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Breast cancer diagnosis - please help with all the emotions - update 4/16


Quarter Note
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(Please don't quote – I'm not comfortable putting this much personal info out on the forum, but I'm desperate.)

Friends, would you please help me work through some of the emotions of getting a breast cancer diagnosis?

Three weeks ago, I was grumbling that I had another pro forma mammogram call back. Within a week, there were two biopsies and then the diagnosis (DCIS, stage 0, grade 2-3). At first, my attitude was that I would just get that “little excisional” and then be done and go on with my life. I was joking that maybe I'd get some good schwag from the hospital and that I'd have to start wearing one of those rhinestone-studded pink ribbon pins. But the more I look into things (and I'm scouring breastcancer.org for hours every day), the more this is not just “a little excisional”. Lumpectomy vs. mastectomy, radiation, genetics, chemo, reconstruction…. Instead of joking, now I'm a sobbing mess. 

Right now I'm scheduled for a lumpectomy, and it's really what I'd prefer (this study seems to indicate that lumpectomies can have long-term outcomes at least as good as mastectomies). But then, many people seem to think that a lumpectomy is just delaying the inevitable mastectomy and giving cancer more time to come back harder. I honestly know no one in real life who has gotten anything less than bilateral mastectomy.  Of course I want to be around to watch my kids grow up. But, I'd also really like to keep my breasts, if possible. I can't imagine losing that sensation there. It's not like a mastectomy is something you can change your mind on.

My husband, who is absolutely wonderful, will support whatever decision I make, so I can count on his support. He doesn't care what body parts I lose if it means that we get to grow old together. But I still can't figure out how to decide what to do. 

Any thoughts? I'd appreciate hearing from those of you who have made this decision. Thank you!

Edited by Quarter Note
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I found this, and this part stood out to me: https://www.cuimc.columbia.edu/news/stage-zero-breast-cancer-whats-optimal-treatment-dcis

 

It’s important to understand that radiation and hormone treatments do not change survival—the 10-year survival rate for women diagnosed with DCIS is 98% regardless of whether they receive either treatment. These treatments instead reduce the risk of breast cancer down the road.  

 

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10 minutes ago, Ausmumof3 said:

I am so sorry to hear this 😞 

do you know if your have the BRCA1 gene?  If you can get the testing to find out I think it helps make the decision a bit clearer.

I had the test done, but don't know the results yet.  I know that that might impact my decision.  I have two relatives on the maternal side who each had cancer, so I'm scared about that, too.

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4 minutes ago, Quarter Note said:

@Arcadia, I just read all the way through your thread.  Thank you for sharing it!  How are you doing now?

I am on hormone therapy. Every year I have a MRI and a mammogram approximately 6 months apart. I see my oncologist for routine visits every 4 months.

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I don’t have any information or advice for you, but I’m sending lots of hugs and prayers your way. 

This is unimaginably scary, so I’m glad you’re talking about it instead of holding your fears inside.

We are here for you whenever you need us. 

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I’m so sorry.
I had dcis stage 0, 12 years ago. The plan was to have a lumpectomy and then radiation. But cancer does not always follow the plan. 

The lumpectomy margins were not clean, and the doctors left it up to me to opt for another lumpectomy or get a mastectomy. After much agonizing, I got a left-side mastectomy. I did not opt for reconstruction, because I didn’t want more surgeries. After the mastectomy, They found that the breast was full of dcis, so the mastectomy would have ultimately happened.  I have a prosthetic boob that I am happy with. I’m active and do sports, even swimming.

The part of the journey that you are currently experiencing is the worst, in my opinion. You are in shock. You have become a cancer person and now you have to face your mortality, your potential absence from your family, and the disfiguring of your body. It’s a lot to process. Don’t spend too much time on the breast cancer websites, if possible. Your husband sounds like a gem, as mine is. But in the middle of the night, when you can’t sleep, you will feel very much alone. It’s ok to feel shocked, depressed, alone, and hopeless; but I believe that you will find hidden strength, faith, hope, and even humor in your journey. Let people help you. Let us help you get through this.❤️
 

feel free to pm if it would be helpful. 

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@Quarter Note I'm sorry that you find yourself in this situation. As someone who was diagnosed with stage 2b breast cancer a little over two years ago, I remember well the stress of processing the diagnoses and making so many decisions. I can also assure you that you can do this. There are brighter days ahead. 

Have you met with your surgeon yet? My first visit with my breast surgeon did so much to calm me. We had a plan and I felt more in control. The waiting really is the hardest part. 

