Forum Discussion

lillekatt's avatar
lillekatt
Member
14 years ago

Is private better?

It started with only 1.8 cm lump which was found from mammogram. L­­­­­­­­umpectomy was suggested.

My doctor said 1 out of 5 may need 2nd operation but not common.

I needed another one. My doc found one more lump which was not showing. Margin was not clear.

Before the 2nd operation there was a discussion. Some doctors thought mastectomy was better and my doctor thought she could clear margin with lumpectomy. The concern was my tissue was too dense and imaging did not show lump which were there. I did MRI and no more lump was found.

I chose lumpectomy for 2nd time.

Now after all the risk for recurrence is higher for me as I had 2 cancer lumps and one of them had large margin also it is difficult to find lump from imaging in my case.

She says 7 to 10% recurrence risk after radiotherapy/hormone therapy.

But if I get mastectomy the risk will be 1 to 2 %. Strangely there is still risk.

I started to incline mastectomy because once I get radiation I cannot get tissue expander if cancer comes back. It is said 10% risk. High?  normal?

I met my doctor once again so that I can really discuss through all option. Now she said it was reasonable to consider bilateral mastectomy. There is around 7% risk that another breast can get cancer at the same time if I get implant done on both sides I don’t need to do implant to keep alignment.

It was started with 1.8cm lump and now I am standing in front of bilateral mastectomy…….

 

My medibank cover does not cover any cosmetic surgery but just when it done with mastectomy it’s covered. Very kind hospital account manager checked it for me.

 

Still I have to upgrade my insurance to prepare for 2nd stage and 3rd stage of the implant.

Also out of pocket will be a lot.

My doctor secured the date at public hospital but she really try to get it done at private. I wonder why. I only need to wait bit over a month vs 1 week at private.

I have done my 2 operations as private and it is a lot out of pocket also very stressful to deal with many bills and claiming process which made me really nervous.

I was told the operation at public hospital will be done by my doctor’s student (general surgeon who is training to become a breast specialist) under her super vision. Some for plastic surgeon.  Is it something to be worry about??

 

9 Replies

  • lillekatt's avatar
    lillekatt
    Member
    14 years ago
    Thank you for your comment! I'm putting all papers and recirpts in breast cancer journal. Each words of ppl in forum mean a lot to me. My out of pocket after 2 lumpectomys is all together about 3500 or more. Next stage mastectomy and reconstruction will cost much more in long run. But I was little shocked when I went to public. My operation date is not guaranteed neither. But it is a little peace of mind that I fon't need to worry about outof pocket for each stage...some doctor charge only scheduled fee. You are lucky:) I'll do more study this weekend to find out what is best for me. I obviously can't make up my mind for bilateral mastectomy. Tough thing...
  • serenity11's avatar
    serenity11
    Member
    14 years ago

    Hi Lillikat

    I have gone private, mainly because I have paid health insurance for 30 years so wanted something back.  Except for my excess my only outlay has been the pharmaceuticals. 

    Regardless of the decision you make,  dont forget to have your safetynet with your Medicare switched on and keep your medical receipts as there may be a tax reimbursement at the end of the year.  In the back of the My Journey journal is a very good little spreadsheet to record these outlays as you go.

    Take care

     

  • LouiseTurner's avatar
    LouiseTurner
    Member
    14 years ago

    My decision for a Mastectomy was the hardest one I have made. Agonizing all about the "what ifs". In the end it was really the lack of clarity surrounding the diagnostic tools. The MRI could still only see high grade DCIS and found it throughout my breast. What the MRI found was not connected to the original mass, and without that test it would have been left behind in a lumpectomy to recurr later. This really scared me as I would be one of the very unlucky ladies who had cancer come back into their lives. The second reason was really about my family. I never wanted to face them in the future with recurrance of cancer, and know that I didn't do everything possible at the time to never have it return. So...I decided mastectomy with immediate reconstruction, bilateral, as the chance for cancer in the second breast was 30-50%. Don't know if my breast are high density. I had the 2 lumpectomies July and August. My mast will be around March next year when chemo finishes in Feb. I had 2 IDC tumors, one positive for hormone, one negative. I am not having radio. I have only seen one plastic surgeon at this stage, I am seeing 3 for opinions. This first one prefers implants with muscle over, for the best cosmetic result and lower risk operation. I'm not sure how long the stages are, but a process that will take many months. You are in a really are place right now trying to decide what to do. What helped me was to say "if there is doubt, there is no doubt". Meaning, if you are not sure, then keep asking until you have no doubts left. Then you have your decision. I also read somewhere, when you've made your decision, go with it and don't second guess yourself....or you'll go mad. I'm very happy to share my experiences if it helps you, good luck. Louie

