Pls help: Lumpectomy or Mastectomy? IDC- 6-7cm

idc-tnc

Hi! im a newbie here and today, July 6 2011, i got diagnosed with IDC. I noticed in the clinic, patients came with a friend or family, and I didnt really thought of it that my meeting was going to be a serious one. Anyway, i registered today so I can be with women who can relate and going through the same process. I havent even told my parents. Im 41, with a 9 year old, separated and was hoping I can get support in decision making here.

My lump is about a size of a plum about 6 cm, a month ago May 30 mammogram, we can hardly find it to fit it into the apparatus and hard time trying to clump it. I think it has grown since. I had biopsy on June 24.

 Today my doctor explained to me that we can try to save the breast going through a seris of chemo treament to make it smaller and then save some of the breast (lumpectomy or partial mastectomy) it takes 6 months before the actual surgery. But if its mastectomy, the surgery can be August.  I was so shocked when he was explaining to me, and probably wasnt mentally there. I didnt know the right questions to ask either. He mentioned either way it is equal risk.

I am supposed to have all kinds of scans, i cant remember what they are.so it hasnt gone to my vital organs.  MRI as well..

Sisters of all ages anywhere, please help me in making my decision. and would like to hear what you went through.what i can ask, tests that i can expect, your side effect on chemo, your growth rate, etc. Questions to ask and or just share anything. Thanks in advance.

Live Strong, kc

jancie

KC - my IDC tumor was 4CM - I did chemo ahead of time and it shrunk my tumor to where the BS couldn't even feel it right before going into surgery.  This allowed me to have a lumpectomy and not disfigure my breast.  You can't tell I even had surgery even though he took that amount out plus more to get clear margins because of the way he sewed me up.  I don't even have a dimple.

Did I like chemo - absolutely not - but I made it through and my hair has grown back and I am getting my brain back.  Radiation wasn't bad at all - I just got very fatigued.

I was diagnosed the end of December 2008 - I had my surgery in July 2009 as I went through 4 months of chemo and then 3 weeks off for my body to recuperate.

dlb823

harlikate, I know you're in Canada, and I'm not entirely sure how your medical system works... but can you possibly get a second opinion?  It seems unfair to put you in the position of making this kind of decision when you don't at this point have very much information to go on.  I'm not sure if the doctor you're referring to is an oncologist or breast surgeon, but it seems like if you could talk to 2 of each, you would get additional insight from their different perspectives, something I would think would be very helpful in coming to a decision.

Some unanswered questions (at least in my mind) ..What is the pathology of your bc?  Some are a lot more aggressive than others, which might point more towards a mastectomy.  If you were to have a mast, what type of reconstruction is available?  Immediate or delayed?   6 cm is a large lesion.  If it doesn't shrink considerably, will your breast surgeon be able to achieve good cosmetic results with a lumpectomy?  (This would depend in part on the size of your breasts.)

Although I know you need to decide as quickly as possible, hopefully you can get some additional information, so that you're not making a decision in the dark.  

I'm so sorry you're going through this, but I'm glad you've found BCO, and I hope you'll get some additional input here to help you as well.      Deanna 

idc-tnc

Thanks to both of you.Jancie and Deanna.. I didnt sleep well last night actually. I couldnt think well and not sure if i should sell my home which is also in forever reno which is another one of my headaches. i know i should just be healing.. My list of worries grows, as a single mom, i only have one year worth of work which i will be skipping alot of days off. I have zero benefits. I will probably pay for my meds on my own, and well, i think OHIP will pay for my treatment/hosp etc. Which poses maybe i should sell my home for meds and when i lose my job because eventually my employer probably will likely have to replace me. I was hoping after a year, I could impress them and make me permanent too. I can't tell my parents, they can be pretty mean hearing their opinions in the past.  I dont even have an idea who will support me as I go through this. But all I can think of is my daughter who needs me. Its not fair I have to put her through this. So thank you.

I had no idea of pathology of my breast cancer. Only that it is large and possibly can still go to lumpectomy. and that it didnt go through lymp nodes, he thinks. My doctor is Dr. Mirsky and he is supposed to be number 2 in Ottawa. I will need to call him today and ask those questions that Deanna had broached. Thanks.

sewingnut

harlikate, 

 I had surgery first then chemo. I was only off work long enough for the drains to come out after surgery.  I only took a few days off after each chemo treatment and worked weeks 2& 3 between chemos. I thought I would be so sick but that never happened. The drugs they have these days to help with all the SE chemo may bring are wonderful.  You have a support system on this board like none other. Good luck with your decision.    joann

suebak

Harlikate-I am so sorry you had to join this group, but Welcome.  You will find so much support, as well as answers to all your questions. Going through this alone would be hell, as long as you are here, you will find new friends that will walk with you every step of the way. I am fairly new here and don't know what I would have done without these woman.  Hang in there, and don't make any decisions too quickly.  Take a breath and get as much info as possible.  Share this info with the woman on this site and they will help you in making your decisions.

Wendyspet

Deanna has excellent suggestions.  I decided on double mastectomies because my tumor was her 2 positive and grade 3.  Your pathology really makes a difference in your decision.  You should get copies of all of your reports.

