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.
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.
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.
Even without dementia I would prefer not to waste one of the few years I have left of my life recovering from major surgery.
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.
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.