Just diagnosed - lumpectomy or mastectomy?? Please help!

joanie63

I was diagnosed with IDC in the left breast. It doesn't appear to be in the lymph nodes but won't know until the surgery. I was considering the lumpectomy then found out I was ER-/PR-. Still waiting on the HER2. My surgery date is set already for May 27th. My surgeon said the decision's up to me; a lumpectomy with radiation or a mastectomy. I'd prefer a lumpectomy, but not if the chance of recurrence is much greater. Any advice would be greatly appreciated. Thank you!

ruthbru

Unless there is a genetic component involved, your chance of recurrence is the same either way. I had a lumpectomy and am very, very, very glad that was an option for me. I think it would have been hard to go flat, but the more I've read about reconstruction, the more I think I couldn't have gone through all the additional surgeries, hassles, pain, possible side effects, uncertain results that it often brings. 

windgirl

hi Joanie, someone posted a great list of considerations when deciding between the two, I'm not sure how to link it but if you do a search for lumpectomy or mastectomy it should come up.

I did lumpectomy and radiation (I tested negative for gene test). The risk of recurrence on the same breast is the same with lumpectomy plus radiation and mastectomy. However I was lucky (after the fact) that I was able to get radiation without scaring my lung or heart. Some people choose mastectomy to avoid radiation and end up having to get it anyway. And then thee are others who prefer a double mastectomy to mentally feel safer or because they test positive for the gene. Once you get more facts on he type of your cancer and whether you carry the gene (which would necessitate bmx), I would recommend that you ask your doctor if you can really avoid radiation with mastectomy. And if you get radiation whether you can avoid collateral damage. I got radiation in the prone position so it worked for me. However radiation did cause some mild lymphedema.

The tissue removed was quite big and even after radiation, you cannot tell other than a faint scar that anything was done to my breast. I'm younger than most so this was important for me. Overall I am happy with my decision. Good luck with whatever you decide and pm me if you have any question

joanie63

Thanks for replying so quickly. By genetics do you mean if it runs in the family? On my mothers side she had 9 sisters, no one has had breast cancer. I haven"t had a gene test.

windgirl

also, my understanding is that now they do chemo before surgery for hormone negatives or her2 positives. I am triple positive and did chemo before surgery. That way you can see how the cancer responds to the treatment. Also it shrinks the tumor so lumpectomy becomes easier (for me my tumor originally was too big for a lumpectomy bit shrank with chemo which made it possible. So if you have only seen a surgeon at this point I would highly recommend discussing this with your surgeon or an oncologist

windgirl

there is a test done to see if you carry cancer genes, Angelina Jolie test is how my surgeon called it I got it done because I have family history. If you don't have family history you probably don't need it but still won't hurt to ask

joanie63

Thanks for that information. I have a lot to learn about all of this!

Weolf

windgirl, I didn't realize radiation caused lymphedema, will yours clear up at some point because it's mild?

I'm scheduled for a lumpectomy- removal of two lumps- with radiation to follow (and possibly chemo). I have been going back and forth myself with the decision, and finally decided this course for now at lease. I'm stage 1, small tumor, grade 3, with no genetics and my doc is really positive about the lump surgery, but it's been a tough decision!

windgirl

hi Weolf,

Good luck with the surgery, it is really easy to recover from based on my experience and hope the same with you. I think my lymphedema is here to stay unless my body miraculously creates new pathways. However because it is mild it does not swell too much, and when it does it takes a few days but goes down on its own for the most part. Radiation damages the tissue so if it happens to damage the nodes in a way to affect smooth circulation I think it's possibly to end up where I am. Its luck really. Key is that if you notice swelling take precautions and don't let it get worse. I wish you the best with surgery and radiation, both were easy for me compared to chemo

ruthbru

Lymphedema is mostly (bad) luck. It depends on how your body handles trauma, so can be caused by surgery (so I imagine the more the extensive the surgery, the more risk of developing it that way....if you are prone to it), lymph node dissection,radiation etc .People without BC can also develop lymphedema from other surgeries, accidents, blows to the chest or other parts of the body (which I never knew before all this and is pretty scary). Yes, I agree windgirl, surgery and rads were a piece of cake for me compared to chemo.