Treatment options

BDS

Hi all,

I am 37 and recently diagnosed with multifocal IDC (Grade 1, largest tumour 6.5mm) arising in a field of DCIS (spans 42mm) on one segment of the breast.Absolutely unexpected and shocking as I had no risk factors at all!    Underwent segmentectomy and SNB. Biopsy revealed margins are adequate ( one margin shows atypical hyperplasia at 1.7mm though ) and lymph nodes clear as well. So stage 1A. Tumour is ER, PR positive and HER2 negative.

It was decided at the multidisciplinary meeting that I will need to undergo radiotherapy with boost (due to 1.7mm margin instead of 2mm,My surgeon assures me that they don't need to excise tissue again as it's only 0.3mm lack and it's just atypical hyperplasia and radio with boost is just as effective) and hormone suppressants following that. He also discussed mastectomy , although he reassured both options are equally effective and excellent prognosis for my cancer status. and he would be guided by my decision.

I was wondering if there's anybody who faced a similar situation like me and what they opted for further treatment and why and their experience beyond initial treatment. My research revealed that although both options have similar outcomes there's slightly higher risk of cancer recurrence with segmentectomy+radio option. 

Although literature states same as above and I know nobody can predict my future, I'm really worried about my chances of recurrence if I go with radio option,as I have a family and and 2 small children to look after.But I also don't want to under go major surgery if that can be avoided My oncology appointments are yet to occur and I will discuss the same with the Oncologist.

I would really appreciate any advise to help me make a decision..

Thank you so much in advance and take care x

BDS

CRM

Hi @BDS  I was diagnosed last year, age 32, Stage 1 Grade 2 ER+ PR+.  I had the lumpectomy, radiation therapy and am now taking tamoxifen daily and on zoladex injections.  I have always felt very confident that my treatment plan is correct for my diagnosis and had complete faith in my surgeon who did not believe the mastectomy would offer any further benefit.  He explained to me at the time that there is such a thing as 'over treatment' and to put me through the trauma of a mastectomy and/or chemo would cause more complications that it would add benefit.  I hope this helps x 

iserbrown

Hi @BDS
I note you are new here!, Sorry you are here but hopefully you will find lots of information to help you through.  The BCNA website has a lot of good factual information, the link below explains your type 
https://www.bcna.org.au/understanding-breast-cancer/what-is-breast-cancer/ductal-carcinoma-in-situ/

Have you been given the booklet on Hormone Therapy?
https://www.bcna.org.au/resources/booklets-and-fact-sheets/#hormonetherapy

Hopefully the above reading will help with your decision making process and or to formulate questions in readiness for your Oncology appointment.

Also there's a group on here that you may benefit from visiting 
https://onlinenetwork.bcna.org.au/group/10-young-women

Take care and best wishes

TonyaM

Hi BDS, sorry you are facing bc at such a young age.I was 47 with my first bc diagnosis and let me say that ANY decision you have to make is a difficult one.I had a lumpectomy,full node clearance(all clear)and 6wks of radiation for a 2cm lump,same pathology as you.I had no family history. The darn thing came back in the same spot 7 yrs later despite clear margins. I’d been told there was an 8% chance of this happening- what are the odds hey! So I had to have a mastectomy and chemo and then Tamoxifen for 5yrs.NOW because of the radiation,I can’t have implants- my choices are limited so I remain lopsided(last 10 yrs). My motto is to hope for the best but prepare for the worst.Your chances of a bc recurrence in the same breast is highly unlikely BUT,in the event that it did come back,what would you want to do? We are all different and some women need reconstruction and some aren’t bothered.Age can also determine choices.At 47 I was horrified to lose a breast but at 54,not quite so.If I could go back in time,I would have followed through with Tamoxifen which I didn’t do the first time.- reason being the side effects were so hard to live with.
I personally think a mastectomy and chemo is a lot harder to do than a lumpectomy and radiation-also a lot more confronting- overkill if you don’t really have to do it.But do your research and ultimately go with what feels right for you at this time. 

Afraser

Hi @BDS
Welcome to the network, a place you would rather not visit but which can be very helpful! I didn’t have the same diagnosis or options but will simply suggest the following:

Talking with your oncologist is important - keep an open mind but it’s really helpful to make a list of questions and concerns, that are important to you, and get as  many answers as may be possible.

There aren’t always clear answers, sometimes we just don’t know for sure. So feeling confident in your medical team and the decisions you make together matters, even if things don’t entirely work according to plan. Especially if things don’t work according to plan.

We all know the feeling of wanting to bombproof ourselves for the future. But all we really can do is make what seems the best decision at the time. And as we are different, and so are our cancers, we don’t all come to the same conclusions. You have the big benefit of an early diagnosis.  Listen to others by all means, consider then listen really hard to your own inner voice. Best wishes. 

kezmusc

Hi @BDS

Welcome lovely.  There are so many choice to make along the way.  Trusting your own instincts is hard to do as well.  The stats are that lumpectomy and radiation offer the same protection but you really have to go wih your gut feeling.  There really is no right or wrong and each has its own merits but unfortunately neither is certain for sure.
For me personally (stage 2 grade 2.  19mm tumour plus nodes) it was a no brainer.  I chose lumpectomy with no regrets and was very thankful that I even had a choice. Unfortunately I got thrown in the chemo pool as well due to node involvement and then 6 weeks of rads with the boost week. I had very little trouble with the radiation.  Opinions differ but I was told that reconstruction was available but would need to wait for around 12months after rads.
Hormone therapy is something you can proceed with and always stop if it sux too much.  
All the best with your decisions lovely.

xoxoxoxo

BDS

Hi everyone,

Thank you so much for your advise,support and the resources you have sent me.  I am going through them now. Felt like I was stuck in whirlwind last few weeks and now  I feel like I can put things into perspective more clearly after reading  your comments. 
What an amazing network
You all are just wonderful x