Risk Reducing Breast Surgery

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Hello, I was hoping for a bit of advice… 

I was diagnosed with HER2+ BC in November last year when I was 34. I’ve had some Chemo, a lumpectomy (lymph node biopsy was all clear and they got good margins), radiotherapy and now am on kadcyla after they found live cells in the tumour they removed. After my diagnosis, due to my age and family history I was referred to another hospital for genetic testing (BRACA1, BRACA2, PALB2, TP53 and CHECK2) and my results have come back as normal. Initially I was given the results over the phone but was asked to provide more details of my family history (my paternal grandmother first got BC aged 35, her sister died with it in her early 50s and her mother died of it in her 40s) after another week or so I was told that they wouldn’t be offering me further surgery. When I got my letter confirming this in the post I was a bit concerned to read that they have not ruled out the possibility that I developed breast cancer because of a generic predisposition and they assess me to be high risk of developing further breast cancer however they conclude that my risk is not high enough to warrant risk-reducing breast surgery. 

I find this completely unnerving, I was hoping they would offer me the surgery to prevent the chances of me having to go through this again and I’m surprised they don’t offer it routinely. I haven’t had a chance to speak to my oncologist about this yet but I was wondering whether anyone has had any similar experiences and could offer any advice? 

  • Hi - really sorry you are having to deal with all this , particularly at such a young age. My mum and her sister had BC , as did I. My oncologist said it is probably a pre-disposed familial link , but not one they have , as yet, identified. As far as I am aware , the funding for preventative treatment is only if you have the fully researched  and identified conditions (that you have listed) Otherwise there is no pathway for the treatment - they just can’t make a case on possibilities, it has to be a factual business case as well as a medical one … having said all of that , as you have already had breast cancer, is it a double mastectomy you are thinking of ? If so you are perfectly entitled to ask for a second opinion at another hospital , who may take a different view on your risk ? 

    Jo x