When I was first diagnosed, I thought that my best chance of survival required that I take the most aggressive measures and began preparing myself for a bilateral mastectomy. But, one conversation with my breast surgeon changed my mind. In fact, she had to literally talk me out of it.
Breast tissue, she explained, is integrated into other upper body tissue, without a clear line of demarcation. So, there is no fool-proof surgical solution. However, by showing me numerous studies on recurrence rates for my stage, grade, and flavor of tumor, she convinced me that the likelihood that my breast cancer would come back with either surgical approach was the same, about 4%.
Breast oncology has come a long way. After studying hundreds of thousands of women, new diagnostics and treatment plans can produce a pretty predictable outcome. My plan involved removing the two-centimeter (.8 inch) tumor by a lumpectomy or partial mastectomy, a form of “breast conserving” surgery. This was followed with internal, high-dose radiation and drug therapy to block estrogen.
Based on where I am in my life and the medical recommendations of three breast cancer specialists, this was the right choice for me. But every woman is different. Ultimately, the choice rests with the woman and it is her right to choose what is right for her.
To help early breast cancer patients make the best choice, Mayo Clinic offers these points for consideration:
-Are you aggressive or conservative? In other health decisions, are you more likely to do the most medically possible although the predicted benefit may be very small? Or, are you more likely to choose the least treatment that can deal with the problem?
-After treatment, how likely are you to worry that cancer will come back to the breast tissue that remains? Would complete breast removal reduce the worrying?
-How do you feel about losing a breast? What are the psychological impacts on self image, sexuality, confidence?
-How does your choice affect your partner? Either choice will impact a woman’s sexuality. From sensitivity to scars to uneven size, there are differences that should be discussed as a couple and with the surgeon.
-Do you have a genetic predisposition to breast and/or ovarian cancer? An analysis of the extracted tissue will reveal if this is the case. If so, most breast and gynecologic oncologists suggest consideration of preemptive surgery of the remaining breast tissue and ovaries, along with genetic counseling.
I have friends who decided to just go for it; had the double mastectomy, some had reconstruction, and all are as healthy and happy as ever.
We now know enough about breast cancer to be fairly certain about how your choices will affect your survival. So if you are diagnosed with this disease, get the best medical advice possible (including second opinions), study the options, and make your decision FOR YOU.