Is 81 too old for a lumpectomy in Stage 1 Grade 2 IDC?

Posted by sunsetsrgreat @sunsetsrgreat, Jan 16, 2023

Surgeon told me that a lumpectomy is not recommended for a small Stage 1 Grade 2 Infiltrating Ductal Carcinoma tumor due to my age 81. I started Anastrozole right away. I am otherwise healthy mentally and physically. Is this a consensus opinion?

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@sunsetsrgreat, I might suggest
a) asking the surgeon more questions about why
b) getting a second opinion.

Here's some useful information:
- Treating Breast Cancer in People Age 70 and Up https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-breast-cancer-in-people-age-70-and-up

Questions I would ask would include:
- What age-related factors does the surgeon believe put you at higher risk?
- What are the risks for you?
- Do you have other conditions that put you at higher risk for surgery?

I would want to know more.

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@colleenyoung

@sunsetsrgreat, I might suggest
a) asking the surgeon more questions about why
b) getting a second opinion.

Here's some useful information:
- Treating Breast Cancer in People Age 70 and Up https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-breast-cancer-in-people-age-70-and-up

Questions I would ask would include:
- What age-related factors does the surgeon believe put you at higher risk?
- What are the risks for you?
- Do you have other conditions that put you at higher risk for surgery?

I would want to know more.

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The surgeon is also the Exec Dir of a Breast Cancer Center which seems to give him some credibility. He does like to use percentages and told me that there is a 30% risk of cognitive decline. I haven’t been able to find an of his stats in my online searches. He did not give me any other reasons. I do not currently have any current cognitive issues. He seemed defensive when I asked questions and maybe was having a bad day (my second visit). He did say I could call him anytime.
I have Celiac disease and had a flare up of my liver ALT and AST and elevated Ferratin that have fallen back to normal and my Gastroenterologist last week attributed the rise and fall to a pharmacological reaction. The only short term med was a PPI for what was thought to be LPR.
I also have been treated for depression and anxiety in the past. Otherwise, fortunately, I have been healthy. Even my bone scan just came back as normal.
Another concern I had was that I was told there was no evidence of the cancer having spread to my lymph nodes based on what evidence I don’t know.
First appointment: “there is less than a 1% chance”
Second appointment: “there is less than a 3% chance”.
I will try and get more answers from the surgeon.
Thank you again for your response

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@colleenyoung

@sunsetsrgreat, I might suggest
a) asking the surgeon more questions about why
b) getting a second opinion.

Here's some useful information:
- Treating Breast Cancer in People Age 70 and Up https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-breast-cancer-in-people-age-70-and-up

Questions I would ask would include:
- What age-related factors does the surgeon believe put you at higher risk?
- What are the risks for you?
- Do you have other conditions that put you at higher risk for surgery?

I would want to know more.

Jump to this post

Thank you for the link. I am post BC treatment but appreciate the information. I'm 76 and received treatment last year. I am in relatively good health and appreciate the fact that my oncology team did not consider my age as a deterent.

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@sunsetsrgreat if I was at all unsure of what my doctor was recommending, I would get a second opinion. Bad day or good day is a thing, but…………….
This is your health and your life we are talking about. Maybe it will turn out that you are really in good hands and you end up feeling like this is the right decision. Maybe the second opinion has some ideas that haven’t even been discussed yet. I always say “a conversation never hurt anyone”. I hope you can find choices you are comfortable with. This is a hard thing, so just always know that whatever decision you make will the best one for you.
Did they do a sentinel node biopsy to check your lymph nodes?

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No, a sentinel node biopsy was never mentioned or offered.

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@sunsetsrgreat

No, a sentinel node biopsy was never mentioned or offered.

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You might then ask how he knows it isn’t in the lymph node. They might be able to tell from a scan or something.

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I am 81 also and had the same stage as you and grade2, I wanted it out of my body so I had the
surgery and that was not bad-- I am now going to start proton Beam radiation, but not like you
I am so afraid of the pill, I am not sure I am going to take it, it is my quality of life, and I don't want thinning
hair or bone problems, I already have that.
There are people that took the pill and after 5 years still got cancer, then there are people that are taking
it and have all these problems.

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I'm 81 now. I had a lumpectomy, radiation and chemo at 79/80. I had traces of it in my lymph node and they removed three. I seem to be fine now after a recheck with 3 MRI's and a CT scan. I am not taking hormone blockers. I've been a bit fuzzy, I assume it was the chemo, but I'm doing well and am glad I had the treatment. Oh, I did get peripheral neuropathy in my feet and can't drive. However, I seem to have inherited a lesser case of it from my Mom.

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@marcia115

I am 81 also and had the same stage as you and grade2, I wanted it out of my body so I had the
surgery and that was not bad-- I am now going to start proton Beam radiation, but not like you
I am so afraid of the pill, I am not sure I am going to take it, it is my quality of life, and I don't want thinning
hair or bone problems, I already have that.
There are people that took the pill and after 5 years still got cancer, then there are people that are taking
it and have all these problems.

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I totally agree with you about not taking the pill. My menopause was such an unhappy time , I don't want to totally deplete my body of estrogen. At 81 my quality of life is important. I don't care about having an even longer life if it is miserable.

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@marcia115

I am 81 also and had the same stage as you and grade2, I wanted it out of my body so I had the
surgery and that was not bad-- I am now going to start proton Beam radiation, but not like you
I am so afraid of the pill, I am not sure I am going to take it, it is my quality of life, and I don't want thinning
hair or bone problems, I already have that.
There are people that took the pill and after 5 years still got cancer, then there are people that are taking
it and have all these problems.

Jump to this post

Some people have no or little side effects from these drugs. Especially since most of the worst side effects seem to be the ones related to menopause, you are surely post menopausal already. If the doctor recommends it, I would try to keep an open mind. Talk to your doctor and you might find peace of mind one way or another.
How long is your course of radiation scheduled for? Did you have a lumpectomy?

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