I wasn't given the option of doing chemo first. So I had to make the decision too quickly. There were only 19 days between dx and my BMX and reconstruction. My PS and surgeon kept telling me reconstruction would make me whole again. Well, reconstruction for me was very painful and is still giving me problwms, 18 months later. I did the BMx so I wouldn't have to worry about reoccurence and now they are telling me there is still a chance of reoccurence, but I won't have the ability to have mammograms to check for it. I thought I would at least get ultrasounds or MRI's as followup Csre but the Cleveland Clinic doesn't use them for followup care.

Even though I no longer have breasts, I can still get cancer again. Tumors can still grow in the chest wall, lungs or bones. Since my ONC doesn't do follow up scans, I will never know if I am getting a reoccurence. My surgeon said the risk factor is the same with either one..

Yes

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Back to post-treatment checking: true, post MX status indicates no mammography or mri (except very occasionally specific to observing the integrity of the implant in that type of recon). An advantage of implant recon is that, with the implant under the pectoral, all the muscle, any remaining breast tissue (there’s always the thinnest possible amount) and skin are pushed out on top of the implant. This would make observation of a recurrence in the muscle, tissue or subcutaneous skin very plain to even the patient. That’s why it’s important to ask for a sonogram (ultrasound) if you see or feel anything out of the ordinary-and, yes, US is excellent of observing these types of things. I’ve run to my surgeon theee times in as many years for such, and each time a reason outside of recurrence has been clearly appreciated.

Here’s a cold hard fact about distant mets: if cells are present elsewhere it matters not their volume. In other words, tx for distance mets would be approached the same whether a few cells or many. Let’s say we get a bone scan yearly (I know it would ease my mind to know I could avail myself of this type of overaite, no matter the yearly anxiety it would cause). If there were distant cells not-yet appreciable by scan, but definitely there, one year yet enough to next to see on scan, they would be treated the same, and likely beat back to NED the same.

My point in this exhausting reply is that to my mind an aggressive (specific to the type of cancer) front line approach, then reliance on yourself as a credible tool in your own follow up. Every tool for follow up has its limitations, including ourselves. It’s more important to use the most reasonable ones, and we women absolutely-definitely fall in that category.

((Hug))

Some types of cancers (and some types of breast cancers) produce markers that can be evaluated with a blood draw, and some do not. There is no point in drawing for a marker of yours is the type that does not. I seriously doubt there are oncos out there that are not drawing on a patient because they don’t feel like including it in their protocol for follow up.

About BMX (or MX or LX) and there differentiated ability to prevent recurrence: each depending on the specific cancer, can decrease chance of recurrence to a higher percentage the more aggressive the approach. Someone with a non invasive cancer could be cleared beautifully with LX, and have no risk reduction return whatsoever on her choice to amputate the whole breast, but definitely increase her chance of complications.
While I suspect in this age of ‘breast conservation’ Surgeons might be overemphasizing LX as THE emotional answer to breast amputation, I also think there are plenty of us where BMX adds to our chance of success (remember: the medical guideline for ‘success’ is 5 years, Ladies...up to that point their may be little difference between Lx and BMX, and a doc can put that patient in the success column. But our terms of success are greater reaching than 5 years, right?? For those with particularly aggressive types of BC, the risk of recurrence between LX and BMX diverge after five years. Here’s a complex but thorough analysis. It may be challenging but worth it to see where you as an individual fit in: http://www.cancernetwork.com/oncology-journal/l...
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