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Breast Cancer, Double Mastectomy, Ovary…

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Large Breast Cancer Tumor, Double Mastectomy Recommended, Ovaries Removal Recommended, Hormone Therapy Recommended, Chemotherapy Recommended- HELP!

From: Lori
Subject: newly diagnosed breast cancer

Hi David-

My daughter is 30 years old and was diagnosed on Nov. 2nd.  She had an 11 cm x 8cm x 4cm tumor removed from her right breast.  She has been advised that she needs double mastectomy, ovaries removed, hormone therapy and chemo.  She is terrified and refuses to do the chemo as she thinks it will kill her.  She doesn’t want to see anyone and she is an emotional mess.  I don’t know where to turn.  

Thank you.

Hi Lori-

A diagnosis of cancer is a very emotional experience. I cried when I was diagnosed at 34. My thinking about the recommendation that your daughter undergo a

  • double mastectomy,
  • ovary removal,
  • hormone therapy
  • and chemo

depends on several things. First and foremost is the aggressiveness of the oncologist who made the recommendation. My guess is that they type, stage, etc. of your daughter’s BC diagnosis is aggressive and therefore her oncologist is treating aggressively. 

Any oncologist should be able to offer intermediate therapies based on the patient’s wants and needs. My recommendation is to get a second opinion from an oncologist who is less aggressive in his/her approach. 

In general I would try to approach your daughter in gradual steps. By this I mean that her therapies offer diminishing returns. The tumor removal offers the greatest benefit, chemotherapy a little more, ovary a bit more, etc. 

Further, if I know more about your daughter’s diagnosis, stage and symptoms I can make further recommendations. I am a long-term cancer survivor and cancer coach. I have lived cancer-free from an incurable cancer called multiple myeloma.

I have done so through the research and pursuit of

  • conventional,
  • integrative
  • and complementary therapies.

All are evidence based therapies. I even recommend those essential oils that studies have shown are cytotoxic to cancer (even breast cancer).

I would like to believe that a discussion with me would help focus your daughter on her life going forward. Of course this is up to you. 

Let me know what you think. Thanks and hang in there, 

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Breast cancer types

“There are dozens of types and subtypes of breast cancer. To determine an appropriate approach to treating breast cancer, your doctor will first evaluate the specifics of the breast tumor, including:

  • Whether the disease has spread beyond the breast
  • The type of tissue where the disease began

Most types of breast cancers are adenocarcinomas of the breast. These types of tumors are found in many other common cancers and form in glands or ducts that secrete fluid. Breast adenocarcinomas form in milk-producing glands called lobules or in milk ducts.

What are the types of breast cancer?

Invasive vs. non-invasive breast cancer types

Breast cancer occurs in two broad categories: invasive and noninvasive. Some are slow-growing, while others are more aggressive. A number of factors influence how aggressive a tumor is, including its biological makeup, size, stage, etc. But generally speaking, the most aggressive types of breast cancer tend to be inflammatory breast cancer and angiosarcoma of the breast, while ductal carcinoma in situ, lobular carcinoma in situ and phyllodes tumors tend to be more slow-growing.

Certain subtypes of breast cancer, such as triple-negative breast cancer and inflammatory breast cancer, are also more likely to recur despite aggressive treatment. Many variables may determine when and whether a specific breast cancer recurs, including the original tumor’s size, its hormone-receptor status and whether the cancer had spread to the lymph nodes. Learn more about breast cancer recurrence.

Types of invasive breast cancer

Most breast cancers are invasive, meaning the cancer has spread from the original site to other areas, like nearby breast tissue, lymph nodes or elsewhere in the body. Invasive (infiltrating) breast cancer cells break through normal breast tissue barriers and spread to other parts of the body through the bloodstream and lymph nodes. The two most common types of invasive breast cancer are invasive ductal carcinoma and invasive lobular carcinoma.