Have you heard yet about the hormone receptor and her2 status of your tumor? 

ETA: Sorry, I just reread your post and see that you are already scheduled for surgery. 

Edited by ddcrook
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20 minutes ago, Quarter Note said:

I had the test done, but don't know the results yet.  I know that that might impact my decision.  I have two relatives on the maternal side who each had cancer, so I'm scared about that, too.

Yep.  I did a bit of typing on this for a job once and my impression was if you have one of the genes mastectomy is the safest option but if not, it’s likely not necessary.  Hoping for your sake you get good results on that front 😞 

I don’t have any personal experience but just want to send you lots of love and support and hope all goes as well as possible.

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31 minutes ago, Quarter Note said:

@ktgrok, the article that you linked just made my day.  There is hope!  Thank you!

Oh my goodness - yes! If you are going to have cancer, stage zero, and something called "non invasive" are the words you want to hear. And 98% survival rate over 10 years, with it being called "not life threatening" means that yes, you have decisions to make, but you can probably shelve the worst case scenario stuff and focus on all the others issues involved, you know?

I'm truly not trying to minimize how stressful this is for you, but wanted to point out those things so that maybe it relieves at least some of that stress. Hope is important!

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13 minutes ago, Quarter Note said:

"Routine visits" sounds great!  I'm glad for you!

PM me if you want to. 

My surgeon and oncologist are really supportive people, laying out all options and then letting us think over and decide. They never rush us to make a decision. Our annual out of pocket is $6k so financially it was okay for us. 

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I'm sorry (hugs). I know we've unfortunately had several ladies here that have been through this I hope they can help you. (I was going to tag some but thought it might be rude to call people out because they may or may not feel up to sharing)

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My sister had breast cancer. The size was .1 cm over the parameter of where the protocol is radiation and chemo.  She did not want chemo.  The doctors pressed her pretty hard and THEN they offered her a grading test of her cancer.  0-50 scale.  The higher your number the greater your chance of your cancer reoccurring.   Her number was 2.  So then they were ok with her not doing chemo.  My question is WHY is that test not administered to everyone with a cancer diagnosis..  I have never heard of that again.  

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7 hours ago, Tiberia said:


The part of the journey that you are currently experiencing is the worst, in my opinion. You are in shock. You have become a cancer person and now you have to face your mortality, your potential absence from your family, and the disfiguring of your body. It’s a lot to process. Don’t spend too much time on the breast cancer websites, if possible. Your husband sounds like a gem, as mine is. But in the middle of the night, when you can’t sleep, you will feel very much alone. It’s ok to feel shocked, depressed, alone, and hopeless; but I believe that you will find hidden strength, faith, hope, and even humor in your journey. Let people help you. Let us help you get through this.❤️

First of all, hugs. Many hugs.

Secondly, I can only address the emotions as a spouse of someone who is walking the cancer road (but the stage IV cancer road, and a type that has massively fewer treatment options than breast cancer, but who has done relatively well for several years now). Even so, I'm the spouse and not the one with the diagnosis, and I'm acutely aware of the differences in those roles.

But I want to say a huge, huge "yes" to the above, and to what @ddcrookposted. It's amazing what terrible shocks we can endure that get normalized with time. Humans are very adaptable creatures. As hard as it is to believe right now, even a cancer diagnosis can--very likely will--become just something else you deal with. You adapt to the new normal and go forward. Or at least that's our experience, and what I've seen of most of the patients on the cancer board I belong to, but of course everyone is different. I'm not trying to tell you it's how you will be or have to be, just to offer the hope of a day when the dark cloud of worry and anxiety isn't hanging right over you. The hardest times really are the first few weeks after diagnosis and the times when you need a plan and don't yet have one. And right now you're dealing with both of those. It will get better. In a way what you're dealing with is a type of grieving, and there are stages and phases you'll work through, and they probably won't be neat and linear and progressive. But you'll get there. If you're being treated at a good sized cancer center then in all likelihood they have counselors who can help you through the emotional aspects of the diagnosis. Don't hesitate to take advantage of that help. And of course we're always here for you.

