Surgery decision--lumpectomy vs mastectomy

foreverfaith

rokaw2000- Sorry you find yourself here. I know what a tough decision this is to make. It's the one situation where I would actually like for someone to tell me exactly what to do. haha

I'm 23 days post op lumpectomy. My surgeon and onco were both supportive of lumpectomy because my tumor measured pretty small, around 1 cm. I was still sore torn because we were pretty sure, by the path report, that the cancer was triple negative. But I wasn't ready to pull the trigger on a mastectomy and really wanted the thing out of my body. So, I opted for lumpectomy and figured if my genetic testing (BRCA) had positive results...well then I would just cross that bridge when I got there. Thankfully BRCA was negative!

Tumor was actually 2.8cm upon removal. Onco said if we have know that on imagine he would have started me on Chemo before surgery. But there was really no way of knowing. So, now we just move forward. Had my first AC Chemo yesterday. Holding up ok so far.

I know this is challenging and we become so cluttered with information overload. If you can, take a moment to push all the details aside and breathe deep. Clear your head and hopefully the right next move with come to your heart. I had to do that several times. All we can do is make one decision at a time and take one day at a time. Praying for clarity for you.

cookiegal

I have not gone through your whole thread, and yes every situation is individual. But research is pretty convincing on this one that lump/rads has a slightly better survival rate than mast no rads.

Also there are so many more complications with a mast than a lump.

buttonsmachine

One more thing regarding a mastectomy - I just want to point out that getting a mastectomy will NOT make it so you never need to deal with screening, biopsies, surgery, recurrence, etc., again. Many here have had a local recurrence after a mastectomy (including me), and indeed local recurrence rates are similar between mastectomy and lumpectomy with radiation.

These are fears that we all have to deal with, regardless of what surgery we choose. Just make sure you are informed about the data and you know what is motivating your surgery choice. All I'm saying is this: if your case allows you to choose between a lumpectomy/rads and a mastectomy, choose the surgery you really want, and the one that you are at peace with, and don't choose a surgery out of fear for what might happen in the future.

octogirl

I think the advice to choose the surgery you want without trying to guess the future is spot on. In my case, I was told by the doc who did the biopsy and original dx that I was probably not a candidate for lumpectomy because of the tumor location right below the nipple...but he was NOT a surgeon, and when I saw my breast surgeon (who I instantly had great rapport with) she explained how she could do a lumpectomy with nipple removal, and I instantly felt such relief that I knew I didn't want to go the mx route (had I needed to have the mx, I would not have done reconstruction by the way, and I am large chested). Recovery was easy and almost pain free, and I've never looked back or regretted my decision for one minute.

I had the 'Canadian protocol' for rads (17 higher dose treatments instead of 30 plus). Worth asking your radiologist about whether you are a candidate. Rads itself was completely painless and not even uncomfortable despite having to stay still. I did have skin breakage and irritation but it healed amazingly quickly (within a week or so) once I was done. As others have said, the worst part of rads for me was the drive there and back every weekday. For me it was 40 minutes each way (!) as I live in a rural area; this is a major reason I asked for the shorter protocol. (and by the way, my radiologist, while in a rural area, had a Stanford Hospital affiliation and asked the entire Stanford rads board to review the case to give an opinion on the shorter protocol. When they said yes, both the radiologist and I were confident with that choice). Anyway, back to the drive, I used the amount of driving as an 'excuse' to buy a new car..

The worst part of the entire process was chemo, which I would have had to have had regardless of type of surgery. And, if you are a candidate for Oncotype or a similar test, you won't know until after surgery whether you need chemo...so that won't likely factor into your decision one way or the other. I will also say that the screenings just haven't been that difficult for me.

I urge you to take a look at other threads on this board, including the Lumpectomy lounge, and some of the threads about MX and about reconstruction, before making a decision. It really is so personal to you. I am very glad I was given a choice and very glad to have made the choice I did. As others have said, this board is a great source of support no matter what you decide. I say talk to your surgeon and MO, do your research, weigh your alternatives, and then go with your gut, and then don't look back. Best wishes and best of luck to you.