Newly diagnosed Tram flap bi or unilaterial??

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UniqueMom
UniqueMom Member Posts: 8
edited March 2014 in Breast Cancer #1
I am 40 and have decided to have a mastectomy done at the same time as the Tram flap. I am agonizing on whether or not to have a uni- or bilateral mastectomy.

I am also going to court on Tuesday to start divorcing my husband and insurance will be expensive. I will only be on his policy for 31 days after the divorce. I can stay on his insurance for 36 months, but it will be around $400 per month. I also was laid off from my job due to a "decline in business" the day after told the hr manager I would be taking time off for surgery.

I do not know for sure if breast cancer is in my family. A great aunt died of cancer, but no one knows what kind. My father died of pancreatic cancer and his father of colon. I wish there was more research out there on if different types of cancer are related.

I have mulitfocal minimally invasive ductal carcinoma (largest 0.5cm), grade II,with 7 points, arising in a background of high grade ductal carcinoma in situ with microcalcifications.

Surgical margins are positive for invasive and dcis.

I do not know if it has spread to the lymph nodes.

How does one make the decision to do one side or both?

Comments

  • greyhoundluvr
    greyhoundluvr Member Posts: 402
    #2
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    UniqueMom
    While I am glad that you found this site, I am sorry that you ever had to look for it. Without doubt, you are facing so much in your personal life that it must be overwhelming. The decisions about what type of surgery to have are certainly one of the most difficult we have to make and I have not seen that there are really clear cut answers in many cases. I was eligible for a lumpectomy and for many women, that is the right choice. But I knew in my heart that I would not be comfortable with it so I opted for a mastectomy. I then made the decision to have a prophylactic mastectomy on the opposite side. From all I have read and all the doctors have told me, the recurrence rate is essentially unchanged as a result of choosing the prophylactic mastectomy. But what I was personally aiming for was reducing the risks of another cancer occurring in the opposite side. I also have a family history of cancer (the only family member was my mother who had BC) so I know that part of my decision making was that she had an initial mastectomy and then developed a second primary tumor in the opposite breast. That was a long time ago and we have come a long way since then but it was the best decision I could make for myself.

    I would recommend getting all of the information that you can before making the decision. I went to the oncologist before the surgeon. I got all of my questions answered about the type of cancer I have, the surgical and treatment options, the chances of recurrence and what I would gain or not gain from the more aggressive surgery. You have to keep in mind that this is usually preliminary in nature as pathology can change from the biopsy to what is actually found after surgery but it gave me a starting point. I then saw the surgeon and the plastic surgeon and they both concurred with my decisions.

    I truly wish you the best and please know that there are many experienced survivors on this board who will be here to help you through this.

    Chris
  • New Flower
    New Flower Member Posts: 4,294
    #3
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    greyhoundluvr said:

    UniqueMom
    While I am glad that you found this site, I am sorry that you ever had to look for it. Without doubt, you are facing so much in your personal life that it must be overwhelming. The decisions about what type of surgery to have are certainly one of the most difficult we have to make and I have not seen that there are really clear cut answers in many cases. I was eligible for a lumpectomy and for many women, that is the right choice. But I knew in my heart that I would not be comfortable with it so I opted for a mastectomy. I then made the decision to have a prophylactic mastectomy on the opposite side. From all I have read and all the doctors have told me, the recurrence rate is essentially unchanged as a result of choosing the prophylactic mastectomy. But what I was personally aiming for was reducing the risks of another cancer occurring in the opposite side. I also have a family history of cancer (the only family member was my mother who had BC) so I know that part of my decision making was that she had an initial mastectomy and then developed a second primary tumor in the opposite breast. That was a long time ago and we have come a long way since then but it was the best decision I could make for myself.

    I would recommend getting all of the information that you can before making the decision. I went to the oncologist before the surgeon. I got all of my questions answered about the type of cancer I have, the surgical and treatment options, the chances of recurrence and what I would gain or not gain from the more aggressive surgery. You have to keep in mind that this is usually preliminary in nature as pathology can change from the biopsy to what is actually found after surgery but it gave me a starting point. I then saw the surgeon and the plastic surgeon and they both concurred with my decisions.

    I truly wish you the best and please know that there are many experienced survivors on this board who will be here to help you through this.

    Chris

    Welcome to the site
    Sorry for your situation. So many thing have happened at the same time. Difficult decision to make. Do you have abnormalities in both breasts or just one? Will your current insurance pay for prophylactic mastectomy? Chris gave you a good advise on decision making. You need to have genetic testing and counseling for sure. What is about your mother? Is she alive and well? Breast and gynecological cancer in the family is the first indication for genetic predisposition.

    Can you ask your lawyer to postponed proceedings due to your medical conditions? Please try, you do not need extra stress.
    Were you the only one who was laid off? Does your company have more than 20 employes? You maybe have a legal case.
    Paying $400 per months is reasonable for cancer treatment. It is a very expensive disease, so keep your insurance if you can.
    Please keep posting and ask as many question as you need.

    good luck
    New Flower
  • Angie2U
    Angie2U Member Posts: 2,991
    #4
    Options
    I am so sorry for all that
    I am so sorry for all that you are going thru. Sending you big hugs and prayers!
  • UniqueMom
    UniqueMom Member Posts: 8
    #5
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    New Flower said:

    Welcome to the site
    Sorry for your situation. So many thing have happened at the same time. Difficult decision to make. Do you have abnormalities in both breasts or just one? Will your current insurance pay for prophylactic mastectomy? Chris gave you a good advise on decision making. You need to have genetic testing and counseling for sure. What is about your mother? Is she alive and well? Breast and gynecological cancer in the family is the first indication for genetic predisposition.

