1. Posted by A Yahoo! Health User on Tue, Jun 30, 2009, 7:18 am PDT

I think you are refering to studies done by Todd Tuttle. I've told him my argument. I think anxiety is one main factor. Who ever wants to go thru BC again after having it once. Let alone a mamogram. If you get a second primary, who's to say it will get caught in time, even with regular monitoring? boobs just are not that important - some women just want them out....

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2. Posted by A Yahoo! Health User on Tue, Jun 30, 2009, 7:20 am PDT

I can say, having had a massive DCIS tumor and as a result mastectomy AND radiation, when I went to get a mammogram of the remaining breast and they had to "review" it. I was mortified. My thought was, take it off. Fortunately, it was nothing. Seriously, it is very stressful to go through that once let alone twice. And once diagnosed there is always something in the back of your mind saying, it could happen again. Furthermore, if you remove a breast preemptively you can't have a recurrence due to a cancer from that breast. This is key, too. I can also say that while I would want reconstruction after a mastectomy in NO way would I ask for any sort of "enhancement". No way. Also, I would not opt for a reconstruction methods requiring as much surgery/recovery/extra scars as a trans-flap or Ab-Flap. So I would go for the expander method. In case anyone doubts my sincerity here, I had the surgeon use an implant size two sizes smaller than my normal breast size (a 34B) due to complications from radiation. I opted for this instead of the other recon methods which would have ensured a natural sized and feeling breast.

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3. Posted by A Yahoo! Health User on Tue, Jun 30, 2009, 10:17 am PDT

I had bi-lateral mastectomy (although two excellent doctors said I should have a lumpectomy and radiation and I actually started with a lumpectomy ). I have had NO regrets. I remember asking the lady I work with who had gone with lumpectomy and radiation thirteen years earlier if you ever get over the anxiety of having mammograms after you have had breast cancer and she said no, but it gets better with time. Then two years later after 15 years, she was found to have a tumor near the original site and at age 74, she had bilateral mastectomy and is now going through reconstruction. She told me that she would have opted for that originally but the doctor had given her the statistics that survival rates are the same for lumpectomy/radiation and mastectomy. What they didn't tell me was that the recurrence rate is higher for lumpectomy/radiation and when I did my research, I decided that I wanted to do everything I could to avoid going through all of that again. I know that the risk is reduced to about 1% and not eliminated completely, but at least I am comfortable that I have done all that I can. I made my decision to have both breasts removed before even considering reconstruction. My doctor told me I needed to see a plastic surgeon before I had the surgery and I had reconstruction with implants and am very happy with that decision also.

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4. Posted by A Yahoo! Health User on Tue, Jun 30, 2009, 3:13 pm PDT

Finding additional breast cancer in a breast may not REQUIRE a mastectomy. I know. It may just widen the lumpectomy a little.

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5. Posted by A Yahoo! Health User on Wed, Jul 01, 2009, 2:14 am PDT

thanks..

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6. Posted by A Yahoo! Health User on Wed, Jul 01, 2009, 6:14 am PDT

I was diagnosed in November 2007 with an aggressive form of DCIS. After research, I decided on the lumpectomy followed by radiation. Yes there is still anxiety with every mammogram. There is still anxiety about whether or not I will get cancer in the other breast. But with the advancement of treatment options and survival rate, I am hoping and praying and doing the 3-day, 60 mile walk so that I will have other options should I again get breast cancer.

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7. Posted by A Yahoo! Health User on Wed, Jul 01, 2009, 12:01 pm PDT

No, I would not (and did not) have a mastectomy when I had stage 0-1 DCIS. However, if I had a more dangerous or larger tumor, I would absolutely consider the mastectomy with reconstructive surgery to both breasts. (Lumpectomy leaves a malformed breast, especially when the tumor is large and more tissue must be removed to get clear margins.) And the reason would be the fear of future breast cancer. Having dense breasts that can mask tumors makes one feel very vulnerable. However, I had no radiation following my lumpectomy, and I'm wondering if we missed a necessary step somehow...

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8. Posted by A Yahoo! Health User on Thu, Jul 02, 2009, 1:25 am PDT

I'm a DCIS survivor. I lost most of my right breast and had reconstruction. I can't imagine having bil mastectomies plus reconstruction.

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9. Posted by A Yahoo! Health User on Fri, Jul 03, 2009, 12:10 pm PDT

Having had an abnormal biopsy recently, I'm angered at how dismissive the medical establishment is of any diagnosis short of invasive cancer, and of any procedure less radical than total mastectomy. The biopsy was significantly disfiguring. It forced me to reduce my training for over a week. The stress was unimaginable to someone who's never been through it. Obviously there are procedures and diagnoses that are far, far worse. But to doctors who suggest that it's "nothing" for women to have breast biopsies every year or two, or go through the horribly disfiguring non-reconstructible lumpectomy and debilitating radiation, I would say "shame on you." It's obvious to me why women are opting for more mastectomies. It's one of two ways to be done with the whole cancer-profiteering industry. I've chosen the other path (telling them to go to h*ll and I'll keep my breasts come what may), which is more cowardly in some ways but scarier in others.