Edited by Pawz4me
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My mother and all four of her sisters had breast cancer, no gene they were tested.  My mother at 45 chose a lumpectomy and no chemo but radiation.  She did great.  At 69 her sisters started being diagnosed with breast cancer and encouraged her to get an MRI and they found cancer.  This time she had a mastectomy as she couldn't do radiation again.  Two sisters got mastectomy and breast reconstruction and two went with lumpectomy.  My mother is now 81, she and her sisters are all doing well.  I do know there is a lot to consider and they want you to make decisions so fast.  I read a lot the second time for my mother as she needed to decide if she wanted breast reconstruction as well. ( she opted out as the only option for her was pretty invasive and long recovery and at her age she just wanted to get back to her life, my dad could care less he just wanted her healthy).  If she was younger like a couple of her sisters she might have done the reconstruction.

I'm sorry you're going through this, it is hard.  

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I need to get some work done, so I will need to come back to this thread when I have more time to chat. However, for now I'll share that I was diagnosed with breast cancer almost three years ago. Mine was larger/later stage than yours. They initially posited that I would be able to do a lumpectomy + radiation, but then discovered a second, smaller tumor that, combined, put me over the limit and into mastectomy territory. I agonized over the questions of whether to remove just the affected breast or both and whether to do any kind of reconstruction. 

That part was really hard.

Eventually, when it was explained to me that, as long as I had breast tissue, I would be considered higher risk and require monitoring for the rest of my life, I opted for the bilateral mastectomy.

And, after a lot of research, I decided not to do any kind of reconstruction. I just couldn't justify in my own brain the idea of undergoing what to me felt like elective surgery (although I know many other women feel differently about it) just to put in place what I knew I would always feel like were "fake" body parts. That was a very personal, individual decision that felt right to me. Again, I know many women have very different feelings and come to a different decision, which I completely respect.

Radiation, for me, was difficult, not really for any physical/medical reason, but because it was exhausting to balance the daily appointments with trying to return to work. Also, I had a hard time feeling like I had lost control of/connection to my body in some ways. Add in the fact that I was hit with a major depression around the same time, and those few months were a real low point in my life.

A little over two years post surgery and the end of radiation, I'm doing well physically/medically. I have complete peace with the decisions I made about the mastectomy and (no) reconstruction. I take one pill per day, have scans done every six months (plus an annual DEXA scan to watch my bone density), see my oncologists every four months or so. 

I experimented with various types of prosthetics, but felt uncomfortable both physically and emotionally with everything I tried. So now I just "go flat."

Yesterday, I got a tattoo that incorporates/covers up the little blue "targeting dot" left over from radiation. 

I'm sorry you're facing this. I hope it's comforting to know that most of us come through it just fine and get on with our lives. 

Edited by Jenny in Florida
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Everyone, thank you so much for your understanding and encouragement.  ❤️  Your words and the hope you give me are priceless.  I wish I could have a long, in-depth conversation with every one of you.  (I may PM some of you later - right now it's just too much.)

It really is the emotions that are the hardest.  I'm not sure exactly how to say this, but I feel so loyal to my body.  I'm one of the least vain people in the world, so it's not about losing any kind of looks (I wear an A-cup anyway), but my body and I have been together for over half a century now.  I have no thoughts of "My breasts are trying to kill me - get rid of them!"  No, my thoughts are more along the lines of, "Cancer is trying to kill my body.  I want to protect every cell that's mine."  And the other thing is, I really want to save the sensations.  (Blush - Blush - Blush)  I can't imagine not having any feeling there when I hug my husband, or when we do more than hug.  (Blushing too much to continue.)  

I'm crying.  Be back later when I can, but special thanks to @Arcadia@Tiberia, @ddcrook, @Pawz4me, and @Jenny in Florida for sharing so much of your personal stories.  You are all brave women (and Pawz' spouse is brave).  Thank you!

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I’m so sorry that you are going through this. 
 

You stated that you do not know anyone in real life with less than double mastectomy. So I want to reassure you that, yes, many people opt for lumpectomy. My older sister several years ago, and a co-worker at least 5-10 years ago chose lumpectomies. Both are doing well, with no breast cancer, I am happy to report. 

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1 hour ago, Quarter Note said:

Everyone, thank you so much for your understanding and encouragement.  ❤️  Your words and the hope you give me are priceless.  I wish I could have a long, in-depth conversation with every one of you.  (I may PM some of you later - right now it's just too much.)

It really is the emotions that are the hardest.  I'm not sure exactly how to say this, but I feel so loyal to my body.  I'm one of the least vain people in the world, so it's not about losing any kind of looks (I wear an A-cup anyway), but my body and I have been together for over half a century now.  I have no thoughts of "My breasts are trying to kill me - get rid of them!"  No, my thoughts are more along the lines of, "Cancer is trying to kill my body.  I want to protect every cell that's mine."  And the other thing is, I really want to save the sensations.  (Blush - Blush - Blush)  I can't imagine not having any feeling there when I hug my husband, or when we do more than hug.  (Blushing too much to continue.)  

