Lumpectomy then Mastectomy?

annabanana28

Hello...

Has anyone ever been told they need a lumpectomy- only to have their doctor call them back and say they are now recommending a mastectomy due to calcfications?  This just happened to me and I am not even totall sure what calcfications are- can they turn into cancer???  so scared and have to make a decision soon....................

Beesie

Anna, how did your breast cancer present initially? Was it in the form of calcifications?

Here's the thing about calcifications - they are very common - about 50% of women get them - and about 95% of the time, they are benign and harmless. But they also can be a sign of breast cancer.  So if you have calcs that have already been tested and shown to be breast cancer and if the calcs that your doctor is seeing appear to be part of the same grouping, then the likelihood that the rest of the calcs in your breast are also BC is very high.  On the other hand, if you had a discrete lump and separate from that you have an area of calcifications, it's very possible - highly likely in fact - that these calcs would not be breast cancer. 

In my case my BC was initially seen on my mammogram in the form of calcs.  These were tested and found to be BC.  When my MRI showed that my breast was full of the same stuff, it was pretty much guaranteed that it was all breast cancer.  So I had a mastectomy rather than a lumpectomy and it turns out that we were right - it was all BC (DCIS though, which is the earliest possible stage of breast cancer).

On the other hand my mammo showed calcifications in my other breast.  These were biopsied and found to be benign.  That means that these calcs won't ever turn into breast cancer.  I might get another area of calcs that is BC, but calcs that are totally benign (i.e. not breast cancer and not a high risk or pre-cancer condition like ADH or LCIS) don't become breast cancer.  So I made the decision to have a single mastectomy and in the 5 years since, my remaining breast has remained healthy (and those benign calcs are all still there).

My answer doesn't help you get closer to a decision because basically I'm saying that your calcs might be cancer or they might not be cancer.  Do you have a copy of your pathology report from your biopsy?  That would be a good place to start to understand if your diagnosis is based on calcs.  Then the question would be whether the rest of the calcs are all part of the same grouping and therefore might also be cancer. That's something that only your doctor can explain to you.  If the calcs are totally separate from your diagnosis, one option if you would prefer to have a lumpectomy is to ask for a biopsy of the calcs.  If they are totally benign then the option of having a lumpectomy would still be feasible.

wendy57

Hi Anna: I originally chose and was scheduled for a lumpectomy, but after re-reviewing my mammograms - the radiologist and oncological surgeon did not "like" an area of calcifications in a different part of my breast- so I had a stereotatic biospy done of the calcifications - which initially came back "equivocal" - so lumpectomy was changed to an excisional biospy, but the evening before "surgery" oncological surgeon called me at 6:30 PM to tell me that he had just received the results and in it was DCIS (Ductal carcinoma In Situ).  Since the DCIS was in a completely different area from my tumor (multifocal/multicentric) -  lumpectomy was changed to mastectomy with immediate reconstruction. 

dlb823

anna ~ Have you already had a lumpectomy?  That's what happened to me.  I had a lumpectomy first, but unexpected pathology results from it strongly indicated that I needed a mastectomy, which I eventually had.  It was an incredible shock, and I think I actually went into shock for a few days.  I kept thinking that it must be a nightmare -- that perhaps I'd been in a car wreck on the way to my first surgeon's office, and that I was in a coma and would eventually wake up.  Seriously.  But I took time to get a second opinion (which led me to a superb medical facility & team that I switched to), and I learned about and had one of the newest types of reconstruction (Diep) that replaced my diseased breast tissue with tummy tissue for a very natural looking outcome.

So sorry it sounds like you've also had this kind of traumatic shock, but whatever you're facing, you will get through it!     Deanna

myesan22

Anna, I know this is an extremely difficult time but believe it or not this can be a blessing. I had a lumpectomy in July and am now scheduled for a mastectomy on 03/04 for abnormal-appearing calcifications. Although the biopsy showed they were not cancerous, they look cancerous and would be difficult to follow up. This may be what your doctors are trying to avoid with you. Believe me, with this disease please try to keep things in a positive light! It is far better to have this happen now before your surgery and subsequent treatment. Good luck!

annabanana28

Thank you all.  I have an appointment with my oncologist tomorrow morning so I guess I will find out what all this means.  No, I haven't had a lumpectomy yet, but I am sure she will want my decision tomorrow.  I am going to try and get someone to go with me, because I don't always ask the right questions and I do not hear very well sometimes.  Thanks again for your responses- I really appreciate them.  

InTwoPlaces

Anna, you should absolutely have someone with you, it's very difficult to remember everything the Dr tell you.

You should also think trough all the questions you have and write them down.

Good luck!

hymil

Hope the appointment with your oncologist went well, and you have a plan for action now, or at least enough information to make a good choice.

annabanana28

I just wanted to give you all an update.  I am going to have a double mastectomy because of the extensive calcifications in both breasts.  I had the genetic testing done (don't know results yet), and I just found out my aunt on my mother's side has BRCA 1 (don't know about my Mom yet).  My mastectomy is next Friday.  I am scared but doing ok.  I will keep you posted.  Thanks everyone.   

steelrose

Hi Anna...

I just wanted to wish you good luck with your upcoming surgery. I know it's scary, but it will be over soon and you will be so relieved! The anticipation is far worse than the surgery! And you are young so you should bounce back quickly. I am thinking of you...

All the best,

Rose.

ALANA49

Hi

If you feel that you are scared don't be I have had 2 mastectomy's and survived.  If I can then anyone can.  Your life is more important than parts of your body so do the best thing and get rid of the calcifications.  Take Care.....

annabanana28

Hi Alana

I did end up having the double mastectomy and I don't regret it at all.  Thank you and I hope you are doing well.

ALANA49

I am glad you decided to do this and chin up things only get better.  Remembeer it is body parts and you are alive.  Everything in life is for a reason it will open your eyes to realty ok.  Take Care, smile ok, Alana