Mastectomy with immed reconstruction without full path report

nurseronda10

I was diagnosed on August 25th with IDC by way of ultrasound needle biopsy.  A 4mm nodule was found on ultrasound.  Met with surgeon yesterday and he gave me two options; lumpectomy with radiation or mastectomy with reconstruction. He was all for me having reconstruction right after he completes the mastectomy so I would only have to be under anesthesia one time.   I chose mastectomy with reconstruction and my appointment to meet with plastic surgeon is tomorrow.  I will not have a complete pathology report until I have the mastectomy, so what if it comes back with something that requires radiation.....and I will already have an implant in place.  I am so confused.  I am 52 and had a complete hysterectomy 7 years ago.  I did tell him I wanted to be aggressive because I have a 15 year old.  Does anyone know if it comes back grade 3, Her2, inflammatory breast cancer, metaplastic would I benefit from radiation, and again I do not even know if these are treated with radiation.  I know you have to be your own advocate.  I did call the surgeons office today to ask him if I should just get the lumpectomy first so I would have a full path report so we would know what we are dealing with or may be all the things I listed above may not even be treated with radiation.  Anyway, he was in surgery all day and hopefully he will call me tomorrow.

If anyone has any info on this it would be greatly appreciated. 

cbm

Hi, nurseronda.  If you have 3 positive nodes or more, radiation would be the standard of care with either mastectomy or lumpectomy.  If you have fewer than three nodes, your treatment might be enhanced by rads, but my oncologist, for example would oppose that much treatment.  

For me, the process of making this decision was guided by a lot of tests--a PET scan, an mri, and some women also have a bone scan and a CAT scan.  All after the biopsy, but before reaching a decision on surgery.  

I got more than one surgical opinion, also.  It's really important that you take the time to think all the way through the effects of each decision.  You are right, if there is a surprise during surgery, you might find it changes the plan.  But you should work that out ahead of time so that you know which of the options insures your health and safety, gives you the best quality of life, and meets other needs that only you can identify.  

I think you should have your complete preliminary path info--her2 status, er/pr status, grade, and stage estimate, before you decide on the surgery, but that's my opinion.  Yours is the only one that counts!

 Hugs! 

Cathy