Breast cancer help

[Supersimkin7]

Very worried about an old school friend.

She’s had a lumpectomy and reconstruction but nhs is saying no need for radio or chemo - can that be right?

Thanks all.

Yes that can definitely be the case - that's what happened with me when I was diagnosed with breast cancer 13 years ago. I was found to have two small tumours in one breast which were quite far apart, and the surgeon told me it would be really difficult to maintain a reasonable breast shape if he did two lumpectomies and very strongly advised thst I had a mastectomy and reconstruction. I had a sentinel node biopsy before the main surgery, which established that the cancer hadnt spread to my lymph nodes. It turned out to be a really good decision to have the mastectomy as a third tumour was found that hadn't shown up on any of the imaging when they examined the breast tissue that had been removed.

I had expected that I would need to have chemotherapy and/or radiotherapy, but when I saw the oncologist, she explained that radiotherapy wasn't necessary because this would usually focus on the area around the tumours, but they had been removed altogether, and because my lymph nodes hadn't been affected, there was no need for chemo. They take so many things into account when deciding on whether or not you need chemo or radiotherapy, and although it's quite unusual not to need either, I'm proof that is does happen and thst there are really instances when it's not necessary.. I was treated at a leading London teaching hospital and was lucky enough to have had some truly outstanding senior surgeons and oncologists. Because my cancer was hormone positive, I took hormone therapy for five years, which I did find quite gruelling, and the recovery from the ten hour reconstruction also took quite a while.

My mum was diagnosed with breast cancer six months after me, when she was 85. She also didn't need chemo or radiotherapy - she had a mastectomy and was offered reconstruction, but didn't want to put herself through the ordeal of such major surgery. Because her cancer was hormone negative, she didn't even have to have hormone therapy.

I was a one to one support volunteer for Breast cancer Care after my treatment and I came across quite a few women in the same position who had had the same treatment as me over the years I worked for them. Oncologists now use more sophisticated testing to determine when chemo is needed, so yes, if your friend has been told that she doesn't need either chemotherapy or radiotherapy, that is entirely possible and she is one of the lucky ones like me. Don't worry, oncologists know what they're doing!

How old is she? There’s evidence that in older women, small, non-aggressive hormone-positive cancers are low risk and for them, surgery and hormone therapy can be enough.

Yes, they really fine tune treatment now to the specific case. It is not ‘one size fits all’.

Thanks so much. You have helped hugely and put minds at rest. She’s just been 60, which counts as old, a bit cheeky cos we both look marvellous 🤣

The ops are gruelling, mega sympathies. But so good to be cancer free, phew - onward and upward 💐 Happy weekend and thanks again.

I'm glad you feel a bit more reassured. While the idea of having chemo and losing my hair was my worst fear, even more so than a huge operation, I still had a niggle in my mind at times in the first few months about whether I should have been given chemo. I think that was because so many women that I met when I was in hospital, at follow up appointments, and rehabilitation sessions had gone through chemo, and I didn't meet other people in my position until a while after that. I also didn't understand at first just HOW much everyone's treatment is tailored individually to circumstances and deciding on a treatment plan really is a very precise art. But I think your friend can rest assured that her oncologist will have made the right decision for her treatment needs.

Your friend might find that she really panics about having a recurrence - that was something I struggled with for a long time and I think initially that was made worse because I hadn't had chemo and didn't fully realise that it wasn't needed in my case. I became even more attuned to every little twinge in my body and convinced myself on so many occasions that my cancer was back somewhere else in my body. I think that can be a fear that takes a long time to go away, but having a sympathetic GP to reassure you can be a great help. I found that oncologists seem to be probably the kindest people in the world, and every time I saw mine, if I mentioned a new pain anywhere, she sent me off for an immediate scan or to see the appropriate specialist.

Many women also feel a bit of a sense of abandonment once all the flurry of hospital appointments and treatment stops, and that is really normal. It's such an intense period when you're going through the diagnosis and active treatment stage, and then suddenly there's no appointment coming up in a week or two where you can share your latest worries.

I don't know where your friend lives, but probably the thing that helped me the most when I was recovering was attending the Moving Forward course that Breast Cancer Now run, and I really can't recommend it enough. They run them in person in various parts of the country and also online. At the time I went. The courses lasted for four weeks, although I think they are shorter now. It helped me so much to be with a group of other women who had been through a very similar experience as me and who had the same worries, and I made a group of new friends who I'm still in touch with 13 years later.

Thanks again, very much. I’ll pass this onto her, as I’m sure you’ll have helped her greatly.