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10. Posted by A Yahoo! Health User on Wed, Jul 08, 2009, 7:03 pm PDT

Sure, there is anxiety at first, and possibly the surgeons take advantage of that. My first reaction to the news was "Get it off me". Fortunately, I wanted to get the best second opinion and the best surgeons, and they were busy, so it took time to get appointments and I calmed down. I had serious calcium deposits in one breast (it looked like a snow storm on the MRI film), with multiple sites with DCIS, but the other breast was clear. I did not consider having a bilateral mastectomy. The risks were explained, and I clearly understood that there was no need. I tried the conservative measures first, with a biopsy of a couple sites. Both were cancerous so they did a lumpectomy which found cancer at the margins. They did more biopsies before scheduling the second lumpectomy. Those came back cancerous and at the margins. At that point, the breast was pretty mishapen. I had numerous discussions with my female surgeon who was willing to continue to do the lumpectomies but insisted on radiation follow-up, an/or tamoxifen (which I could never understand if it wasn't invasive). I went to the hospital for a radiation consult, and then to see the treatment area. That was the turning poing. The waiting room was more depressing than I could bear. It was a dismal place of last resort, filled with pale, weakened, wheel-chair bound, hopeful patients with all types of cancer and little strength or hair. I cried when I sat there and watched them roll in and out, their faces pained and weak. I knew that I would not keep my spirits and energy up for my three kids if I had to start my day this way for six weeks in order to finish the prescribed treatment, which was going to scar me and burn my skin. At that point I just wanted to get my life back. Fortunately, I finally got a straight answer from someone: the radiologist told me, when asked, that if my film were her film, she would have a mastectomy, as it wasn't a matter of if, but when, the cancer would be found next. It took me eight months, three biopsies and two lumpectomies to decide to have a mastectomy for DCIS. They removed the alphabet soup (the eight letters that the surgeon placed to mark the biopsy locations so that she could go back and remove the correct spots) and I have never regretted the decision.

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11. Posted by A Yahoo! Health User on Thu, Jul 09, 2009, 10:42 pm PDT

No, that is not the reason whatsoever. Do you know the risk of future health problems from getting radiation premenopausal? Radiation is damaging to your heart, something you don't want to do when you are still a young woman. Plus increases your risk of other cancers. I had a mastectomy with no reconstruction at all, so in my case it wasn't to get the free boob job. Also, I had young kids at the time and the radiation treatments took a lot of time that I didn't want to waste. The mastectomy was over and done with in a matter of days and I didn't have to worry about anymore treatments thank god, since it was confined to the breast. A few years later I was tested for BRCA and was positive, so ditched the other boob too. I had great breasts before but started to think of them as my enemy and am glad they are gone- no worries. Other women don't want to get rid of their breasts and that's fine too, but I think most women who get mastectomies don't want to further damage their health with more medical interventions.

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12. Posted by A Yahoo! Health User on Wed, Jul 15, 2009, 3:25 pm PDT

I was diagnosed with DCIS and LCIS in two different areas of the same breast almost 11 years ago at age 42. I had a lumpectomy and radiation after being told that my prognosis would be virtually the same as having a mastectomy. I now know that the odds for having a recurrence are a bit higher for a lumpectomy/radiation than if I'd had a mastectomy. However, I took tamoxifen for five years which leaves me with about the same odds as if I'd had a mastectomy. Now having explained all that, I do get anxious when I go in for my yearly mammograms. I have an appointment coming up in two days, which has once again brought me to this site for reassurance. My upcoming appointment brings up a lot of painful memories of fear and sadness, not only for myself but for everyone who has to deal with this dreadful disease. My 87-year old mother died from breast cancer two months ago. She had an aggressive type that returned two years after she had a mastectomy. I know what she went through having a mastectomy. It was tougher than what I had with a lumpectomy/radiation and tamoxifen. My affected breast is a little smaller now than the other one. Seeing it reminds me that I'll never be cured – nor would I be if I'd had a mastectomy - and that other women have to deal with a lot worse prognosis then what I have. For my mother, when her breast cancer returned it didn't return to her other breast or chest wall, it returned to her bones and liver. I'm not terribly worried that I'll get breast cancer again. I don't like having to go to my yearly mammography appointments or my yearly check ups with my oncologist, but then I don't like going in for dental check ups either. My mother's oncologist told me a few months ago that I should have both of my breasts removed. Of course he knew nothing about my health history other than that I had already had breast cancer at some point in my life. That doctor's attitude might be the reason why more women are having mastectomies. I think either type of surgery is traumatic because it's for breast cancer. For me the lumpectomy/radiation/tamoxifen worked out well. Six weeks for radiation sounds like a long time, but it went by fast with no ill effects. I lived in the same town where I had radiation and my children were all school aged, so I had my appointment right after I dropped them off at school. I don't think having a mastectomy would give me any more confidence than what I have now about whether or not I'll have a recurrence. There's no guarantee either way, and for me the lumpectomy/radiation was a less drastic solution for a less drastic form of breast cancer, which is what I had with DCIS.

