Expert: Claes-Gustaf Nordquist, M.D. - 3/1/2009

Question
My Mother (70 years old) has recently been diagnosed with breast cancer in the milk duct and has decided to have a mastectomy on that breast because there are at least 3 other suspicious spots in that breast.  However, she also has pre-cancerous calcifications in the other breast and doesn't want to go through another surgery to remove that breast in the future.  Her breast surgeon is recommending a lumpectomy in the breast with the pre-cancerous cells to remove the calcification.  She had a similar calcification removed from that breast 4 years ago.  What are the chances that these pre-cancerous calcifications will turn into breast cancer given her history and current cancer diagnosis in the other breast?
Should she think about other drug therapies to reduce the chances of developing breast cancer in the pre-cancerous breast, should she decide to not have that breast removed also?

Answer
Ideally she should have both breasts removed. Since that unfortunately at the moment seems impossible due to her refusal of that option the next best would be removal of the breast she has accepted to have removed together with - as her surgeon suggests - a lumpectomy of the lesion in her other breast in combination with radiation therapy. If hormonal receptors are found in her pathology material after surgery hormonal treatment should also be given. That is what at present is possible unless she changes her mind.