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bilateral mastectomy

My 75 yr old mother is presently booked for a bilateral mastectomy and sentinel lymph node biopsy for a week from today (July 17th) which is scheduled as an outpatient procedure. She is apprehensive (terrified actually) about surgery and possible secondary health set backs; at this time she is fully functional (other than some impairment from arthritis).

I am not sure what to advise her; no one has discussed treatment options and/or expected outcomes of a) proceeding with full surgery, b) a surgery of reduced scope, c) no surgery or d) other possibilities. Could someone please kindly review her case and advise?

My concern is that if her the surgery it is not curative, but rather the first in a long list of painful and debilitating medical procedures from which she may never fully recover (due to her age etc), the quality of what is left of her life may be considerably diminished. I feel we don't have enough data to make an informed decision.

Biopsy results: Unusual in that they found 2 different types of Infiltrating Duct Carcinoma (IDC) in each breast. The tumor in the right breast shows cells with progesterone and estrogen receptor involvement and the left breast was triple negative (presently breaking through the skin).

Staging tests: Bone scan report indicated “extensive metastasis” in her sternum that is worrisome. Ultrasound and chest x-ray were clear.

Note: It is only because I requested and read the bone scan results that we learned about the metastasis to the sternum - no doctor has talked to us about metastasis and a prognosis. From what I understand, once the cancer has metastasized to the bones it is incurable and therefor has significant implications re: prognosis and treatment options. Is this right?

Possible complications: With increased stress of testing & news of cancer, her blood sugar levels (type 2 diabetes - under control up to now without medication) have been consistently elevated (13-16). Yesterday she received a prescription for a diabetes medication, Diamicron (glyclazide) - I just read is not an appropriate means to control blood sugar during surgery.....

Any input would be greatly appreciated!
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replied July 11th, 2008
Extremely eHealthy
Hi!
People that are due to have surgery, have their blood sugar levels temporary controlled by insulin (surgery is causing additional metabolic stress which emphasizes the predisposition to hyperglycaemia-increased blood sugar levels).

The "triple negative" breast cancers, tumors that do not contain any of three significant tumor markers, are usually aggressive, deadly cancers. They are associated with later diagnosis and shorter survival regardless of stage at diagnosis.
Women who have both estrogen positive and progesterone positive receptors in their breast cells, respond best to hormone therapy treatments.

The sternum is a common site of local spread of breast cancer and in most of the cases radiation therapy is indicated as a palliative treatment (there is no way to guarantee whether this will result in temporary or permanent control of the tumor in this area)

Having bilateral mastectomy like an outpatient surgery is a relatively new approach, after which patient usually feel better (need less painkillers and feel less nauseous)
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