Wednesday, August 18, 2010

The Case for Mopsy

As you know, I am thinking about what to do about Mopsy when Flopsy is retired.  The following article, from WebMD, was very interesting reading for me.


New Debate on Breast Removal to Prevent Cancer

Study Suggests Counseling May Change Patients' Opinions About Prophylactic Mastectomy
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD

March 26, 2010 -- Counseling on actual recurrence risk can lead to a reduction in the number of women who choose to have both breasts removed when only one breast is affected by cancer, new research shows.
Many breast cancer survivors believe that their risk of developing breast cancer in their other breast is about five to 10 times higher than it actually is. As a result, more and more women are opting for a prophylactic mastectomy (surgical removal) of the unaffected breast, even though there is no evidence that this will affect overall chances of survival among women at low or moderate risk for breast cancer recurrence.
Ajay Sahu, MD, a breast surgeon at the Frenchay Hospital in Bristol, England, noticed this trend in his practice and sought to determine why 27 women aged 31 to 65 who underwent a mastectomy on the breast with cancer were also requesting the surgical removal of the other breast, and whether or not a "cooling off period" and counseling would help them understand their actual risk of recurrence and lead them to change their minds.
It did.
After one year, 23 of these women chose not to have a prophylactic mastectomy, Sahu reported Thursday at The European Breast Cancer Conference in Barcelona, Spain. Women all received chemotherapy and/or radiation after their mastectomy to kill any errant breast cancer cells, and they were counseled and followed for one year. After one year, women who still wanted to have their other breast removed were offered the surgery.
The women, all of whom were considered at low or moderate risk for breast cancer recurrence, were asked why they wanted to have both breasts removed at the time of their initial diagnosis.
  • Twelve women in the study said they wanted the other breast removed because of family history of breast cancer.
  • Four women said that a family member or friend had a bad outcome with a single-breast mastectomy.
  • One woman wanted to avoid radiation.
  • Three women wanted a prophylactic mastectomy due to their young age, even though they were considered low-risk for recurrence. 
Seven women had lobular breast cancer, a cancer that begins in the milk-making glands (lobules) of the breast, and can be difficult to diagnose by mammogram.
After counseling and the cooling-off period, "[women] had an understanding of actual risk of bilateral breast cancer, an understanding that the risk can be reduced by treatment and surveillance by annual mammography, and that no survival benefit is conferred by the operation," Sahu says.
"I felt that the time of diagnosis was a moment of increased stress and not the right time to make such a decision," he says in a news release. "The 'cooling off period' actually helped to reduce anxiety (although we did not explore this specifically) and helped the women to be comfortable with the decision they made in the end," he says.
He plans to continue this study on more women to see if the results hold.

I keep going around and around about this.  I don't know how much fear is influencing my decision making process, as well as being a current chemo patient.  Hello???  It's got to be a huge factor psychologically.  When you are in the thick of it, the thought of ever having to go through it again is unimaginable and downright repulsive.
I plan on discussing this with the plastic surgeon Friday morning, not that she will help me make a decision regarding my cancer.  Rather, if I do have the DIEP done, which is the tummy tuck procedure, doesn't it make more sense to do both at the same time to achieve the best uniform result?
I realize that everything I may think about this right now will probably be thrown out like a baby with the bath water after meeting with her.  I do think it is telling that after a "cooling-off period" many of the women decided against the bilateral mastectomy.
I plan on posting about this topic on my favorite breast cancer message board (Network of Strength) and see what the response is.  I can't tell you what a resource this has been for me, talking to my cancer peeps and cancer sorority sisters.
To update you on my arm, I've been taking ibuprofen every six hours and that has helped.  I will continue with that over the next couple of days, until chemo on Friday, when I'll have my favorite nurses take a look.  The numbness and swelling is about the same, but it's not worse!
While I was sitting here writing my blog tonight, Batman came through the door with a goodie bag for me!!!!!!!!!!!  Thank you Mama Dez, you are the best!!!!!!  I loved it.  What a fabulous surprise!!!!!  How thoughtful, I absolutely loved it!!!!!!!!
Presents are good.  Very good.  Me likey.
I will be putting on my apron tomorrow afternoon, putting my wine key and crumber in my pocket, brushing on eyebrows cause mine are almost gone, and giving the red wig a little extra tease.
I absolutely cannot wait to go back to work tomorrow night.  Wish me luck, and wish my co-workers luck too, cause I'll be slobbering and hanging all over them!!!!!!
I'm a little worried about getting really hot with my wig on, but will jump in the walk-in if I need to cool down.
Here I go, will report tomorrow night!!!
Woo hoo!!!!!!!!!!!!!!!!!!!


Anonymous said...

What Cancer Cannot Do

It cannot invade the soul, suppress memories,
kill friendship, destroy peace, conquer the spirit,
shatter hope, cripple love, corrode faith, steal eternal life, silence courage.

writergirldreams said...

Anonymous, whoever you are, thank you for reminding me of this, thank you. That was good, real good, real real good. Especially the silence courage part. That made me proud of me. I am yappin my trap off, not going quietly in to this thing, making sure I am counted. Thank you. hugs.

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