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She has responded well to oral medication. Are there any alternatives?
She was diagnosed in February and has been on letrozole ever since. The lump has shrunken but the standard of care still dictates that she have surgery. We are afraid that this surgery will be too much for her and she will be miserable in a long recovery. Added to which it will exacerbate her dementia.

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In our case, my mom's dementia was in the mild to moderate stage when she, herself found a lump. The fact that she found it, and had concerns, for me, was a sign that we should act on it. Turns out my mom's tumor may have been there for almost 10 years, but all signs made us feel that acting on it was the right thing to do. It was a full month and a half from diagnosis to surgery. She healed quite quickly physically, and the cancer did not spread... however, post hospitalization delirium, as well as the adjustment have been up and down. Surgery was in the first week of February and now we are starting the first week of July - so 5 months in and its still a recovery period. Lots of ups and downs with confusion, but the delirium has somewhat worn off. Oddly enough its the phase between a full moon and new moon that have my mom most troubled-dementia wise compared to anything the cancer did. I think it really depends case per case. If we had to do it again, I would. I would prefer her confusion over pain any day. It really comes down to knowing your loved one, and knowing what feels right.
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My mom chose a lumpectomy instead if mastectomy. She had to have 2 operations since the biopsy on the first wasnt clean and they dont get results for 2 weeks. May be different now. Dementia diagnosis came about a year after these surgeries. Mom came home with a drain both times that we were taught how to clean and empty. I would also suggest to find out the type of cancer. If slow moving then i would definitely say no. I might say no anyway. How far advanced is the dementia? Another thing to consider. Good luck
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Breast cancer is usually slow growing in the elderly.As long as the medications are not causing unpleasant side effects that is the way i would choose for myself.
Even without dementia I would prefer not to waste one of the few years I have left of my life recovering from major surgery.
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My boss's wife had a lumpectomy done for her cancer and she was almost half way through her journey with Alzheimer's. But it all depends on what type of breast cancer one is dealing with, there are so many different types. Also depends if it is a very slow moving cancer that took years in the making.

I agree, having a mastectomy is traumatic, even if one is of clear mind. The physical and emotional pain can last for months. Plus now a days a mastectomy is out-patient [yes, crazy isn't it]. Then there is physical therapy to help the arm muscles from not freezing up. Oh the list goes on and on.

There are so many factors involved. No matter what decision is made, there will always be questions if it was the right choice.
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Jessie, I immediately thought of a mastectomy; a lumpectomy didn't even cross my mind. That would be less traumatic than awaking confused and finding a major body part missing. Still, I too would be concerned about the anesthesia.

My mother had a pacemaker replacement in her late 80's, I think a year or so before she died. She didn't have general anesthesia, so that may or may not have caused some of the trauma. The operation itself was very upsetting for her, and the follow-up was worse, not because of the pain but because of the need at that time to keep her arm immobilized so as not to disturb the sutures and placement of the pacemaker. She didn't understand what was happening or why they "had me all tied up!"

Mom didn't have what I would consider more than just mild dementia, but the surgery (she said "they threw a towel over my head!") and the immobilization really agitated her. I ended up staying overnight in the hospital with her.

The pacer surgery was necessary, but it was traumatic; she was more confused for a few days and at that time we didn't know as much as we did later about handling the confusion aspect. When she came home, she stayed at my sister's and my father and I stayed there as well so we could all help her, and it did become necessary.

I think Sunnygirl makes a good point - it's a personal family decision. In retrospect, I'm glad we didn't have Mom go through chemo or surgery; it would have been too traumatic.
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That is a tough situation. When my cousin had a scan of a lump on her side, I was wondering the same thing. I wanted to make sure she wasn't in pain, but I knew that I would not consent for any surgery, even if it was cancer. I read a lot of material from the Alzheimers and Cancer Society websites. Even the American Cancer Society does not recommend cancer screenings for dementia patients and others with terminal illnesses, because the person is terminal with the dementia. And the surgery often makes the dementia worse and the patient is left to suffer worse and for a longer time.

It's a personal decision for you to make with your family, but I bet you get some more personal stories here about how others have dealt with this same situation. Take care.
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GA, do you think a lumpectomy would be too much? I would worry most about the anesthesia in that case. I don't know enough about the lumpectomy operation to know if it is too traumatic.
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No, no, no. It will be too traumatic for her.

Standard of care is exactly that - it can still be modified or adapted to each individual, and it should be when the individual is older.

The only way I could think that kind of surgery would be appropriate is if she's been diagnosed as Stage IV, but there's still the issue of which is worse - taking meds to shrink the lump or surgery.

My mother was diagnosed with breast CA at age 85; we all agreed with her oncologist who felt treatment with tamoxifen was better than chemo and/or surgery. Slash and burn methods are traumatic for anyone at any age but more so for an older person with dementia.
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