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13. Posted by A Yahoo! Health User on Mon, Jul 20, 2009, 2:27 pm PDT

I was diagnosed with dcis in one breast and am opting for mastectomy with reconstruction on effected breast. I would prefer to have double mastectomy but was told that with dcis insurance will not cover mastectomy on unaffected side. Is this wrong?

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14. Posted by A Yahoo! Health User on Wed, Aug 05, 2009, 11:36 am PDT

Lillie, I realize that you are a nurse, author, and administrative director of the Johns Hopkins Avon Foundation Breast Center. But when did a diagnosis of DCIS(Ductal CARCINOMA in situ) ever become less frightening to any woman. I was diagnosed with a tumor at the 6 o'clock position and after a stereostatic biopsy I had a lumpectomy with radiation on my right breast (back in 1999 at the age of 41) they burnt my lung so now I suffer from dry lung on that side. My ribs have become weaker because of the radiation, not to mention the nasty burn it gave me topically, They gave me Silvadene (Silver Sulfadiazine) which caused an infection and I healed it up using neosporin and aloe juice. I was having problems in my left breast SEVERE MASTALGIA. My breast had erupted and spewed blood from my nipple like Mt. St. Helens spewed ash over the state of Washington after several tests I was once again diagnosed with DCIS (age 49) in my left breast this time at the 12 o'clock and 6 o'clock positions. I had just lost my husband of 26 years and had to make a decision. I chose a bilateral mastectomy for myself. It took me 2 years to convince the Doctor that DCIS even though it is an early stage cancer, it was none the less CANCER. First and foremost the darn Medical community needs to realize this and not make light of it. Then explain to the patient the options available to them and what the reoccurence rates can be after each procedure. One thing you have to remember is they live in their bodies 24/7/365 and only they can make a decision that is right for them. I do say that it does need to be an INFORMED decision though. I just got my bilateral mastectomy on Friday July 31st just before my 51st birthday. It is the right decision for me. I could give you all the comedy I give to my friends such as my husband is dead now and he doesn't need them for pillows but I won't. I will give you the truth. It is disgusting to look at, but I am the only one that will see it. I chose no reconstructive surgery, again my choice. I have reduced my CANCER reoccurrence rate down to 5% and that gives me a considerable peace of mind. I have a suggestion for The Medical Community CANCER is CANCER no matter how you label it. When you say pre-cancerous that really upsets me because that in my opinon is the earliest stage of Cancer and as in polyps of the colon you remove them for that very reason. Don't diminish your patients feelings or wants like my surgeon did me. He only did the surgery for the Severe Breast Mastalgia he put the DCIS as an after thought and that really urks me to no end. It is my opinon that doctors should do anyway with the words pre- (anything) as in: diabetes is diabetes you either have hypoglycemia or hyperglycemia which can be controlled in different ways. Think about it can you will see that sometimes you are all too dang BOOK smart to understand most of the patients that you treat and you know what they say about that fine line between genius and moron.

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15. Posted by A Yahoo! Health User on Tue, Aug 25, 2009, 7:36 pm PDT

I can easily answer why more women are having a mastectomy instead of "breast conserving" surgery and radiation. I was diagnosed with DCIS and told I would have surgery and radiation. When I found out that the breast tissue would never be the same and that in order to get good margins I would "not wear a low cut blouse ever again," I looked for an alternative and found a surgeon who recommended a skin sparing mastectomy with immediate reconstruction. I couldn't believe how little information there was about this choice. Radiation is no joke. There should be a sign at every doctor's office explaining that once you have radiation, you can't then have a skin sparing mastectomy with a pretty implant if you change your mind or have a recurrence. The damage will have been done. Having a mastectomy is sometimes your best chance to have a breast that looks nice in the end. And even though your chances of survival are the same for either procedure in the long run, you are more vulnerable to a recurrence with lumpectomy. Once they find something, even if it's "just" DCIS, your boobs will never be the same. So a lot of smart women are just going ahead and doing what they think is their best chance for being cancer free AND looking good.

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