Surgery, lumpectomy, Tuesday 5/11

mercurialqueen

Hi Girls:

Finally I have the date for my surgery for DCIS.  Surprisingly I am very calm.  I trust my surgeon.  He was my second opinion.  The first surgeon I saw told me she needed to do a mastectomy for the size of the area were the calcifications are , 10 cm.  I want to try first the lumpectomy or quadrantectomy, like my surgeon called it.  I am scared with what my husband said to me, we've been separated for two years, but he's been /supportive at this moment, he said: "well, you finally found somebody to tell you what you wanted to hear".  Am I wrong to wanting to try the lumpectomy first, then if the surgeon cannot get clear margins, I can always have the mastectomy, right?

Wish me luck ladies.

Maria

momand2kids

Maria,

I cannot speak for others--I had a lumpectomy and don't regret it---- I think you can try this route, then if the margins aren't there- you can go back again--some people just don't want more surgery--- or sometimes the cosmetic results may not be as good---but you don't know this until you are done.  It is very quick surgery and they often do a sentinel node biopsy as well and that seems to take longer to heal from (I don't know if they do that with DCSIS)....

Best of luck-- you will have time to make different decisions if you need to.

momand2kids

Maria,

I cannot speak for others--I had a lumpectomy and don't regret it---- I think you can try this route, then if the margins aren't there- you can go back again--some people just don't want more surgery--- or sometimes the cosmetic results may not be as good---but you don't know this until you are done.  It is very quick surgery and they often do a sentinel node biopsy as well and that seems to take longer to heal from (I don't know if they do that with DCSIS)....

Best of luck-- you will have time to make different decisions if you need to.

mom3band1g

For me, I would absolutely be fine with lumpectomy first.  A  mastectomy is huge.  I did have a lumpectomy but did not get clear margins (I had a very small breast).  I would have been just fine had my margins been good.  When I did have the mast I did feel better knowing I tried to save my breast.  Best of luck to you.  With DCIS they generally do not do a SNB but with the mast they do.  HTH.

SJW1

Maria,

My first surgeon also told me I needed a mastectomy for my DCIS. When I asked for a 2nd opinion, I was sent to a surgeon who said she thought she could get good cosmetic results with only a lumpectomy. She ended up doing a very wide excision and taking out a large chunk about 1' x 2" x 3", but other than leaving a small dent, I think it still looks quite good.

Unfortunately, my pathology report after surgery showed 5 out of 6 positive margins, so once again I had to fight to keep my breast. I had Dr. Michael Lagios, a world renowned DCIS expert and pathologist who runs a consulting service that anyone can use, review my pathology slides. He disagreed with the local pathologist and not only again spared me from a mastectomy, but also rated my chances of recurrence at less than 5 percent using the Van Nuys Prognostic Index, which meant that radiation and tamoxifen also were not necessary for me.

I guess your husband would say I am the champion at "finding someone who would tell me what I wanted to hear". Although there might be a small element of truth in this, YOU must be comfortable with the doctor and the treatment you choose.

Since DCIS is a non-invasive cancer, the truth is that it probably won't matter if you decide to have a lumpectomy or a mastectomy. The survival rate for DCIS is close to 100 percent with either. I wanted to do the least invasive treatment I could. If that is want you want too, then I say go for it. You can do the mastectomy later if needed.

If you would like anymore info or have any more questions, feel free to send me a private message. 

I have been helped by many other DCIS sisters and would be happy to help you in any way I can.

Best wishes with your surgery this week,

Sandie

Kitchenwitch

Maria, I had a lumpectomy and a re-excision and was glad to go that route. I am not yet done and my course of treatment isn' clear since the re-excision still didn't get clear margins. But I will cross my fingers for you and hope that lumpectomy gets everything they need to take out and still gives a good looking cosmetic result.

By all means i think it is more than reasonable to try to avoid mastectomy if you want.

Best of luck,

Jill

mercurialqueen

Thank you everybody for your input and wishes.  God bless all of you.

Maria

mercurialqueen

Well, the surgery could not be done because my thyroid levels are too high and it is dangerous to have anesthesia with high levels of thyroid, could have a heart attack, etc. I have hypothyroidism and have been taking Levoxyl, but it looks like it is to much medicine.  So I have to have the medication adjusted and the surgery has been postponed for two weeks.  Bummer.  I was already psyched. 