Invasive ductal carcinoma

The most common type of breast cancer—accounting for roughly 70 to 80 percent of all cases—is called invasive ductal carcinoma (IDC). IDC is a cancer that starts in a milk duct (the tubes in the breast that carry milk to the nipple) and grows into other parts of the breast. With time, it may spread further, or metastasize, to other parts of the body.

Invasive lobular carcinoma

Invasive lobular carcinoma (ILC) is the second most common type, accounting for roughly 5 to 10 percent of all breast cancers. ILC starts in lobules (where breast milk is made) and then spreads into nearby breast tissue. Like IDC, it may metastasize.  However, this cancer is harder to detect on mammograms and other exams than IDC. One in five women with ILC have both breasts affected.

Inflammatory breast cancer

Inflammatory breast cancer, which may be detected in the ducts or lobules, tends to spread faster than other types of breast cancer. This quick-growing, aggressive disease makes up about 1 to 5 percent of breast cancers in the United States, according to the NCI. It gets its name from the inflammatory signs it causes, usually redness and swelling on the surface of the breast. Because of these signs, it’s often misdiagnosed as a breast infection. In fact, for one out of three patients with this type of cancer, it’s not diagnosed until more advanced stages of the disease when it’s already metastasized to other areas of the body, according to the American Cancer Society (ACS). For these reasons, inflammatory breast cancer has a lower survival rate.

Paget’s disease of the breast

Also known as Paget’s disease of the nipple, Paget’s disease of the breast is a much less common type of breast cancer. It primarily affects about 1 to 4 percent of patients also diagnosed with another breast cancer, according to the NCI. It develops in the skin of the nipple and the areola, creating unique tumor cells called Paget cells.

Angiosarcoma of the breast

Angiosarcoma is breast cancer that forms in the lining of lymph or blood vessels. It’s rare and accounts for only 1 to 2 percent of all sarcomas (including those found anywhere else in the body), according to the NCI. Though anyone may developangiosarcoma, it’s most common in people older than 70. It’s frequently caused by complications from radiation therapy to the breast, but it may not occur until eight to 10 years later. Angiosarcoma is a type of cancer that grows quickly and often isn’t diagnosed until it’s already spread to other areas of the body.

Phyllodes tumors

Phyllodes tumors are rare and are found in the connective tissues of the breast. This type of tumor mostly affects women in their 40s, though it may develop in patients of all ages. People who have an inherited genetic condition called Li-Fraumeni syndrome are at an increased risk for this type of tumor. About 25 percent of phyllodes tumors are cancerous, according to the ACS.

Other, even more rare, types of invasive breast cancer include adenoid cystic carcinoma, low-grade adenosquamous carcinoma, medullary carcinoma, mucinous carcinoma, papillary carcinoma and tubular carcinoma.

Noninvasive (in-situ) types of breast cancer

In situ breast cancer cells are non-invasive and remain in a particular location of the breast, without spreading to surrounding tissue, lobules or ducts.

Breast cancer that does not spread beyond the milk ducts or lobules is known as in situ. The two types of in situ cancers are ductal carcinoma and lobular carcinoma.

Ductal carcinoma in situ (DCIS)

About 20 percent of newly diagnosed breast cancers are classified as DCIS, according to the ACS. DCIS starts out as a mass that grows in a milk duct, which carries milk from the lobules, or glands, to the nipple. A DCIS hasn’t spread to other parts of the body.  Over time, chances increase for the mass to break through the ductal walls into the surrounding tissue and fat of the breast. With advances in diagnostics and treatments, however, most patients treated for DCIS, also called stage 0 breast cancer, have positive outcomes.

Lobular carcinoma in situ (LCIS)

An LCIS is technically not considered cancer, but rather a change in the breast. In the breast are tens of thousands of tiny clusters of lobules to produce breast milk. Cells that resemble cancer cells may grow inside these lobules. LCIS tends to remain there and not spread. However, having LCIS puts you at an increased risk for invasive breast cancer, so your care team may want to monitor you in order to promptly address any changes.

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