Sunday, November 23, 2008

SINGLE OR DOUBLE MASTECTOMY?





We met with Dr Carol Benn again this morning to discuss the next step.
I know what the choices are, I now just need to make them. Although it is such a horrible decision to make, I think a double mastectomy is the way to go form the start.


THE OPTIONS AT THIS POINT:
• Carol recommends a right mastectomy based on the fact that the breast duct that was removed had high grade, aggressive, non-invasive cancer cells in it, and that the whole of the right breast tissue is hyperlastic.

• If I had a lumpectomy (a lump out with a clear margin of 1cm), I would need to radiate the right side. Once radiation has been done to one side, you cannot have it again. The body cannot with stand a double dose of radiation. Mastectomy would be the next step.

• Radiation damages healthy tissue along with cancerous tissue so it makes any future surgery (like a mastectomy) more difficult. This is because blood vessels, skin, and the pectoral muscle (muscle under the breast) would be damaged, even if just slightly, resulting in a slower healing time, and therefore a higher chance of infection, and scarring. If breast reconstruction is done, there is a greater chance of infection and a capsule forming (scar tissue that shrinks very tightly around the implant) after radiation. A subsequent op is then needed to loosen the scar tissue and the implant may need to be replaced.

• If I only remove the right breast at this point, because the tumor in the right breast was estrogen-sensitive, I would possibly need to go on hormone therapy now or some time in the future to block estrogen in the left breast tissue.

• Hormone therapy blocks the uptake of estrogen by estrogen-sensitive tissue (like breast, ovaries, uterus). This medication induces early menopause (along with all the symptoms of menopause like hot flushes, night sweats, irritability, and insomnia) and I would need to take it for 5 years!! I am not a candidate for this.

• Although, I would go for regular checks on the left breast, Carol says the stress of worrying about the left breast is very draining.

• Although a double mastectomy is not being prescribed, it is being suggested.


This is a very tough decision and I hate that I have to make it. But I am so grateful that I caught the cancer now. I am so grateful that I have a chance of living the rest of my life.

I now need to decide when I want to have the op, within the next week or so, or early next year. Carol is going away on the 9 Dec so she will not be around for follow ups etc. I would be referred to the plastic surgeon who works with her, Gereth Edwards.

We are going to my sister’s wedding on the 12.12.08 and then a full on family holiday after that. My mom is suggesting I have the op before we go away so the family can help me with the kids thru my recovery. I need to be comfortable with my decision before I go ahead.


Hyperplasic – definition (Wikipedia):

Hyperplasia (or "hypergenesis") is a general term referring to the proliferation of cells within an organ or tissue beyond that which is ordinarily seen in e.g. constantly dividing cells. Hyperplasia may result in the gross enlargement of an organ, the formation of a benign tumor, or may be visible only under a microscope. Hyperplasia is considered to be a physiological response to a specific stimulus, and the cells of a hyperplastic growth remain subject to normal regulatory control mechanisms. This stands in contrast to neoplasia (the process underlying cancer and some benign tumors), in which genetically abnormal cells proliferate in a non-physiological manner which is unresponsive to normal stimuli.

LiveHeidi

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