Expert: Claes-Gustaf Nordquist, M.D. - 3/12/2009

Question
I ended up having double mastectomy(Seperate operations). The left breast had 3 lumps; the largest being 2.3 cm. I had LCIS;DCIS;and invasive DC in all areas. They did a sentinel node biopsy and nothing showed until after surgery that I had microscopic cells in 1 of 3 lymph nodes. I am 46. My oncologist said that it is a very slow growing cancer and I was in the lower 3rd on the oncoytpe dx test but she still wants me to do 8 treatments of cmf every 3 wks; will also put me on tamoxifen and 30 treatments of radiation because of risk to return to the chest wall and also the lymph nodes. I chose to have implant surgery. I am a ballroom dancer and hope not to affect other areas of my body for tissue. My PS is concerned on that and wants to keep the extenders in until all treatment is complete. He has warned me about the possibility of taking other tissue for worst case scenario. My oncologist would like to have all reconstruction done including implants. What is the best procedure these days? I am also both estrogen and progesterone positive and HER is normal; no brac gene and I did have extensive xrays at birth. Thank you very much for your time.

Answer
I'm not a surgeon (I'm a medical oncologist & a radiation therapist) so I'll leave all surgical technical questions aside. You have to ask your surgeons about them.  However I do support your oncologist on all these issues! Chemotherapy, radiation therapy and hormonal therapy! Even if slowly growing cancer is still a potentially deadly disease and must be treated accordingly - especially as it HAD spread in your case. You also had multiple tumors. Good luck!