Oh well, more patience and more waiting.

Maria

CTMOM1234

Sorry about the delay, the waiting is so stressful. Of course you are not wrong. These are your decisions to make, they're personal and you must follow your feelings.  My motto continues to be not to second guess/regret my decisions.  We cannot control the future, unfortunately recurrences and new bc happens, but I'm happy to have been given the option and chose lumpectomy (and rads) over mastectomy.  I'm now < 1 month since my last rad zap and ~ 4 months post-surgeries, and I'm happy to say that all things considered, my good ol' left breast looks pretty good (and more importantly, I have full sensation).

CrunchyPoodleMama

HOW did I miss this post?! I had a re-excision the day after you were supposed to have your surgery, but I wanted to tell you that even though I had doctors strongly recommending mastectomy, I am VERY VERY glad I have gone the lumpectomy route so far.

My reasons for deciding against mastectomy were:

 - My nature is to go the more conservative route first, and "self-treat" with diet and lifestyle changes
 - You can always have a mastectomy later if you need to or want to. Once you've had it, you can't go back. I'm young (late 30's) and that's a LOT of decades ahead of me to live with something I may regret.
 - Loss of skin sensation that seems to accompany many mastectomies

I went into it expecting to be "deformed" (my surgeon's words - I had 9cm removed the first time and another good chunk removed in the re-excision), but actually I've been pleasantly surprised. Other than the scar, it looks better (more rounded) than it did before!

Sorry you're having to wait, but it will give you two more weeks to confirm your decision. I don't think you're making a bad choice AT ALL. I know some women with as much DCIS as we had have not hesitated to do a mastectomy, and that was the right decision for them. But someone else's decision is NOT necessarily the right decision for US. Even if I eventually have to have a mastectomy, I am 100% satisfied with the choices I've made so far... don't let a comment by your husband make you second-guess what you believe is the right decision for now!

mercurialqueen

Hi everybody,

My surgery is on June 1 now, as I said above it was postponed.  But I feel so anxious now, can't wait any longer, I feel like I'm sitting on pins and needles. I can't concentrate at work, when I'm with people I don't want to talk, I feel like I have nothing to say.  All I do when I'm home is be in bed, sleep or watch tv.  I may be hypo on my thyroid hormone due to have medicine changes, but I cannot do anything about this until the surgery.

Julia, I just read your response, I didn't see it before, it helps me a lot to know that you're satisfied with your results.

Thanks everybody.

Maria

CrunchyPoodleMama

Best wishes to you on the surgery!! I know the waiting period until surgery is horrible... I was on pins and needles and could barely concentrate on anything. But now that the surgery is over, I feel SO MUCH BETTER... especially now that I have clear margins this time... I have every confidence that I am CANCER-FREE right now (though of course I'll be closely monitored for a while). It will be a good feeling for you too once it's finally over!

Every day that goes by I'm more pleased with my decision. First of all, the recovery is a snap. I didn't need a single pain pill after either surgery. I felt totally fine within a couple of hours of waking up in the recovery room. I was pretty much doing my normal activities within two days, and today I was gardening for hours and doing heavy lifting etc. (with doctor's blessing!). If I'd had a mastectomy, I'm sure I'd still be feeling the effects, having trouble lifting things etc. -- not to mention the emotional factors and probably a series of reconstructive surgeries ahead.

Someone mentioned a recent Stanford study that recommended THREE re-excisions before proceeding with a mastectomy... I haven't had a chance to look for that study yet but it sounded interesting. Also, a friend told me that Dr. Michael Lagios, a breast specialist who does second-opinion consultation, said that in some cases it makes sense (with DCIS) to have a lumpectomy, wait 3-6 months to give any remaining DCIS a chance to grow large enough to be seen on mammo or MRI, and THEN have a re-excision -- that way the surgeon isn't going into it as blindly. That gives the surgeon the opportunity to get very wide margins, which have been argued to be as effective as radiation in terms of prognosis.

Like I said, I don't mean to dismiss that choice for someone who's decided a mastectomy is the right choice for them. But we have to make the right choice for US. If someday I have a recurrence and it turns out I end up going with a mastectomy, I still won't regret the course of action I have taken so far. 

Anyway, best wishes to you and I look forward to reading about how it goes!