I have decided to have a double mastectomy. Today(4 weeks after the surgery) I saw my oncologist.He told me that my decision was a right move. In my Rt breast they found LCIS. I don't have a high risk family history and I am 47. My oncologist told me that because of the characteristics of my cancer and the type of surgery I do not need any further treatment. I was surprised, and asked him regarding Tamoxifen. He said that because I don't have my breasts anymore the chance of a relapse of my cancer is very low and that the side effects from taking this drug are far greater.I am confused. Please, let me know if this all sounds like a good decision that my oncologist made or I definately need a second opinion. Thank you. Natalie.
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Q: I was diagnosed with IDC, I.5 cm, grade 1, N0M0, Estrogen+, Progesteron+,HER2 - in my left breast. I
Answers (3)
12/15/08 9:01pm
Natalie, I believe your oncologist is making a very good decision for you. From what I can see, he's absolutely right; your cancer is so "minimal," that once you've had both breasts removed, it would be practically impossible for it to return. And, he's right - tamoxifen comes with a host of side effects, some dangerous (chance of endometrial cancer), most just vastly irritating (weight gain, hot flashes, etc.) If you want a second opinion, and you think it would set your mind at ease, go for it; but my belief is that you're being given good advice by your oncologist. Good luck - PJH
12/16/08 2:12pm
Your very lucky to have caught your cancer so early, however I am concerned that your oncologist doesn't think you need Tamoxifen or an AI treatment. Even if you are menopausal, your body still produces estrogen in other areas of your body. Without hormone therapy it is possible for that estrogen to bind with cancer cells and recurr in your chest wall. A mastectomy is not a definitive cure against cancer retuning - this I know from personal experience.
At 31 I had a complete hysterectomy and found out I had breast cancer that was stage IIa IDC that was 2cm, NOMO, est+, pro+, Her2-. I got a modified radical mastectomy with 4 sessions if AC chemo followed by 3 years of Femara - 3 years later my plastic surgeon found suspicious scar tissue in my chest wall that came back positive for breast cancer. The Femara failed to prevent my estrogen (even though I am menopausal) from binding with cancer cells. All it takes is one speck of breast tissue and your estrogen can make it grow into another tumor. I'm not saying you should get chemo or radiation - but I would think hormone therapy as well as quarterly blood tests and yearly diagnostic tests like bone scans, dexa scans or pet scan should probably be done.
I would ask your doctor to clarify his/her reasoning for no treatment and/or get another opinion. Everyone's cancer is different as well as their treatment - so we're not all one and the same - meaning just because my cancer came back does not mean yours will but in truth both of our risks should have been very close to the same, so it doesn't hurt to ask. You need to be proactive when it comes to your future and staying cancer free.
Good luck!
Angi
12/16/08 9:17pm
Natalie, clearly I favor the less aggressive approach and Angi, the more aggressive. Like you, I was age 47 at diagnosis, with ILC. I had a single mastectomy. Unlike you, I had it in my nodes, so had chemo/radiation, then tamoxifen, now take an aromatase inhibitor. I'm going on 8 years out, and cancer-free, but the treatment hasn't been easy. The tamoxifen had a number of side effects; and the Arimidex has even more, including quite devastating bone density loss leading to osteoporosis. I'm considering dropping the Arimidex; would I rather have almost sure osteoporosis, or take a chance on breast cancer? At my age (55), I might take the (very, very small) chance on a recurrence, rather than know that my life from here on will be one of "fear of fracture."
Many of us, when we have cancer, say, "I'll do whatever it takes to guarantee it won't come back — bring it on!" I did it myself. But in retrospect, understanding the treatment and what it can do to you... I think I'd pay closer attention to my odds, take a very realistic view of them, and think hard aboout how much I really want to destory my body, in order to get that additional 1% or 2% reduction in risk of recurrence.
Tough decision, Natalie - wish I could be more help to you. PJH
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