I'm crying.  Be back later when I can, but special thanks to @Arcadia@Tiberia, @ddcrook, @Pawz4me, and @Jenny in Florida for sharing so much of your personal stories.  You are all brave women (and Pawz' spouse is brave).  Thank you!

I have higher risk due to family history and I have twice yearly scans. Breast cancer is something I think about. And I am absolutely sure that I would feel exactly as you articulated in the bolded should they actually find something. Don't feel that you are odd for trying to preserve as much of your body as possible. I also know many women who had the lumpectomy.

 

Edited by fairfarmhand
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I am flat chested, less than A cup size. We just tell my oncologist and my surgeon that we wanted the least invasive treatment possible and that’s what they aim for in my treatment plan. 

Edited by Arcadia
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4 hours ago, Splash1 said:

My mother and all four of her sisters had breast cancer, no gene they were tested

Splash1, I'm not sure when they were tested but I was initially tested 10+ years ago and my BRCA1 and BRCA2 was negative.  I have a very strong family history.  Fast forward 5 years ago and they are now able to test for many, many more genes that cause breast cancer.   I came back positive for a different breast cancer gene.  

I'm letting you know this to encourage you to have the full Myriad panel if they were only tested for BRCA.   

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3 hours ago, Quarter Note said:

It really is the emotions that are the hardest.  I'm not sure exactly how to say this, but I feel so loyal to my body.  I'm one of the least vain people in the world, so it's not about losing any kind of looks (I wear an A-cup anyway), but my body and I have been together for over half a century now.  I have no thoughts of "My breasts are trying to kill me - get rid of them!"  No, my thoughts are more along the lines of, "Cancer is trying to kill my body.  I want to protect every cell that's mine."  

Everybody reacts to this in individual ways.

What helped me make choices, finally, was to really think about who I am, how I perceive myself as a whole being, not just a body. What do my other life choices say about me and my priorities? And what choices would be consistent with that understanding?

I didn't feel like my breasts were tying to kill me, exactly, but the longer I had to live with the knowledge that there was a toxic entity inside me, the more insistently I felt I needed to get rid of it, in the most decisive way possible. And, because I tend to be a pretty practical, no fuss person, my decisions came down to how I could deal with the getting rid of most efficiently and get back into my life as quickly and healthily as possible. 

At that point, I was a few years back into full-time work post-homeschooling. My kids had moved out or were about to do so, and I had just started a job for which I had high hopes. (I was actually diagnosed two weeks after I started working there.) 

When it came to choosing the bilateral mastectomy, it felt at first distinctly wrong to choose to cut off a perfectly healthy part of my body. (I should clarify that at least the single mastectomy was a given; there was too much cancer to make a lumpectomy possible for me.) But, with the above in mind and with the knowledge that keeping that one breast would mean a) walking around lopsided or sentencing myself to wearing a prosthetic for balance and b) being a "high risk" patient who required additional monitoring and treatment for as long as I had any breast tissue, it became very clear that the most logical, practical and efficient way for me to get healthy again was to remove both breasts. 

Similarly, since I tend towards the least invasive treatment whenever possible, and since I value my "self" more than my physical body, it felt out of character to incur the risks inherent in undergoing additional surgeries/medical procedures to do any kind of reconstruction. Also, I felt, for lack of a better word, sentimental about my breasts, rather than loyal. I was definitely sad to lose the breasts I'd been travelling with for the last few decades--the ones that got me teased in middle school, the ones I used to feed my babies, etc.--but I knew myself well enough to know that I would always feel "weird" about what I would relate to as artificial replacements. 

It's a terrible situation, and I remember feeling infuriated that "the experts" were leaving such huge, life-changing decisions to me, who had no idea how to figure out the "right" thing to do. But I felt things shift into place once I was able to take a step back and focus on who I am and who I want to be, then figure out how to put all of these choices into that context. 

I'm sure you will figure out what makes sense for you. Feel free to think "out loud" here. I did, and I am forever grateful to everyone who helped me process.

Edited by Jenny in Florida
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I really appreciate your story @Jenny in Florida.  I remember reading through your post when you were diagnosed and making your decisions. I gained a lot of info that helped me when I was diagnosed a few months later. I'll share a little of my experience and hope that it helps someone else. 

