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Direct to Implant and Reconstruction Same Day
My daughter is 43 years old and has the BRCA2 gene. She was just diagnosed with Stage III Invasive Ductal Carcinoma(Breast Cancer). She is a professor at Temple University and lives by herself in Philadelphia. We(her parents), live in Ohio. She does not want to do radiation or chemotherapy. Neither she nor us are in a good financial situation. We are right at that lower middle class line. She has been checking around and is set on a surgeon and plastic surgeon in Beverly Hills, California. We would have to fly out, have someone take care of our two dogs, get a hotel, Uber back and forth to the hospital and of course, eat. We would have to take a loan out for $60,000. We are in our 60’s and I am disabled. The financial burden alone is immense. The place in Beverly Hills is called Cassileth Plastic Surgery. The surgeons name is Dr. Mensick. My question is; does the Mayo Clinic do direct to implant surgery all in one day, and is it safe? Any suggestions for a worried parent who doesn’t know what to do and if it’s the right and safe thing to let her do. She has big breasts with dense tissue and with the BRACA2 gene, both of which make the surgery and follow-up more concerning.
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Was radiation or chemo recommended? It may not be known if one of these are necessary until after surgery.
Your daughter and your family have been in my prayers. Has she received treatment? I am hoping your family has had a positive outcome.
I was told the same as you that the radiation will hardened the best implant. I also had Immediate reconstruction. Diagnosed with stage 2 invasive ductal carcinoma and in 1 lymph with cancer. All good margins. Radiation was suggested to me because of ONE lymph positive, the other 2 were clear. I feel like you, wonder if I made the right decision for direct to implant. At the time I didn't know that 1 lymph had cancer. More decisions to make. Ie radiation. I feel my Dr is being super aggressive. He wants 32 treatments, for my left breast, underarm and the center of my chest. Not sure if I will do it yet. Being terrified is an understatement.
My Dr. only checked 1 sentinal node it was positive for cells, no tumor. I’m feeling uneasy since no others were checked. I was told there would be 2-3 removed and checked. I’m scheduled to start radiation on Monday the 24th. Left breast and axilary nodes for 16 treatments. My Mammaprint was ultra low so no chemo.
I feel as you and would made a different choice.
Prayers for you I know I’m still terrified as well!
No chemo for me as well. Mine score was a 6. I’m leading towards a hard no on the radiation. (Mine were cells as well no tumor). I wish they checked more lymph’s on you. That may have helped in making your decision. Have you read all your reports?
I found reading the TAILOR RT clinical trial helpful.
One arm of trial is AI only ( anti hormone treatment) - second arm of study was AI plus standard radiation. It’s phase 3 trial so they pretty much expect AI only to be an effective treatment because they cannot offer an “inferior” treatment in a clinical trial.
I applied for the trial and was eligible from a BC perspective but had had a solid tumor stage 1 other ( resolved) cancer within 5 years prior . The trial required a 5 year lapse .
Check it out and discuss with radiation oncologist
I am going to get a second opinion on the sentinal lymph node. I am willing to go back to surgery to get 2-3 more checked. Piece of mind! I read that some people have only 1 sentinel node?? My nuclear tracking didn’t work and that’s why I believe only one node was removed. I’m scheduled for radiation to start tomorrow. I’m really on the fence about it. I’m very healthy otherwise and don’t want to wreck my body with radiation. I’m on hormone inhibitor. I hate that because up until now at 69 I’ve avoided pharmaceutical meds. My radiation oncologist is a breast cancer survivor. Should this make me feel better about the radiation?
I was healthy as well. I’m 62.
I don’t know if I would feel any different about the radiation if my Dr is a survivor. I think she would have to be exactly like me. Type, size, family history, stage, lymph involvement.
As mentioned my 1 lymph had cancer cells the others 2 did not. I’m still torn.
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1 ReactionI’m not five years. I’m just had surgery June 2, 2023.
I am reviewing the trial now to see what it is all about. Thank you for posting.
My mastectomy was Feb. 22. It was a 3 year prior ( not breast cancer) cancer that excluded me from the trial . The trial parameters were NO other cancers within 5 years. I’m 4+ years now but 3 then. It would have been an intervening variable. But the fact that I qualified from a BC perspective gave me good information. I was 2 lymph node positive but the 5 nodes next in line were negative.
I opted out of radiation. Hope I made the right decision. So far so good.
Very hard decisions we are faced with. Very personal choices. No guarantees! It would be nice though.
Best to you on the path.
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