upon recommendation from the genetic DR. out in Duarte, CA  and don't regret my decision in any way.
Having had very large breasts on a 5'2" frame, they turned heads, they fed my kids and they were the butt of many jokes and laughs with my friends and family. My flat chest and refusal to wear my falsies are the butt of the jokes now!  All in good fun and I am so happy to be alive and be able to laugh about it with my friends and family.
God bless you with whatever decision you make, may he guide you to the one you will be able to live with.
Avatar universal
Thanks for all the supporting comments. I know that this is what I have to do in my heart but sometimes I think in my head and wonder if going through the pain will be worth it. I know that peace of mind will be worth the pain. I went to the plastic surgeon's office Monday for the consultation. Now I am waiting on the two doctors to get their schedules together to do the surgery. I have a good support group in my family, church, and Arm-n-Arm.  They will help me get through this tough time. thanks again for your supporting comments.
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