84 year old mum diagnosed with grade 1 breast cancer

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hi everyone 

my mum (84yrs) has today been told she has breast cancer. They said it was grade/stage 1 which I think is the “least” aggressive) and said it appears to be at a very early stage - there are 2 very small lumps (described as a few mms in size).  They were only visible on an ultrasound - mum had gone as one of her nipples was bleeding but that breast was ok and it’s the other that has the lumps.

mum’s general health is ok, not great. She does have dementia although manages at home with my dad. 

She’s been told that her treatment options are hormone therapy (Letrazole), a lumpectomy (with radiotherapy) or mastectomy.  The consultant seemed to say that all 3 treatments would likely be as successful; the nurse clarified that the hormone therapy wouldn’t get rid of it and if it was unsuccessful at containing it, then surgery may not then be as successful/may be more problematic in years to come as mum may be more frail/cancer may have spread.

theyve started her on Letrazole whilst she makes her decision.

it’s obviously only a decision my mum can make, obviously the dementia makes it an even more difficult decision both in terms of her decision making process and for fear how surgery may adversely affect the dementia. I think mum does still have the capacity to make the decision - her dementia isn’t so advanced.

i know no one here can say what my mum should do but I’ve found the prostate cancer group helpful - my dad was diagnosed earlier this year - so would welcome insight from anyone who has experience of someone near my mum’s age / someone with dementia who’s opted for the various treatment options - we’re all just worried what effect the surgery/anaesthesia may have on mum’s dementia/her quality of life.

thanks 

keeley

  • Hi

    I haven't had a situation similar to yours with breast cancer, but my Dad had vascular dementia following a stroke.  He had better days than others and stress played a huge part in when he was good!  

    He was in a care home whilst my Mum was recovering from an infected toe, which was subsequently amputated, then sepsis and then an overdose by the hospital and she died after 3 months - from a cut on her toe.  His dementia became worse when I had to tell him Mum had gone, bless him.  When that care home closed, I had to find another one for him and  introducied me as his cousin (who he'd been brought up by when he was 9 years old) and the same happened when he had an ingrowing hair on his face (but they were worried it was cancer) and I took him to the hospital for it to be checked out.  Those were the only times he didn't know who I was. Other times he was 'sharp as a tack' and we would do crosswords etc.  He was very good at disguising his dementia so much so that some people didn't even realise he had it, but I knew the signs.  I am sure you will know the signs in your Mum and to pick the 'right day' to have a discussion to get decisions from her.

    Like you say grade 1 is the best - and she has oestrogen positive which means she avoids chemo. and just has radiotherapy (providing the biopsies confirm this).  If you read my profile, you'll get an idea of timescales as I had Grade 1 ER+ (oestrogen positive), but despite having DCIS in 2 large areas (54mm), they managed to save my breast and I have been clear for 2 years.

    Normally they try to get clear margins within the operation and saved me having a mastectomy.  My age is obviously vastly different to your Mum's.  A friend's mum had BC at 80 last year and although it had spread they didn't offer chemo. 'cause they clearly felt the benefits for life expectancy weren't worth it, but a lumpectomy with sentinel node biopsy really (for me anyway) wasn't that hard.

    I hope this helps a little and hopefully someone else may be able to offer some advice.

    Best wishes

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  • Hi Keeley,

    My mum had dementia,  but was a little more advanced than your mum before starting medication for it,  which held it as moderate for 10 years.  She fractured a bone in her leg and coped ok with that and a few trips to hospital over the years 

    Is a hard one isn't it? If it was my mum I'd feel bad going for the first option as it doesn't get rid of ther cancer,  and it will possibly spread.  The second one involves radiotherapy, and I'd think that it would be very difficult for her to stay still with dementia,  far less cope with the potential skin soreness and tiredness. That leaves the mastectomy,  which may also confuse her as I imagine it would be done without reconsteuction, but would be the easiest one for her as long as she's ok with the anaesthetic. I presume that they have done a biopsy on the lumps to know they are ER+ Did they do anything with the other breast to discover why the nipple was bleeding?

    Best wishes to you and your mother whatever choice you make. X

    “Remember to look up at the stars and not down at your feet.  Stephen Hawking,
  • Hi lesleyhelen

    thanks so much for taking the time to reply.

    my mum seems to want to go for the lumpectomy, we’re going to see her gp on Monday to see if she can offer any advice x

  • Hi londonmumof2

    thanks so much for taking the time to reply.

    as you say, the fear is if we just leave it with tablets, that it may spread and she might become so much more poorly.

    mum seems to favour the lumpectomy, but my fear is if they need to go in and take more, that means another general anaesthetic and as you say, I’m not sure how she’ll cope with radiotherapy.  I just worry that a mastectomy might be more of a big operation for her to endure and recover from.

    we’re going to see her gp on Monday to see if she can offer any advice.

    x

  • Hello ,

    I am sorry you find yourself here, however, you have come to the right place, this group is filled with so much information and knowledge.

    I will give me opinion, however, it really does depend on what 'type' of BC your mum has.  This is where the other ladies will help, as there is one type that needs chemo, whilst other types don't require it.

    Dependant on how small the lumps are and how close together they are, I would be saying 'lumpectomy' then either with or without radiotherapy (depending on which the doctors advise) followed by hormone therapy (Letrazole) to remove oestrogen that is made up in the body (fat cells).

