Lumpectomy or Mastectomy

Tucker519

I am hoping for some guidance from other TNBC ladies. I am 29 years old. Diagnosed 12/10/12. Had sentinel node biopsy, with micro met. Chemo first with 4 rounds adriamyacin/cytoxan and finishing up 4 rounds of taxol. I have one left intro weeks then need to make my surgical decision. I am so torn. Before I had breast cancer I always said I would just get them both removed. But that's easy to say when you don't have breast cancer. I feel like I want to have a lumpectomy but should have a mastectomy. Everyone thinks I should go the aggressive route. But oncologist told me studies show TNBC's do better with lumpectomy and RT, as far as recurrence goes. Just don't know what to do. Any advice is greatly appreciated!

Luah

Tucker, welcome, and so sorry you are dealing with this - and at such a young age!

There have been many threads on this topic, the most recent here: http://community.breastcancer.org/forum/72/topic/801612?page=1#idx_13

although I hesitate to refer you to it, as there was some misinformation there - so please read thoroughly.  

At the end of the day, your surgical decision is a very personal one and should be yours alone... informed by your doctor's medical knowledge and familiarity with your own situation and risk factors. 

grover

Tucker

My tumor was very sim.to yours. My docs did surgery 1st, then we'll do chemo & RT. My surgical onc. assured me that there was no dif. in success rate btw. mastectomy & lumpectomy w/RT, that I needed to decide what I'd be more comfortable living with after. I still felt mastectomy seemed more aggressive, plus I had a sm.tumor in other breast at same time that was triple pos.! So I opted for BMX. I am older,though-43-so that probably is a factor. But unless there is some other factor to influence you or your drs. I'd tell you the same- YOU are the one who has to live comfortable with your decision...as crappy as it is! Several women who've had SINGLE mastectomies have told me they regret that they'll never "match!"

Tucker519

Thanks, Luah and grover! Just waiting for that sign that will give me a decision I can be at peace with. I have consults with RO and PS this week, so hopefully that will help. I know there is no wrong choice, but just want to make the right one for myself, my husband, and children.

gillyone

This is mostly a personal decision. But there are many TNs who go the lumpectomy rads route.

Luah

Tucker: I know what you mean about waiting for a sign... if only.Whenever I am undecided, I know it's because I need more information or another conversation. You will get there. And you will know. 

Fiercer

After much thought and consults, I chose chemo first. Then I will have a lumpectomy, then rads.



My TNBC is grade 3, stage 2. They feel no node involvement on an MRI.



My genetics came back negative or I would have done bilateral mast and had my ovaries out. I am 48 years old, and want to keep my breasts, provided it does not make my chances at recurrence worse. I trust my docs and feel I am on the right path.



My best wishes to you Tucker.....

Lauren15

I'm glad I found this thread.  I was about to start my own.  I'm going thru neoadjuvent treatment now.  Since January the tumor has shrunk for 3+ to .58, and they're not sure if that is still a tumor or just residual.  I just had another TAC treatment Thursday and will have another ultrasound in three weeks to determine the rest of the chemo regimen.  I think it will be Abraxane for another few weeks at a higher doese.  Nevertheless, I'm going to need really soon whether a lumpectomy or BMX.  Although I had wanted to have them re-done, I never thought BC would lead me to this.  Nevertheless, I'm going to use this as the light at the end of the tunnel.  My MO also told me that stats are the same for recurrence with either procedure.  I want this to be over after surgery, and since I've already lost sensation in both nipples from the prior breast augmentation, what's a little more numbness and perkier matching boobs.  It's still hard though.  I want them to look natural, or as natural as they can, which would probably be lumpectomy with with boob to follow.  I could use a tummy tuck as well, so I'm leaning towards one of the flap procedures but don't know which of the procedures gives the best results.  It's so confusing.  If anyone wants to share your stories, I'd love to hear them.  Thanks, Lauren

burge

Hi Lauren,  I had TNBC with lumpectomy,chemo and rad in 2005.  tested + for brca 1. had my ovaries remove 2011. First screening MRI in June 2011. Found small tumor in other breast (<1cm).  Choose bmx with LD flap reconstruction.   Now I was 56 at the time.  this was a good choice for me.  I also choose no additional chemo or rad.  Now I have no feeling around my back (from the LD flap) no  feeling in the breasts. Now they do look good (Imust say) my plastic surgeon was great and she did a great job. They look natural. Just no feeling. It has been almost two years and it is much better. Let me say that the surgery wasn't that bad and the recovery was about 7 weeks. That was when I could lift enough to go back to work.  The drains were the worst and once they were out life was  good.  Good luck to you.

Tucker519

Hi all! Just wanted to give and update. I have decided to have a bilateral mastectomy. I feel like a huge weight has been lifted, now that I have decided. I will be having surgery on Monday. There is one more decision I am trying to make. I am to decided whether to have nipple sparing mastectomy or just do nipple reconstruction. Have any of you had the nipple sparing mastectomy? Any stories or advice would be appreciated.