Thursday, July 8, 2010

Plastic surgeon appointment

Today I had my follow up appointment and every thing looked good. Every thing has healed nicely and I haven't had any chest pain. Dr. D told me that it can take a couple of months for the radiated side to drop into the space she made to even them out, so it could still happen. She said I should massage them to keep them soft and I go back in three months.

I talked to her about the no scanning thing and she explained that mammography is out of the question, because I have implants and breast MRI's are out, because I don't have breast tissue, but thinks I should be having some kind of annual scan or x-ray to check for cancer. She gave me the name and number of another oncologist and suggests that maybe I should get a second opinion.

I talked with some of the YSC girls and it seems like it is standard protocol to not scan, but some oncologists do. I personally would feel better getting them, but I don't know that I want to switch oncologists to get my way.

Here are some facts I found:

***Many radiologists feel breast cancer screening imaging after simple (total), modified radical, or radical mastectomy is unnecessary as any cancer recurrences are usually able to be felt.

***When breast reconstruction has occurred, routine mammography after mastectomy can result in false positive abnormalities.

Mammography After Simple (Total), Modified Radical, or Radical Mastectomy

While some mammography centers/radiologists recommend routine imaging of the affected breast(s) after simple (total), modified radical, or radical mastectomy with or without breast reconstruction, many radiologists feel that there is little statistical evidence that imaging is effective after these surgeries. Most recurrences of cancer in the breast area (or reconstructed breast) are palpable (able to be felt) and do not require imaging for detection. If the patient has had subcutaneous mastectomy (discussed above), annual mammography is often recommended.

Some studies, including two small studies by the University of Michigan (released October 2000), show that careful screening may detect breast cancer recurrences early in women who have had TRAM flap reconstruction. However, routine mammography after mastectomy can lead to false positive abnormalities seen in the reconstructed breast that are indeterminate and lead to unnecessary biopsy (the biopsy determines that the abnormality is not cancerous).

While researchers will continue to investigate the effect of screening mammography on women who have had reconstruction, most physicians do not recommend screening mammography on women who have undergone mastectomies. Many abnormalities found in the reconstructed breast are palpable and are discovered by a physical breast exam. Physicians are not certain whether the early discovery of a recurrence of breast cancer will have any significant impact on the overall survival of the patients. However, once an abnormality is found by physical exam, physician will then order diagnostic mammography and/or other breast imaging tests. Biopsy may be performed to determine whether the abnormality is cancerous.

I don't know what to do!

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