    Can you ask your lawyer to postponed proceedings due to your medical conditions? Please try, you do not need extra stress.
    Were you the only one who was laid off? Does your company have more than 20 employes? You maybe have a legal case.
    Paying $400 per months is reasonable for cancer treatment. It is a very expensive disease, so keep your insurance if you can.
    Please keep posting and ask as many question as you need.

    good luck
    New Flower

    more info
    New Flower,

    I should write a book. So many things have happened in the last 8 months. I did not mention them all. Cancer and insurance are my concerns that I am focusing on now.

    I believe insurance will pay for both sides. I called once, but hadn't decided on what type of surgery. I will call again to make sure it covers the tram flap on both sides. I have dense tissue on the other side, but no abnormalities. My mom has no history of cancer, but insurance will pay to test me since I am diagnosed. Results could take 2 weeks and time is against me.

    I am working on that with my lawyer, she has not been helpful and told me early this week that with her caseload she did not have the time for my case and wants to know if I would withdraw her from the case. She has not returned my calls. If I withdraw her it could make the case go on longer, but yet I do not want the hassle of finding a new lawyer. I guess I will see if she shows up in court on Tue.

    I'm looking on the legalities of my lay off. It was due to a decline in business and one other person was laid off the same week as me. They also laid off someone in another location. but I feel it is worth looking into.

    My mom can help me with expenses. I am very fortunate to have her to lean on and have a great support group.

    Unique Mom
  • UniqueMom
    UniqueMom Member Posts: 8
    #6
    Options
    greyhoundluvr said:

    UniqueMom
    While I am glad that you found this site, I am sorry that you ever had to look for it. Without doubt, you are facing so much in your personal life that it must be overwhelming. The decisions about what type of surgery to have are certainly one of the most difficult we have to make and I have not seen that there are really clear cut answers in many cases. I was eligible for a lumpectomy and for many women, that is the right choice. But I knew in my heart that I would not be comfortable with it so I opted for a mastectomy. I then made the decision to have a prophylactic mastectomy on the opposite side. From all I have read and all the doctors have told me, the recurrence rate is essentially unchanged as a result of choosing the prophylactic mastectomy. But what I was personally aiming for was reducing the risks of another cancer occurring in the opposite side. I also have a family history of cancer (the only family member was my mother who had BC) so I know that part of my decision making was that she had an initial mastectomy and then developed a second primary tumor in the opposite breast. That was a long time ago and we have come a long way since then but it was the best decision I could make for myself.

    I would recommend getting all of the information that you can before making the decision. I went to the oncologist before the surgeon. I got all of my questions answered about the type of cancer I have, the surgical and treatment options, the chances of recurrence and what I would gain or not gain from the more aggressive surgery. You have to keep in mind that this is usually preliminary in nature as pathology can change from the biopsy to what is actually found after surgery but it gave me a starting point. I then saw the surgeon and the plastic surgeon and they both concurred with my decisions.

    I truly wish you the best and please know that there are many experienced survivors on this board who will be here to help you through this.

    Chris

    decisions, decisions
    Chris,


    Thanks an oncologist could give me more insight. General surgeon said to do it after the surgery, but several people have said to do it before, because this doctor is the one you will see the most.
    Unique Mom
  • UniqueMom
    UniqueMom Member Posts: 8
    #7
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    Angie2U said:

    I am so sorry for all that
    I am so sorry for all that you are going thru. Sending you big hugs and prayers!

    Thanks!
    :-)

    Unique Mom
  • New Flower
    New Flower Member Posts: 4,294
    #8
    Options
    UniqueMom said:

    decisions, decisions
    Chris,


    Thanks an oncologist could give me more insight. General surgeon said to do it after the surgery, but several people have said to do it before, because this doctor is the one you will see the most.
    Unique Mom

    Cancer treatment could cost up to $300,000.00
    I am glad that your Mom can help you with expenses. Mastectomy, reconstruction, Chemo and radiation all together will cost between 200, 000.00 and 300,000.00. Yes you need to focus on your health that is why I think delay divorce maybe helpful. You need a good lawyer.

    I had left side mastectomy.
    Good luck and keep us posted
  • Cindy Ann
    Cindy Ann Member Posts: 101
    #9
    Options
    Colon Cancer
    My Mom was diagnosed at 70 with stage 4 breast cancer. It was 10 years ago. She had a mastectomy, chemo, and radiation. She is still alive at 80. Miracle.. She was the 1st in her family(sibs 10) to have BC. She had genetic testing for colon cancer gene.Her onco wanted it asap. They are closely related to each other. My husbands gram died at 53 from BC. His cousin just died at 44 from colon ca. My Mom tested negative for the gene for colon ca. Relief!!Don't know about Dad? It can come from your Mom or Dad. Men can carry and pass the gene. Breast ca increases your risk of developing colon ca.Please talk to your Onco about genetic testing for colon ca gene.It is a choice you have to make on your own. Knowledge is power. Please see your onco for a eval of your personal situation and stats pertaining to you. I hope I did not upset you!! But thought since you have Colon ca on your Dad's side you should know they are related to breast ca.
  • DebbyM
    DebbyM Member Posts: 3,289 Member
    #10
    Options
    UniqueMom said:

    decisions, decisions
    Chris,


    Thanks an oncologist could give me more insight. General surgeon said to do it after the surgery, but several people have said to do it before, because this doctor is the one you will see the most.
    Unique Mom

    Just want to welcome you to
    Just want to welcome you to the site and to wish you good luck! You have come to the right place for support and help!

    Hugs, Debby

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