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|Concerns about Breast Cancer Family History
Questions on genetics, family history & breast cancer.
|Asked||Publicly Submitted Question|
|9/29/2010||My mother had a "ribbon-like" form of breast cancer that went undetected for several years. It was never picked up on any of her numerous mammograms or ultrasounds. She found a lump when she was 44 (premenopausal) and after many tests, her doctors insisted the lump was benign. Over a year later, despite her doctors' advice (to ignore the lump) my mom went in for a lumpectomy. When they started the procedure, they were shocked to find massive breast cancer in the whole breast. The doctors said the other breast was "fine" but she opted for a bilateral mastectomy. Good thing, because the other breast was just as engulfed with cancer. Bilateral Invasive Lobular Carcinoma Estrogen Receptor (ER) Positive Grade 3 (Grade 3 cancers are the most different looking and considered the most aggressive.)My mother had breast discharge and/or galactorrhea. Cancer of unknown origin took my maternal grandmother's life at age 64. Though she was checked regularly, her cancer was undetected until it was too late. She lived in a very small South Carolina town and the doctors there were not the greatest.I have breast milk, breast discharge and/or galactorrhea. I am not nursing or expressing. (I haven't in 2 years.) Because of my strong family history of breast cancer, I am considering a prophylactic bilateral nipple and skin sparing mastectomy with expanders and then implants. I would love to hear your thoughts on the success of this procedure.I am concerned about how my breasts will look after the reconstruction. What type outcomes have you seen in cases like mine?What is your opinion about saline vs. gummy bear implants or other silicone implants?Can they liposuction some fat out of somewhere else and add it to the breasts and implants to make them look more natural?How does the surgeon determine where the incisions/scars will be? Are they ever along the base of the breast horizontally? Or around the nipple?Is there a way of boosting your circulatory system before surgery so that the tissue will be more receptive and viable?I am trying to decide between Johns Hopkins and George Washington Hospital. Any thoughts?Does insurance usually cover it with my type family history? (Cigna)Are there any other questions I should ask my breast surgeon and/or plastic surgeon?I really appreciate your help. This service, your advice and encouragement are so important to people like me who face all these decisions.|
|Replied||JHU's Breast Center Reply|
|9/29/2010||Your first step should be to meet with a genetics expert to evaluate your family history (including other types of cancers that are sometimes linked to breast cancer) and get counseling as well as get blood drawn for genetic testing. this will greatly help in determining your risk of getting breast cancer. if you carry a gene or if you still wish to pursue prophylactic bilateral mastectomies with reconstruction, we are happy to take care of you for that purpose. cosmetic results are very dependent on who is doing the operation.you want a breast surgical oncology and a breast reconstruction plastic surgeon. skin sparing mastectomy and nipple/areola sparing mastectomy is something we specialize in. we also offer every form of reconstruction- implants, DIEP flap, S-GAP and even TUGs. we need to see you for consultation to determine which reconstruction options are best for you. when implants are used they are placed underneath the muscle so they do have a more natural look, specially silicone models. we do use sometimes fat to fill in areas if needed too. let's first get you to us to review all of these options. when ready call sheila at 443-287-2778|
Please note: This service is not intended to provide primary medical advice concerning specific medical care or treatment. Ask an Expert is a free service operated by health care professionals at the Johns Hopkins Avon Foundation Breast Center. Due to the volume of questions and their complexity, there are times when medical oncologists, surgeons, radiation oncologists or oncology nurses are consulted for their input. These individuals volunteer their time for this service and will respond as soon as they are able. Please do not post or send the same question to us in multiple locations or categories.