Recurrence statistics lump vs mastectomy

marycal

Hi everyone,

As I'm agonizing over which type of surgery to do, I can't seem to find any consistency with recurrence statistics on mastectomy only vs. lumpectomy+radiation vs. mastectomy+radiation. I know there is a ton of information on these boards, but I don't feel like I'm getting anywhere.

I originally thought the recurrence rate after mastectomy was something like 2-3%, with the lump+rads around 5-7%. But every article or study I read has different numbers. I just read an article that said mastectomy recurrence could be up to 40%! Not to mention that I seem to be reading a lot of posts here of ladies with recurrences after MX. Obviously, those without a recurrence would likely not be posting, it still seems like a lot.

I know this also depends on the type of cancer/tumor/treatment/etc that one has, along with difference in lifestyle, along with no-one-really-knows-and-it's-in-large-part-a-crapshoot!! so I realize it's complicated to get a good solid picture. But does anyone know the best place to find this information? Is there any kind of prediction tool where you can plug in your particulars and get an estimation? (By the way, the only one I know that is kind of like this is the Predict Tool > http://predict.nhs.uk/ This doesn't take into consideration the type of surgery nor radiation though.)

Thank you!!

Maggieroe1

I also deliberated over this decision. My oncologist told me that he would recommend a lumpectomy for me, and quoted research which suggested the survival rate is not better after a mastectomy and recovery from a lumpectomy is much easier. I'm sure the recommendation was based upon the size and type of my tumour. I have since had 12 weekly sessions of Taxol and Herceptin, radiation, and am now on every three-week Herceptin until next September. If he had told me that my prognosis would have been better with a mastectomy, I would have gone with it. Good luck with your decision

Falconer

Marycal, I am not a doctor, so please take this as my opinion really; your health care team are the experts. As you and I have a similar Dx, though, I can say what my experience was. My RO (whom I completely trust) had suggested to my BS that I have a lumpectomy and rads instead of an MX. However, as I am only a 34B once my BS did the lumpectomy there wouldn't have been a lot of tissue left anyway. After the pathology came back I was glad I had as much tissue removed- I had microdermal invasion so it was a relief to know that the cancer cells growing there were out. The real work I'm doing for prevention of recurrence is adhering to the antihormonal plan, which I suspect will be your recommendation as well. Good luck as you decide.

Icietla

Hi marycal. I am so sorry about your diagnosis.

There is recurrence; there is local recurrence; there is distant recurrence; there is overall survival; and there is disease-free survival. Each is different, understand. If you look again at the Predict Tool, you will see that it predicts overall survival, not disease-free survival.

Many mastectomees have radiation treatment too, besides mastectomy surgery. They would be counted among those having mastectomy surgery.

The local recurrence rate is lower with mastectomy than with lumpectomy; however, overall survival is about the same.

See the section titled Lumpectomy: Advantages and disadvantages__

http://www.breastcancer.org/treatment/surgery/mast_vs_lump

Here is some BCO discussion content that may be helpful to your understanding__

https://community.breastcancer.org/forum/105/topics/812929?page=1

marycal

---

Thank you all for your replies!

Maggieroe1 - how are you faring after radiation? Any side effects?

Falconer - I'm about the same breast size as you and that's one of my concerns too. They wouldn't have found the microinvasion with lumpectomy?

Icietla - Thank you for posting that conversation. Very interesting reading indeed.