Fay, this is a tough decision, and will most likely end up being based on your capacity for worry; and/or what type of personality you have. LCIS is a pre-cancerous condition; it might become cancer, it might not. And it's not a recurrence of your original cancer, so don't worry about that. You might remain cancer-free the rest of your life simply by doing nothing - no drugs, no radiation, no surgery. If you choose that route, yes, you'd defnitely want to make every lifestyle change possible to stay healthy: lower your stress levels, healthy diet, exercise, no drinking/smoking.

At the other extreme, you could remove both breasts. This won't reduce your risk of dying from breast cancer; but it'll reduce the risk of cancer recurring in the first breast, and cancer developing in the second breast. The downside? Double mastectomy. Very aggressive surgery, with lifelong repercussions.

You wouldn't take tamoxifen again, unless you're still premenopausal. In fact, with LCIS, I don't believe you'd be offered any hormone drugs at all - unless it was an aromatase inhibitor. Ask your doctor about that. And, hopefully you've been having yearly mammograms for awhile anyway- they're recommended by most doctors starting at age 40 (and by federal guidelines at age 50). With your history, it's pretty much a given to have yearly mammograms. Yes, they add a bit of radiation to your system, but balance that against the risk of cancer recurrence (or development of the LCIS).

This sounds like a discussion you should have with your oncologist. Get the data about risk of recurrence/risk of LCIS becoming cancer, with/without the mastectomies; as I said, studies show mastectomy wouldn't affect your survival rate. Then make your decision, and go forward without second guessing. Best of luck to you- PJH

fay

2/15/11 6:41am

I appreciate your response. It was interesting to read that having the mastectomy wouldn't change my survival rate as that would have been a reason to have it. I wasn't wanting to cause more risks with the added radiation exposure. The reason for tamoxifen again was due to being bone sparing as after the aromatase inh for 2 yrs my  bone density has reduced. The lcis is oestrogen +ve and proges -ve. I am postmenopausal now. Yes have been having mamos and u/sound yearly the last 10 yrs but started about 32 (less frequently) due to dense fibrocystic breasts. The cysts seem to have disappeared now and breast tissue a little less dense . Am doing the lifestyle things-trying to give up the occasional glass of red wine.

Thank you for you assistence. I'll make my decision once I have all the facts and I talk to bs again in 3 weeks.

Ft

PJ Hamel, Health Guide

2/15/11 9:12am

OK, I understand about the tamoxifen. I had bone loss issues with Arimidex, too; tamoxifen is a good second choice. Surprised they'd actually treat the LCIS so aggressively, though - although, having had one bout of BC, perhaps they feel your overall risk for a new breast cancer is increased?

 

A good, comprehensive discussion with an oncologist (maybe a better choice than the surgeon?) might help you with this decision. Take care- PJH