Expert: Claes-Gustaf Nordquist, M.D. - 5/1/2008

Question
I am 33 & have been diagnosed with stage 1 ductal carcinoma & also had another lesion that is DCIS in the same breast.  After 2 tries at a lumpectomy, we have clear margins and negative lymph nodes.  My drs are encouraging me to have a masectomy because my cancers were multi-focal & I am young.  Also, the invasive one was only found on MRI.  I would like to delay the masectomy until September (5 months) because I have 4 kids that I am not sure I will keep up with them if they are home on summer break during my recovery, so my question is how long can I delay the masectomy before I will need to do something (i.e. radiation - obviously I don't want to do both & will reprioritize if I have to)?

Answer
This is a difficult question to answer. Yes a mastectomy would almost completely eliminate the risk of new  breast cancers - on THAT side! To almost eliminate the risks on BOTH sides you would need to do mastectomies on BOTH sides! The choice must be yours. However my advice would be to accept radiation therapy on the operated side and then have regular MRI breast scan check ups of both breasts with needle biopsies of anything unclear that shows up. If your cancers were having hormone receptors maybe also (anti) hormonal treatment should be considered.
This way you would be able to keep your breast and yet you would be (almost) as well protected from a new cancer as with a mastectomy of both sides scheme. Good luck whatever you decide!
However if you want to follow the mastectomy scheme it should be done as soon as possible.