Catherine,

 

It sounds like this mom has already had 2 types of breast cancer confirmed
by biopsy and a suspicion of Paget’s also.  Personally, I would not want to
take my chances of conserving my breast with lumpectomy and radiation.  It’s
not worth the risk.  With her 8 month history of nipple problems they will
probably have to remove the nipple so she wouldn’t be able to successfully
lactate on that breast in the future anyways.  This is a young mom with
young kids.  She needs to be concerned about preserving her life, not her
breast.

 

I am a 4 year survivor of DCIS and had a mastectomy and reconstruction.  I
do not regret for a minute my decision to have a mastectomy, although I have
many times regretted my decision to have reconstruction due to all the
complications.  If she is concerned about recovery time and she has a
mastectomy, I would suggest delaying reconstruction.  I needed physical
therapy and other scar releasing treatments for over 2 ½ years after my
latissimus flap reconstruction.  My best friend had abdominal flap
reconstruction and also had debilitating complications.  I know others who
had silicone implants instead who had a much easier recovery but there is a
high risk of long term complications with the implants too.  No
reconstruction is also an option.  It’s a very difficult decision to make.  

 

My tumor was presumed to be estrogen receptor positive because I was
premenopausal so I have 1 more year to go on Tamoxifen.  From what I
understand, the Tamoxifen is given to prevent contralateral breast cancer
after mastectomy.  It is also given to women at high risk to prevent breast
cancer.  It’s taken over 5 years.  While she would probably not want to wait
too long before taking it, delaying administration until weaning may be an
option if her sentinel node is negative.  Chemo is not given for DCIS.  It’s
unclear if she actually has adenocarcinoma or if it was misdiagnosed on the
first biopsy.

 

Dee Kassing is very knowledgeable about breastfeeding and breast cancer.
Maybe she has some answers for your client.  I wish her successful treatment
and a speedy recovery.

 

Linda Anderegg, RNC, IBCLC, RLC in Chicago celebrating 4 years cancer free
as of Monday :-)


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