Breast Cancer Update 2/21 - Treatment Plan Discussion

Today is the 7th day after knowing I have breast cancer and Jia and I went to meet with my disciplinary team to discuss the breast cancer treatment plan. 

The treatment team includes oncologist, surgeon, radiologist, pathologist and other experts. We talked to surgeon first, then oncologist, then radiologist, and then the coordinator. The two treatment plans were presented and later on, through research and going over and over in my head, I have to write down the pros and cons to consider the following: 

Treatment plan option 1: Mastectomy

Pros -
- It has much less reoccurrence rate.
Cons-
- Mastectomy takes longer and is more extensive than lumpectomy, with more post-surgery side effects and a longer recuperation time.
- Mastectomy means a permanent loss of your breast.
- additional surgeries to reconstruct your breast after mastectomy.

Treatment plan option 2: Lumpectomy + Radiation

Pros -
- it can preserve much of the appearance and sensation of your breast. 
- It is a less invasive surgery, so your recovery time is shorter and easier than with mastectomy.
Cons -
- It is required to go with radiations
- Somewhat higher risk of developing a local recurrence of the cancer after lumpectomy than after mastectomy. However, local recurrence can be treated successfully with mastectomy.
- You may need to have one or more additional surgeries after your initial lumpectomy. During lumpectomy, the surgeon removes the cancer tumor and some of the normal tissue around it (called the margins). A pathologist looks to see if cancer cells are in the margins. If there are cancer cells, more tissue needs to be removed until the margins are free of cancer. Ideally, this is all done during the lumpectomy, but analyzing the margins can take about a week. So sometimes after the pathology report is done, the margins are found to contain cancer cells and more surgery (called a re-excision) is needed.

It was a bit overwhelming with a lot of info as I didn’t expect mastectomy as the recommended treatment - or mentally prepared for it. I am still struggling reaching a decision - it is just not easy as later I find it harder and harder to just make decisions based on the only known facts for now. There are so many conditions and real facts we don't know about each individual cancer case.  

Writing down the pros and cons for each treatment plan definitely help. Another thing that helps is to talk to different doctors to get second opinions. Different doctors will have different opinions and how they talk about the case. At first I feel it might be too much information but later on, the more I discussed with more doctors, the more I gain knowledge about breast cancer and the more I can sense deep down in the heart what I prefer and believe.