I am in the U.S., but is there a social service or maybe your doctor can refer you to a support group that can give you information to help you with the financial decisions?  Maybe a non-profit group or cancer coordinator?

idc-tnc

I have a dumb question. Is the pathology report in the biopsy and ultrasound report? I am confused. I came to my general family practitioner, and I forgot to get a biopsy result. She suggested I see Dr. Mirsky (my breast surgeon) again and ask him what would he do if he was in my situation. 

Thanks for all your ideas. I think Dr. Mirsky told me of a social worker, I will meet him again next week Wednesday. I would have settled in on my situation and researched as much I am better prepared when I seem him. Probably a much better time to ask for the social worker.

 I have another dumb question.: Am I allowed to exercise now that I have cancer? 

 Thanks again. Sending you all the positive vibes and dealing with breast cancer gracefully! Keep getting well.

dlb823

There are no dumb questions!  A pathology report (lab analysis) would have been done on your biopsy (the tissue samples they removed).  Normally, the u/s report would be a separate report, describing what was seen on the imaging they did.  It's a good idea to always ask for copies of any test you have done. That way, you can refer back to them as you become more familiar with the terminology and more questions arise, as they will.  The pathology report from your biopsy will be somewhat "tentative" and more limited than the one they will do from whatever they remove during your surgery.  That will show a much more detailed picture, so may change a bit from the biopsy pathology. 

I think asking a doctor what he would do, or what he would want his wife or sister or daughter to do in your situation is often an excellent question.  But keep in mind that it is you that will have to live with your decision, so while it's helpful to get that kind of reaction from our docs, it may not always be what's best for you -- if that makes sense.

If you've always exercised, I can't think of any reason to stop it now.  In fact, being fit and in the best health possible should make surgery and any other treatment easier than if you're not in shape.    Deanna 

mdg

I am sorry you have gotten diagnosed and had to join our club but I am glad you found this site. It has been a big help to me during the last 7 months.  My tumor was much smaller than yours but I did have a lumpectomy, then a BL mastectomy and chemo after surgery.  I struggled with deciding on MX.  I guess you have to look at all the data in terms of recurrence rates (local and distant) and survival rates for both MX and lumpectomy and understand them.  This is such a personal choice.  It also depends on how you feel about your body - some women are more attached to their breasts than others. 

For me I was not that attached to my breasts the way they were - I always wanted to be bigger (I was an A+ before surgery).  I am a worry type person so I wanted to treat this aggressively.  I have a 4 year old son and wanted to know I had done everything possible to be there for him (recurrence rates are different for MX vs lumpectomy).  I also knew that I was now at a greater risk of getting BC in the other breast too. I weighed all of that out and decided on BLMX.  I also reviewed my reconstruction options at that time and decided on tissue expanders and implants.  I just got my implants in a week ago.  

Make sure you write down all of your questions and concerns and discuss that with your breast surgeon.  I also suggest meeting with a plastic surgeon just to evaluate the options and know what your choices are just in case.  Good luck with your decision.

idc-tnc

Hi Deanna and MDG, Thank you both for your recent replies. 

I somehow tried to get my pathology report and the clinic refused to give it to me anyway..another story.. With all the hesitation,  I finally had told my parents, and a friend of mine, and work too. I think I have somewhat gotten used to my situation.   The first thing I told my doctor was I want it gone right away but he want me to think about it.  And somehow he gave me a choice and it confused me.  My friend says the same thing, just get rid off it. Im having my menses anytime soon and my breasts are tender, and somehow it affects my lump and it shoots a brief pain, and because it is big lump, i find sometimes its heavy to breathe. And the more I want to get this thing off me. and the thought of it attaching to my muscles, rib, my lungs gives me chills up my spine. I lilke my breast to keep it, but after I found out, I suddenly became not so attached to it. I guess it really is how you feel about the keeping it. Thanks for pointing that out.

They scheduled me for the 19th and I have to get my menses by 12th.I cant wait to get my period because somehow my MRI is dependent on it.  Waiting game is excruciating.

 I didnt know of BLMX Bilateral Mastectomy till now. My doctor somehow did mention full mastectomy..i wonder if he meant both my breasts.  Im so glad I am learning terminologies here. I learned more from researching here than I do from what was explained to me or from books.

After I told my work, they were very supportive.Thanks, I think i will keep on exercising. I start walking 30minutes a day too. That alone help me get in touch with nature, and somehow relaxing. Thankyou for giving me courage, insight and knowledge. Im not afraid anymore. With that Im so appreciateve of all your gestures and info.. Wish someday its like lets all have a cup of coffee in starbucks.

motherofpatient

My daughter's tumor was much smaller than yours and she had one postive node - however, there was a lot of micromets so she opted for a double mx with reconstruction with tissue expanders. She did chemo before surgery becasue the initial plan was to go with a lumpectomy until the other areas were discovered in the path lab. It did not show on the numerous specialized mammos she had. I am glad she decided on the DMX because it so drastically reduces her chance of recurrance years down the road. I think the younger you are, the moore aggressive treatment you need to protect your many, many future years.

idc-tnc

Hi motherofpatient: thank you for sharing your daughters situation. As it stands I am tending towards mastectomy. I am worried as I wait for the other tests im supposed to take. And while  waiting for my MRI and other scans I wonder if this thing is growing inside me.

 Just a question though..does anyone know if the tests are prerequisite of each other?