Angelina had a double mastectomy for prevention, does that mean her lymph nodes and axillary nodes were also removed, Doc?

[rgci13]

[rohankhandelwal]

Well the angelina effect has struck this site as well .. I have been answering queries regarding this since the news hit the media. Personally, I feel that this is going to lead to more unnecessary mastectomies and create unnecessary anxiety in the families of breast cancer patients.

Coming to your question. Prophylactic mastectomy (or risk reducing mastectomy) is indicated in high risk patients, who have a very strong family history of cancer or are BRCA positive. In this only the breasts are removed and the axillary lymph nodes are not addressed.

This is not the only method of risk reduction present. Options like bilateral oophrectomy (removal of ovaries) and chemoprophylaxis (tamoxifen) are also available.

Dr. Rohan Khandelwal

[kontak TeamBCI]

Yesterday it has seen on many of the TV channels. It is shown that she had done gene test and taken the decision as she was 87% carrying the risk.

Doctor I am also tense - as my sister is recently diagonsed - though I personally do not feel anything abnormal in breasts but many times under tension feel like I am also having pains in the breast. Whether I should go for mamogram urgently - I was of the opinion once I complete the treatement and after 4 to 5 months I should go for my checkup. Is it OK

[sumeet_shah Administrator in reply to kontak]

kontak,

No need to worry. Pain is a very common symptom. If it bothers you or affects your daily routine, you can take an opinion from your doctor. A routine mammography, once a year, after you have crossed 40 years of age is good enough. You must also do a routine breast self examination once a month. Watch out for any abnormal lumps or bumps.

Let not stress eat you away. Just be 'aware', that's all.

[rgci13]

Whose treatment your sister's kontak? But don' don't you think everyone should a mammography after the age of 30 once in two years? I got my daughter' s done also and she is 36, with a son. Thankfully it is good infact I advised all my friends to get it done of course some have ands one have not , yes out if fear-:).

[sumeet_shah Administrator in reply to rgci13]

A 'screening' mammography is not helpful before 40 to 45 years of age. So routinely, mammography should be done only after 40 years of age. For ladies below 40, the ideal thing would be to do a regular breast self examination once every month, and a Clinical breast examination by a doctor well versed in breast diseases, once a year. If the doctor feels anything abnormal, he might ask for a sonography and if need be, mammography. But otherwise, on a routine check up basis, mammography should not be done before 40 years of age. Of course if I have a strong doubt of cancer, I will be doing mammography, irrespective of age.

The reason is that, breast tissue is very dense till the ages of 40 to 45 and smaller tumours will easily be missed by mammography. I have seen tumours of 4 cm in younger women and mammography being absolutely normal.

[rgci13]

Well I think shikhscanfight has had it done after 6 years. Survival record. I had requested my surgeon also but he refused bluntly with folded hands.-:). Well cancer is the most painful treatment and long marathon to overcome nowadays. Diseases like. Hypertension, diabetes or cholesterol etc are Jewellery which are worn by each and everyone nowadays. What do you think Doc and kontak?

[sumeet_shah Administrator in reply to rgci13]

rgci13, there are particular criteria for prophylactic mastectomy; only particular women at a very high risk can undergo that. The rest need not. And besides, if you be under a regular checkup, it suffices.

I know so many women, who had breast cancer, were fine for few years, developed cancer in the opposite breast, were operated and are now again fine. If one remains alert, one can easily detect any cancer in the opposite breast while it is very small, and can treat it, with barely any additional risk to life.

Shikha did it, because she had genetic mutation (BRCA1). Genetic mutations account for less than 6 to 8% of all breast cancers, the rest ladies have other causes. So even if a breast cancer patient were to do a prophylactic mastectomy, there is no guarantee that cancer will not come up somewhere else, like in the liver, lungs, bones etc.

So rgci13, do not let these thoughts come up; you have a beautiful life ahead, just be aware, keep listening to your body and enjoy yourself. Go for a nice long drive (I know you love driving) and have a nice coffee at CCD! And keep on helping us at the forum, like you already do. It's because of people like you all, that the forum is doing well. We want more and more present patients, survivors and relatives to join here and share and care.

[kontak TeamBCI in reply to rgci13]

Thanks rgc13 for all the times with your adivse & Dr Sumeet too. Yes you can find in all the families having some or other problems like diabetes, hypertension

[rgci13]

Thank you Doc. Yes I regularly keep updating on this site. In fact today shirdi wants some help for her pains and aches. Actually through this site we who are recent patients have become half baked doctors. Well in fact am not too well down with a dry allergic cough from Abudhabi . No, no I had taken it with me there and it just worsened with temperature change , hectic trips to Dubai and cruises and desert safari. The desert safari was real fun but increased my affected hand pain, but I think now that I am back home with regular diet and exercise and REST it should subside in a few days, but I know I have to live with it and so has to all others. In fact I was just meet up one or two days in a seminar it would be great, what say you? Thanx again.