Hi! I've got so many questions

Hi Cass

Most of the other ladies have already covered most of the issues that your sister will face.  It is a very daunting time and the amount of information and the decisions that you need to take is quite overwhelming.  What I would say is take each day as it comes.  Try not to think too far in advance.  Get through the surgery before you worry about having chemo/radiation as that is enough to think about at this stage and the chemo/radiation will be done later and there is nothing that you can really do to control that.

Your sister may not need radiation if she has a mastectomy (i've had two mastectomies, 7 yrs apart and never had radiation).  Generally if they can get clear margins then they don't do radiation.

Chemo is a very scary prospect.  I found losing my hair to be more upsetting than losing my breast!  I had my two sons shave my head (which they thought was hilarious and I thought was devastating) about a week after my first chemo session.  I put on a brave face for the boys but ran upstairs and cried my eyes out once it was done!  I wore a wig most of the time as this kept my family more comfortable but I also went bald a lot at home.  When I went out, I almost invariably wore a wig.  I worked all the way through my chemo and my clients (I'm an accountant) didn't realise that I didn't have my own hair!!  I bought two wigs from a US website (makemeheal.com) and I also borrowed one from the Cancer Council Wig Service (free of charge).  You can go in and see the Cancer Council ladies before she loses her hair and choose one that is close to her own style (or try something completely different if she wants to!).  They are so helpful and you can use the wig for as long as you need it.  The wigs look lovely and natural too.

I went private for both my breast cancers and was definitely out of pocket but probably only about $2000 each time.  I was more comfortable to be able to choose my own surgeons etc and have a private room for my recovery.  I had reconstructions done both times.  The first time was a delayed reconstruction due to an allergic reaction that I had in my initial operation.  I wore a prosthesis for about 4 months and absolutely hated it!  My reconstructions were both different kinds (one TRAM flap and one Lat Dorsi) but both look very realistic.  My second reconstruction was done at the same time as my mastectomy - with my lat dorsi muscle and expanders inserted, then a subsequent small operation to replace the expanders with permanent prosthesis.  If you have any questions, please feel free to ask :)

With the lymph nodes, generally when you go into surgery the surgeon will at the very least do a "sentinel node biopsy" which involves taking the first node that the area drains to to see whether it contains any cancer cells.  If this is clear then the won't take any more lymph nodes (other than incidental ones which are taken as part of the mastectomy site).  I only had my sentinel nodes taken each time.

I can't help with the fertility side of things.  I was 35 the first time that I had BC and had already had my kids.  I'm sure you will get advice from others though.  Chemo didn't put me into menopause and my ovaries are still working perfectly fine now (I've just turned 45).

Tell you sister to keep a positive mindset as this really helps in the way that you cope with everything that is going on and with the recovery.  I was surprisingly ok when I woke up after my first surgery with only one breast, so if she can't have a reconstruction straight away, tell her not to be too worried.  By the way, if she has to have radiation, they generally won't do an immediate reconstruction...

Keep in touch and let us know how she goes and if she has any questions, you know where to come.

Take care,

Louise x