I was diagnosed with bilateral breast cancer and at first I didn't understand what was going on. I thought that the cancer had spread, and I was certain that I wanted a bilateral mastectomy. When I met my breast surgeon, she explained that these were two completely different tumors, not a spread. She explained my options and said that she felt that lumpectomies should be all that I needed, but she needed to check a couple of things first. 1) She sent me for genetic testing because of my age and bilateral cancer. 2) She sent me for an mri because the lump felt much larger than the measurement from the mammogram. It turned out that I had a brca mutation, so bilateral mastectomy was clearly the best option. We also discovered during surgery that the tumor was bigger and was hiding a third tumor- thanks brca! 

At first I didn't think I wanted reconstruction. I didn't want any more surgery, and I was concerned about having fake parts in me.  After visiting with the surgeon, I decided to go with a DIEP flap reconstruction at the same time as my mastectomy. It was a longer surgery with a longer recovery, but I am so glad that I did it. I feel and look very natural. I don't know what kind of voodoo my surgeons did, but I definitely still have feeling when I hug someone or hold a baby. But not everything feels the same because they remove parts (blush). Even so, I'm very happy with the results 

So, you can see that three different women on this board have taken three different paths. When it comes down to it, the kind of surgery you get is really a personal decision based on what your doctors say and what makes you most comfortable. Your surgeon has looked at your situation and has decided that a you will be fine with a lumpectomy. Now it's a matter of you deciding what choice you are most comfortable with- what will give you the most peace of mind. That really can be a difficult, exhausting choice. Many women find it helpful to go on anti anxiety medication during this process.

I'm sending you many hugs and well wishes!!

 

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40 minutes ago, ddcrook said:

So, you can see that three different women on this board have taken three different paths. When it comes down to it, the kind of surgery you get is really a personal decision based on what your doctors say and what makes you most comfortable. Your surgeon has looked at your situation and has decided that a you will be fine with a lumpectomy. Now it's a matter of you deciding what choice you are most comfortable with- what will give you the most peace of mind.

That is absolutely the key: This is a completely individual decision that you need to make based on what your instincts tell you is best for you. It's helpful to hear other people's experiences, but ultimately, the "right" choice is what's right for you.

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8 hours ago, Amy in NH said:

If you decide that you need to go the mastectomy route, please look into Sensation-Preserving Mastectomy. 
It is possible not to lose this part of you.

Amy, this is amazing!  I had no idea anyone was trying to do this!  I just did a quick google search and will look some more later.  Thank you, thank you, thank you!

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@Jenny in Florida and @ddcrook, I don't want to quote either of you since you both shared so much of your personal stories, but I want to give you both big thanks for your last couple of posts.  Sharing so much of your thoughts and recounting your journeys has given me peace that I can get through this, too.  

Everyone, how amazing you all are with your kind words and encouragement!  I can't tell you all how much better I feel tonight than I did yesterday.  There are still far more questions than answers, but you have all given me new hope.  

And for those of you who are survivors, thank you for being so open with your experiences.  I admire you all!

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  • 1 month later...

Friends, I'm so sorry it's taken me this long to get back on the forum to update you.  Just wanted to let you all know that I decided on the lumpectomy and had it three weeks ago.  The pathology report says that the surgeon got clean margins.  Except for the ugly scar, I think the surgical site has healed. (I've even started doing some gentle aerobics.)  

Next up is radiation, but that seems to be slow to get started.  

Thank you all for your prayers, good wishes, and information that you've shared.  I can't even tell you how much it meant to me to have so many of you ladies sharing your stories and rooting for me.  😊

 

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  • Quarter Note changed the title to Breast cancer diagnosis - please help with all the emotions - update 4/16
1 minute ago, Catwoman said:

Thank you so much for the update — I have been wondering how you were doing!

What's kept me away has been kids hanging over my shoulder, "I want to be on the computer, Mom!"  It just didn't feel right trying to do this update in a hurry.  But they're at a movie now - so I get to browse the forum in peace!

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2 hours ago, Quarter Note said:

 

Next up is radiation, but that seems to be slow to get started.  

The surgeon might have to sign off before radiation starts. There is a recommended minimum number of days from lumpectomy to radiation. 

My schedule was:

Surgery July 29th 2019

Post op Oncology Surgeon August 7th 2019 

Post op Mammogram September 4th 2019

Radiation Oncologist August 15th 2019 

ETA: radiation treatment was October 1st to 21st 2019

Edited by Arcadia
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