Trouble deciding between lumpectomy and mastectomy

laney64

Hello,

I'm really having trouble deciding upon a lumpectomy and mastectomy.  I was all set to have a lumpectomy when it was thought that the mass (while on chemo) had migrated about 4cm.  The mass in the original placement could not be seen on ultrasound but the smaller mass was seen.  An MRI was ordered and the surgeon wanted a clip placed in the new location.  When I went to have the clip placed, the Dr at the mammography clinic said that the MRI showed that the tumor did not move, and it's over 50% reduced.  She felt that the new spot was a cyst.  Rather than placing a clip, they drained the cyst.

This has really shaken my confidence as to what else is there in my breast lurking but unidentified.  The cyst is what had been palpitated in my bi-weekly exams. I can't really feel the original lump. I can feel some thickening.  I've been unable to speak with my oncologist since all this has happened because she is currently on vacation.  This week, I will have my 9th weekly taxol treatment out of 12 and am disappointed in my response.  I'm really hung up on the size of the tumor. During the original ultrasound it was 1.7 cm, but after the biopsy it measured at 4.9cm on the MRI.  My oncologist felt that this was due to the swelling and bleeding from the biopsy and that they were going with the original size.  However, the doctor who drained the cyst said that the tumor was now measuring a little over 2 cm.  This is still larger than the original ultrasound size.  She said that they had to measure the new MRI against the old MRI.

I only have 4 more taxol treatments left and am feeling discouraged that I will not be getting a PCR.  Also, I still feel pain sometimes in the breast which would it mean that the cancer is still alive.

If one is not going to get a PCR, would it be better to have a mastectomy so that nothing is left over even if clean margins are obtained.  I believe that I will still have radiation if I have a mastectmory

Also, have many of you had additional chemo after surgery if a PCR was not achieved.

I'm getting more and more anxious the closer I get to the end of chemo.

Thanks,

Lisa

claireship1

I only had a small reduction in tumour during chemo. I had a lumpectomy after chemo and they didnt achieve clear margins so I then had a mastectomy. There was no discussion of further chemo and they just went ahead with the radiotherapy as originally planned. The breast they removed had a lot of cancer in it and I had cancer in 4 of the mymph nodes that they removed during clearance.

A friend had a lumpectomy and then radio therapy and she and I are both still okay (our surgery/radiotherapy was 2010). I do identify with that panicky feeling towards the end of chemo before surgery, wanting it all gone, but don't make any hasty decisions before having a good talk with the onco.

I went on to have the other breast removed as I did not want reconstruction and they examined that and found no cancer. Subsequently I have been told that this has greatly reduced my chances of recurrence but I have also had 2 years of tamoxifen and am now having hormonal treatment.

laney64

Thanks Claire for your response.  I am guessing that you are not triple negative as you are on hormonal therapy.  Is your friend TN?  And did she have any cancer in the lymph nodes?

Thanks,

Lisa

addisonse

I say go with the MX. You don't k ow what's lurking in there and I'm assuming you don't want to deal with this again. Just get rid of them! I was IIA. 3cm, grade 3, no nodes. Did AC (pregnant), Double MX (pregnant), and taxol (postpartum). Radiation after all chemo.

Luah

Lisa: Unless you are BRCA+, your TN status and response to chemo probably has very little bearing on the surgical choice, though it may affect whether they want to give you more chemo afterwards. In any case, I hope you have been able to get some good information from your oncologist and breast surgeon to make an informed decision that feels right for you. That is the most important thing of all.