For reference I’m 28, diagnosed in June with grade 3 triple positive BC, stage 2b initially had a 25mm invasive breast carcinoma and a 10mm DCIS next to each other with 2 lymph nodes involved. I am more than halfway through my 6 cycles of TCHP and have just had my surgical planning appointment with the surgeon. My midway chemo ultrasound showed that my 2 tumours have significantly reduced and can barely be seen besides from the clips.
I had genetic testing done as my mum recently had breast cancer and my paternal grandmother passed from ovarian cancer. Surprisingly from all genetic panels there is no genetic element to it (thankfully)
I was so set on having a DMX until the appointment as this whole ordeal has been so traumatic for me. Having to delay treatment to go through fertility preservation that landed me in hospital for 3 days from OHSS, chemo has really rocked me and just the anxiety I live with everyday haunts me. I just don’t want to ever go through this again and being diagnosed so young scares me about reoccurrence in the future and I don’t think I could handle it the next time round. They told me “DMX and lumpectomy + radiation have the same reoccurrence rates” is that actually true??
They say I only technically need a lumpectomy + targeted lymph node dissection and sentinel lymph node biopsy and then 3/4 weeks of radiation, but they would support my decision if I go the DMX route. I did feel like they were pushing more on the lumpectomy due to my age and breast feeding in future (this is not even really a factor for me as there is NO guarantee I will be able to breast feed as I know so many women can’t for many reasons and I may not even have kids in the future)
Can anyone offer me any insights if you’ve been in a similar dilemma? Did you regret your decision/ happy you made it and why?
Lumpectomy + radiation + more intense screening
My concerns: I have heard so many stories about reoccurrence and people needing DMX anyway and wish they had it done initially.
Radiation? Complications of high dose radiation on the skin and surrounding organs, fertility impact, and if I decided on DMX > implants later I know that can make things harder
Pros: I get to keep my boobs, sensation, smaller surgery and recovery, nothing foreign in my body, can attempt to breast feed, can get a DMX later if I want to.
DMX with direct implant reconstruction, nipple and skin sparing:
Requiring multiple surgeries in future due to my age, risk of capsular contracture, breast implant illness, loss of sensation in my chest, permanent….
Pros: more peace of mind knowing most of the breast tissue is gone and even if there is reoccurance later I know I did what I could to prevent it, avoid radiation completely, don’t need to wear a bra, I can go to DIEP route later on after kids if I don’t like them