mastectomy vs lumpectomy

allinha321

Hi there,

i have been recently diagnosed with breast cancer (right breast), Grade I/II IDC, ER8, PR8, HER-2 negative, Ki-67 8-10%, DCIS probable extensive. Initially they found only 1 lump around 2.5cm but now it seems that there is another one around 1.5cm and some potentially pre-cancerous cells. Given extent of lumps, it seems like i have 2 options, do a lumpectomy (which will reduce my breast by at least 30%) or have a mastectomy with reconstruction. Also if i do lumpectomy first it does not mean that i won't need mastectomy later if more cancerous cells are found on edges; also they will need to reduce my other breast to match the right one or insert an implant to cover the bit that was cut out. I would really like to avoid mastectomy if i can being young and worried about the lack of sensitivity post reconstruction (as well as extensive reconstruction surgery) but given the extent of actual plus potential cancer, i wonder if it even makes sense to consider doing lumpectomy first?

Moderators

Hi allinha321,

Sending you a warm welcome to the community.

We're glad you found us and decided to reach out to others for support and information.

Surgery decisions are never easy and it's important to get as much information as you can before you make your decision.

Other members should be along soon but in the meantime you may find it helpful to read the links we've added here.

Mastectomy V's Lumpectomy

Surgery: What to Expect

Best wishes,

The Moderators.

Bootscootin

So glad you found us here. There is a wealth of experience from a group of wonderful folks. Sounds like you are leaning toward a lumpectomy. As several ladies have pointed out on these forums, if you have a lumpy first, you can always have a MX later. If you go ahead with MX, your breast is gone forever. I had a lumpectomy and then bilateral reduction from G to C and have been very happy. Only missed a week of work. Listen to your doctors, get a second opinion if needed, and do what feels right for you

ML1209

allinha - I was offered similar options. Just recently made the decision for a lumpectomy. My BS offered a lumpectomy with a minilift and may also have to place a prosthesis that will dissolve over the next year as the tissues fill in (he said he wouldn't know until he is there) or the lumpectomy with reduction. I didn't realize the second was even an option so wasn't prepared for that. Hard decisions to make. Right now I am leaning toward the lumpectomy with the minilift.

Bootscootin - would you mind sharing abt the lumpectomy and reduction? I am a c cup. I have heard radiation can make the breast smaller as well.

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Bootscootin

For some, radiation does make the breast smaller. My plastic surgeon left the cancer side a little larger to compensate for that and then it didn't shrink. It is not noticeable in a bra or in clothes. Have you had an appointment with a plastic surgeon? My breast surgeon recommended one and we talked about what he would be able to do. They were both in the OR when I had my surgery. I had very little pain and only took a week off from work. They told me I could drive as soon as I was off pain medicine but I didn't take anything stronger than Tylenol after I left the hospital. I had the surgery in the afternoon and went home the next morning. Let me know if you have any specific questions.

allinha321

Thank you very much to the Moderators for welcoming me and for other . I already read those articles before posting. My posting is slightly more specific as my overall cancer area is larger than in those posts. I wanted to understand if people considered lumpectomy where overall area was relatively large 30/40% of the beast. I also would not want to do breast reduction (esp to my healthy breast) esp since after lumpectomy it may be determined that i still have some cancer cells on the edges and still need a mastectomy (would like to avoid having to reduce breasts and still needing a mastectomy). ML1209 how did you find the option that was offered to you - a mini lift with prosthesis? Do you know if you may still need a reduction if, for example, prosthesis does not dissolve?

ML1209

Allinha321 - sorry I am so slow to respond. End of school year activities and sports have me hopping. Maybe a good thing - no time to focus on myself . My BSO offered that option to me- it is what he does. My understanding is that the tissues grow over this prosthesis as it dissolves and fills in the gaps. he says that a reduction after radiation is not easy to do so if I wanted a reduction it would need to happen now.

Bootscootin - My BS did offer for me to see a PS, but after talking with my MO, I decided I was at peace with the lumpectomy with mini-lift - so that is what I will be doing on 5/24. Thanks for sharing!

ML1209

Allinha321 - sorry I am so slow to respond. End of school year activities and sports have me hopping. Maybe a good thing - no time to focus on myself . My BSO offered that option to me- it is what he does. My understanding is that the tissues grow over this prosthesis as it dissolves and fills in the gaps. he says that a reduction after radiation is not easy to do so if I wanted a reduction it would need to happen now.

Bootscootin - My BS did offer for me to see a PS, but after talking with my MO, I decided I was at peace with the lumpectomy with mini-lift - so that is what I will be doing on 5/24. Thanks for sharing!

Bootscootin

ML...so glad that you are happy with your plan! I'll be thinking about you on the 24th. Check back in and let us know how you are doing