  • lillekatt's avatar
    lillekatt
    Member
    14 years ago

     

    Hi, Louise, if you don't mind I'd like know why you have decided to get bilateral mastectomy. Do you also have high density breast which can hide cancer shadow? When did you get your last lumpectomy? Do you have Hormone positive? Have you had radiotherapy yet?  Do you know how long you need to wait for the 2nd stage of the implant if you have chosen implant?  

    And I wish you a very good luck for you operation and I hope you recover quickly. I’d like to know the result as well..

     

  • lillekatt's avatar
    lillekatt
    Member
    14 years ago

    Thank you very much everyone..  I have 8/10 for operation in a old building.

    The date is good as I have to look after my work and I need to get treatment for my right leg pain.  I cannot walk without pain now. 

    I cannot make up my mind I need more information about my case from doctor who knows my case. It is impossible to get an appointment with my doctor in public system but I asked her secretary today. I can't get my operation without understanding everything. I feel bilateral mastectomy might be unnecessary after I read American article and study. It said getting cancer on the other side of the breast when women is over 50 and hormone + is not very common.  I need to find out more even I don't want to be a troublesome patient ..

  • TonyaM's avatar
    TonyaM
    Member
    14 years ago

    There is a compromise - you can go to a public hospital as a private patient. There are no out of pocket fees for the hospital charge but there is a gap to pay for your surgeon's fee and he/she does your operation.They have a resident doctor to assist.You are also eligible for a private room if one is available. That's what I did for my last mastectomy and it was much cheaper than going to a private hospital -which is what I did for my lumpectomy in 2003. I am sorry to hear that it has all changed from a lumpectomy to double mastectomy and recon. Unfortunately,breast cancer throws lots of surprises at you.Just ask questions so you feel really comfortable with your decisions.

                                                                   Tonya xx

  • TonyaM's avatar
    TonyaM
    Member
    14 years ago

    There is a compromise - you can go to a public hospital as a private patient. There are no out of pocket fees for the hospital charge but there is a gap to pay for your surgeon's fee and he/she does your operation.They have a resident doctor to assist.You are also eligible for a private room if one is available. That's what I did for my last mastectomy and it was much cheaper than going to a private hospital -which is what I did for my lumpectomy in 2003. I am sorry to hear that it has all changed from a lumpectomy to double mastectomy and recon. Unfortunately,breast cancer throws lots of surprises at you.Just ask questions so you feel really comfortable with your decisions.

                                                                   Tonya xx

  • TonyaM's avatar
    TonyaM
    Member
    14 years ago

    There is a compromise - you can go to a public hospital as a private patient. There are no out of pocket fees for the hospital charge but there is a gap to pay for your surgeon's fee and he/she does your operation.They have a resident doctor to assist.You are also eligible for a private room if one is available. That's what I did for my last mastectomy and it was much cheaper than going to a private hospital -which is what I did for my lumpectomy in 2003. I am sorry to hear that it has all changed from a lumpectomy to double mastectomy and recon. Unfortunately,breast cancer throws lots of surprises at you.Just ask questions so you feel really comfortable with your decisions.

                                                                   Tonya xx

  • LouiseTurner's avatar
    LouiseTurner
    Member
    14 years ago
    I had a similar experience as you. 2 lumpectomies and no clear margin. I'm now having a bilateral mastectomy. I have been public all the way. My breast surgeon and plastic surgeon treat both private and public. I would never afford private reconstruction fees and have contributed to Medicare for more than 25 years so figure that is what it's for. My only out of pocket expenses so far is for the MRI which is not a standard breast cancer diagnostic tool. You should have the right to choose either public or private. We have a great health care system, now is the time to benefit from it. You would be anxious to have the surgery done, but waiting for the public hospital date is not too far. My next surgery is not till chemo finishes, 6 months away. Good luck with your decisions, keep asking questions, it's the only way to get answers. Cheers Louie