I had a new diagnosis of ILC on 12/27/23 from needle core biopsy, EP+/HER2-, stage 1a, 1.7 cm tumor, no apparent imaging evidence of node involvement. MRI done 1/9, showed a few irregular nodes, followed up with axillary U/S on 1/11, apparently thought to be "reactive" from biopsy.

Other MRI results for R. breast did not reveal other areas of suspicion, L. breast with multiple oval masses that are documented as "probably benign", when asking surgeon whether to include the possibility of trouble in that breast into my surgical considerations, I was told they "are" benign, don't worry. MRI picks up all sorts of stuff." Somehow, that didn't console me, but I am trying to put faith into the person planning to cut into my breast and does this for a living.

I am awaiting genetic panel results-opted for just the basic breast genes-due to result this week, hopefully. Not sure if anything will sway my plan.

I am an active person, and feel like I need to try the least invasive option first. With that, though, comes a giant dose of anxiety and fear that removal of the tumor , itself, will free some captive cells to vacation in my bloodstream and visit remote destinations.

My gut is telling me to proceed with lumpectomy as plan "A", then have a plan "B" to proceed to bilateral mastectomy with immediate reconstruction if there is any node involvement, need for re-excision of margins, or any indication on follow-up imaging of trouble in either breast.

I am really stuck on the radiation piece of things and will be asking the plastic surgeon (consult on 1/22) how having radiation from lumpectomy would or wouldn't impact potential reconstruction options should there be a need or decision later on to proceed with mastectomy, find out what sort of flap options are available for me and have somewhat of a plan "B" sorted out before committing to lumpectomy. I don't want implants due to more frequent need for radiation (from what I am able to discern in literature...correct me if wrong.

I welcome any pearls of wisdom you can share.

The planning and being at peace with it are more difficult than I envisioned.

Thanks in advance!