Ray and I went to my consultations today. Mercy is a very nice place and everyone was very nice to us. We met first with Dr. Friedman in the Hoffenberger Breast Center. He is the director of the breast center and came extremely highly recommended. He first spoke to us about BRCA and the implied risks of the mutation. He then talked about different treatments. He strongly feels that in my case "wait and see" in not the best choice. He said something though that really hit me. Having an oophorectomy only decreases my breast cancer risk by 40-50%, which means I still have about a 50% chance of developing it. He completely solidified my decision to have a mastectomy and an oophorectomy.
We saw Dr. Ryu next who performed a routine exam on my ovaries and uterus. We then sat down and again talked about my risks with the mutation and what an oophorectomy would give me. Basically it would take my risk of ovarian cancer down to the single digits just like anyone else in society. We talked about a totally hysterectomy, but we decided against it. While I will still have periods if I choose to, there are additional risks to removing the uterus. As well as being more invasive (something I tend to avoid like the plague), BRCA2 (and 1 for that matter) are not related to uterine cancer, so it doesn't buy me any benefit for its risks. He will though be taking the corners off the uterus where the fallopian tubes enter.
After Dr Ryu, we saw Dr. Chang. He will perform the DEIP flap surgery and reconstruction. Basically, they will take skin from my abdomen (there is plenty thankfully) and move it to my breast pockets to form breasts. They will also have to spin an artery from my sides up to provide blood to the tissue to keep it alive. There is a chance the tissue could die in which case the DEIP flap would need to be removed and I would have to have more surgery to reconstruct. While this is my biggest fear, it is minimal that it will occur.
Overall, we were very pleased with what everyone had to say. All three surgeons felt that if I was ready and don't want to have anymore children, the sooner the better in my case. I appreciated their support and confirmations on my own feelings. I should find out this week when the surgery will take place. I asked for anytime after May, and I am hoping for later in June to avoid missing any work.
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