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Ok this is a strange one Dr J Lo help please!!



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I just wanted to get some feedback on this really and get my thought down on paper as it were.

Ok....... my family has unfortunatly a very strong history of breast cancer, but in order to be tested for the cancer genes BRCA1 and BRCA2 you have to have a LIVING family member that has survived the disease....none of my family survived.

Now I come from a very small gene pool, my ancestors werent big breeders(unlike me!!) , there are lots of only children,so it could be that the picture appears worse than it is, but none the less EVERY woman in the 3 generations preceeding me died from breast cancer, no exceptions ( well my mum died from cirrosis of the liver at 52 but she had a suspected tumour wouldnt get it looked at but she had all the signs)

Which brings me to my dillema, when I told my dad about my planned BL/BA he freaked...big time....he is a firm believer that with my history I should cause as little trauma to the breast as possible.

Then when we got talking he came up with the senario that if I were to REDUCE my risk by having this op he could understand.

So here is what I am asking, if I were to have all the TISSUE removed, but leave the skin and nipple, then fill the space with an implant would I massivly reduce my risk of cancer? I know that it only takes one cell going rogue, but surely if I were to remove 90% of the mammary tissue then I have reduced my risk by 90%. The only thing that I have been offered by the NHS is early entry into the breast screening program, which doesnt stop you GETTING it, it just means that you get treatment earlier. The UK survival rates for cancer are pitiful.With 6 kiddies it is a worry.

Do you think I am mad? More importantly can it be done? I am NOT talking about a prophylactic masectomy, that is just too radical for me, just the tissue being removed.

Your thoughts would be appreciated.

NIna x

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wow, interesting question... (my mom had and survived breast cancer) so I'm very intersted in the good dr's response.

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this is something i am interested in as well. with my recent scare, i even said if there was just one small area, i'd go for a double mastectomy no questions. maybe this could be an option. my mother had breast cancer at 36, was in remission for almost 5 yrs and then got it in the other breast. so it's very real for me as well...

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I think if you are done with breastfeeding (for life, of course!) it might be a good option! That's a very scary family history.

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Hi. There is a lot of debate over this. Carriers of the BRCA gene may be candidates for prophylactic mastectomy (the skin and nipple can be spared) but a careful analysis of the risk and benefits must be done.

The BRCA risk is manifested by the development of cancer in a first degree relative (mom, sister, or daughter) at a young age.

A genetic counselor can probably get you more complete answers here.

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Thanks so much Dr J Lo , as much as anything for not telling me that I am mad - or a self mutilator as my GP tried to a few years back.

I spoke to Breast Cancer UK and they said that with the history I have I would fall into the 'high risk' category, and that even if it wasnt BRCA1 or 2 they are now coming to the realisation that there are probably more breast cancer genes that they havent discovered yet, as they have found families like mine with terrible historys who test clear for the gene, yet still all go on to develop it.

My sister is only 32, I am 39 there are just the 2 of us, and my mum died when she was 52, her nipple was sunk in and discharging, and she had a huge lump, unfortuntatly you can't make an alchoholic do anything they dont want to :confused: so she refused to let the doctors look at it. She died in awful circumstances so we never thought to ask the coroner.

I dont want to wait to see if one of us develops it....thus confirming the risk...and I sure dont want either of us to die.

If I were your wife or daughter what would you recommend?

I know this is a worry for more people than just me, so I would really appreciate your honest reply.

Thanks again

Nina x

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Hi Nina,

Well this is a little out of my area of expertise so I cannot make a recommendation...other than to say you need a general and a plastic surgeon to talk to you about the downsides of the procedure compared to any benefit you may have.

I agree that you may be at high risk and the procedure is something to consider.

JL

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