Decisions

I've been grappling with my surgery choices since the consult with the breast surgeon. Tentatively, I have a lumpectomy scheduled for September 25th. But there's an inner voice that's telling me I should have a double mastectomy instead. The surgeon's willing to perform this operation. Although, I can tell her preference is breast conservation surgery with radiation. 

Here's the thing, this is my third go-around with breast cancer. Granted, the other two instances (in 2012 and 2016) were pre-cancers. However, there was malignancy present. And it was in the other breast. Having a lumpectomy with radiation for the new cancer only helps this breast. The opposite one receives no benefit from the radiation. I know I am going to fret about the potential return on the other side, especially right before my annual mammogram. My PCP thinks it's time for mastectomy. She said three instances of BC in 8 years is a lot. 

I tend to think she's right. Because there's something more eating at me, too--the idea that it will come back on the untreated side. And then what? Do I have a fourth lumpectomy? Or will I then face having the double mastectomy I'm thinking of having now?

I'm also super tired of diagnostic mammograms with ultrasound once a year. To most, it probably doesn't sound like much. It certainly is tolerable physically. But emotionally, it's a drain. I've now sat in a breast clinic on three separate occasions to be told I have suspicious micro-calcifications or masses that have all turned out to be malignant. When they find something, it always requires a biopsy. I'm sick of those, too. Plus, this last time, I had to have two diagnostic mammograms (one with contrast) and two ultrasounds--all within the span of a month. It's because my breast tissue is so dense, they have a hard time seeing everything. 

I've been lucky. They've caught the three instances. But what if they miss it next time?

Then there's my fibrocystic breasts (I know, probably TMI). This makes it even harder to read the mammograms. The cysts are also incredibly painful at times. And though the surgeon said the tamoxifen I'm expected to take that will put me in early menopause will decrease the cysts, that is contrary to what the radiologists have told me. 

The bottom line is--there's no good solution. There would be if I had a crystal ball. But right now, I feel like I'm playing a game of roulette, banking on my hopes of what may or may not happen. 

Next week, I meet with a plastic surgeon to discuss breast reconstruction. I'm hoping the consult will help inform my decision. But probably not. I've already researched all of my options pretty extensively. I know there's no right answer. 

Double mastectomy has the same percentage of recurrence as lumpectomy with radiation.  But radiation has side effects. Double mastectomy is a more complicated surgery with greater risks. 

And while I'm leaning in one direction, I still have not made up my mind. 

I think of both of my sons, who have each undergone major surgeries. If they can do it, then so can I. And that may be the thought that sways me one way over another.