    You would have to see what the doctors options are on anaesthetic - if your mum has any other medical conditions that make this a risk. I am not sure if this operation ca be done under a local anaesthetic - if your mum does have medical conditions that would cause complications this is something you could look into.

    With regards to the lumpectomy operation in itself, well apart from the operation which I knew nothing about - the rest was plain sailing, recovery was straight forward, think the only thing I avoided for the first week or two was washing my hair (I could of done this but choose not to over do things).  It's strange looking back now I can't remember much about this time.

    I stepped outside the box and went private for a treatment called Target IORT (inter-operative radiotherapy treatment).  This enabled me to have combined treatment - lumpectomy followed by radiotherapy treatment during the 'same' operation.  This did away with three weeks of daily radiotherapy treatment. (one of my main reasons for choosing this route is my dear mum is over 85 years young, I choose not to tell her about the BC, instead I said it was 'just a lump that needed removing' - by having combined operation and radiotherapy I was able to say this, I could not of hid this if I'd had to have the daily radiotherapy treatment.

    This treatment is now available on the NHS at a limited number of hospitals around the country, most are in London.  Sadly, this treatment hardly ever gets offered and there is certain criterias that you need to fit.  I think one been that you only have 'one' lump or they have to be 'very' close together. 

    Sometimes letrozole is started before treatment (if it is a larger lump - has this can shrink the BC) otherwise it is given after operation.

    With regard to lumpectomy operation and pain, well, what can I say, I think I had one ibuprofen the day after the operation and that was it.  I can't answer for the other ladies, but, for myself there was no actual pain in the operation site (this totally amazed me, I've not had surgery before and I was expecting to be in agony). Maybe other ladies can share their experience.  

    The only area that was 'sore/stinging' was where the lymph node biopsy was taken from (this was done during the lumpectomy operation), this soreness came on a few days after operation, so I would say whilst the area was healing, it was a strange feeling, it didn't hurt it 'stung' a sort of soreness that just as you'd think 'I can' stand this, it would go'.

    My lumpectomy/operation site had a straight cut around approx. 4" in length, with internal stitches and on the outside was the, what they called steri-strips, there was two of them and a very light dressing over the top of this (large plaster, this had to stay on for a week, till I went back to have it checked on).

    I think this is about all I can share with you.  Of course when I first joined this site and had my diagnosis I was beside myself, you do think the worst, but everyone on here helped, you soon understand there is hope, these lovely ladies and gents have trod this path and all help in getting thought it, it is a wonderful feeling to know you are not alone.  You can't help but think of the worst and your poor mum goodness knows what she is thinking at times she remembers this - if you can, find a way to let her know she will be safe, she is not alone. This certain is like a roller coaster of a ride, with us all saying that the worst part is the waiting on results and treatment plan, once you know what is happening you start to feel more at ease.

    I hope this helps, remember, we are all here for you, any questions you have just ask away.

    Thinking of you and sending big hugs xxx

    I'm hoping this makes sense - only my mind says one thing and my fingers type whatever they like x
  • Hi whathappened

    again, thank you for taking the time to respond.

    they said mum’s cancer was stage 1 - very early stage and 2 small lumps that was “oestrogen receptive” - they didn’t say anything about chemotherapy.

    ive tried to write down the pros and cons of the various treatment options but it’s just so difficult - I wish the medics were more directional with their advice but I understand they can’t tell anyone what to do. It’s awful seeing mum get so upset and confused about it all.

    will ask about the treatment / op you had xx

  •  The lumpectomy with TARGIT IORT would be the best option if they'd go with that as it isn't meant to be done when more than one , but if they are close she'd not even realise it had happened. If your local hospital doesn't offer it you can choose any in England,  though you'd need to check that they could do it before moving treatment. She'd so have her breast so it would be less confusing. I don't know where you live, but my local hospitals all offer it in London (UCLH, Whittington and Royal Free). Above is a map of venus from 2015 doing it. .  X

    “Remember to look up at the stars and not down at your feet.  Stephen Hawking,
  • Hi 

    I can't add much to what has already been said about your mums cancer and possible treatment as I don't gave enough knowledge of that, 

    On the dementia side My mum was at home on own with care going in after dementia diagnosis also day centres etc . For 3 yr As it worsened she stated to wander So went into a home . 5yr  Which was difficult for us but best for her . So enough background.

    I would want to talk if at all possible someone who has experience of dementia patients reaction anethestic. I.e. Does length of time make a diff , also pain relief afterwards ( morphine caused a bad reaction on my mum )  and very high infection control . 

    Sorry if I'm making your mind racing worse just think two expert teams working tog would be a great help.

    I know my Onco works closely with my bowel professor about which chemo and removing some bowel meds and it does help .

    I know we all diff and recognise I'm someone who prefers control ,

    . In this case I think the important thing is you have two teams who need to commnicate to help mum as much as possible 

    take care 

    margaret x

    One step at a time and ...Breathe !
    xoxox
    Margaret
  • Hi Margaret - I’ve just seen that the message I’d typed didn’t post. Sorry for the delay in replying but thank you for your thoughtful response x

  • What food your mum decide to do in the end? 

    “Remember to look up at the stars and not down at your feet.  Stephen Hawking,