Young, have to choose between keeping it or not

AniAndLucas

Today I went together with my girlfriend to the hospital to discuss breast removal or a preserve operations. I got a little confused because a couple days a go my girlfriend went alone and she had a talk with the surgeon. She got advised by this person to remove the breast because of her young age and that she has to choose between keeping the breasts or not. When my girlfriend asked what the sergeon would do if it was her daughter, the sergeon said she would probably try to keep it. She said that she doesn't know what to choose for us and it's up to us to choose.

So today I went together with my girlfriend to get more detail on the subject. We went to the person that helps us through the whole journey. She told us a different story. She also couldn't make the choice for us but she said preserving the breast is a better option. Research has shown that there is no difference in outcome between the two. So better keep the breast because it would be easier. She said sergeons are quick in removing the breast because not that long ago it was standard to remove it at young age. But now breast cancer is really good to heal. So again she says she can't make the choice but it was pretty clear she prefers to preserve.

So today I was pretty happy because it was clearly the best option. Than I got home and did some more research on it and saw that the mortality of people with breast cancer is pretty high and that especially younger people with breast cancer have a higher risk that it can develop again.

So I don't know what to think anymore. What is true and what are the facts.

Is the risk that high to remove the breast?

Lula73

the numbers can be tricky. Bottom line is mx and lumpectomy + radiation have equivalent overall survival rates but mx has less risk of recurrence. Personally, I want that recurrence number to be as low as possible. I went with bilateral mastectomy and immediate DIEP flap reconstruction and have absolutely no regrets. I’d do it again in a heartbeat. With DIEP they basically take tissue from your tummy and create breast mounds out of it leaving you with soft warm natural looking and feeling breasts. Plus now I have a flat tummy! There are other areas they can use too. Here’s a a great resource for anyone facing these questions:

https://m.youtube.com/watch?v=yJnntB6Bn9c

NotVeryBrave

In most cases - it really is up to the patient to decide what they want. The survival statistics are very similar whether the breast is saved (lumpectomy and radiation) or removed (mastectomy).

Most doctors would not advise lumpectomy if the breast would end up being very disfigured - like if they have to remove a lot of breast tissue. And you are watched very closely afterwards with frequent mammograms.

Younger women often have more aggressive cancers and it's true that there are many more years for a recurrence to happen. I was 50 when diagnosed and that did play into my reasoning. If I had been 70 or 80, I probably would've chosen differently.

What does your girlfriend think? Is she leaning one way or the other? It's good to get the facts but also listen to your heart.

oxygen18

Is she being referred for genetic testing?

Kiso20

Ani as the others have mentions it is up to the patient to make the final decision. In my case I was very much against radiation as the complications for future reconstructions and possible secondary cancers are high. I did also do a genetic testing and all my genes were negative for mutation. This did have an impact on my decision. I am 32 not married so the choice was very hard but I chose to have a mastectomy on the affected side with reconstruction. I’m happy with the decision and although I had the surgery a few days ago and it’s very uncomfortable and very painful, I know with time it will get better and it was the right choice for me.

This is a tough decision and the hardest I had to make but as one of the doctors put it, lumpectomy is a quick recovery but also a short term solution but mastectomy is a longer recovery but also a long term solution. Hope this helps.

WC3

AniandLucas:

I saw all three surgeons before my path report was back.

The first one said it was entirely up to me whether I do a mastectomy or lumpectomy.

The second one said she would do either but recommended a mastectomy because of the size of the tumor vs. the size of my breast.

The third thought I could get away with a lumpectomy if I do radiation. After my path report came back the oncologist said that if I did a lumpectomy I would definately need radiation.

I meet with the surgeon I went with again in a few days and I don't know what she will recommend now that all of my receptor typing is back and I have undergone chemotherapy but my cancer has a high local recurrance rate with lumpectomy.

buttonsmachine

AniAndLucas, if your girlfriend is very young at diagnosis, I would get an opinion from an NCI designated cancer center if you haven't already. See: https://www.cancer.gov/research/nci-role/cancer-centers/find

In my experience, BC in young women often behaves differently, and really needs expert care. I was diagnosed at age 32 - the local doctors (who were supposedly good in my area) treated my BC like it was ordinary. My BC was anything but ordinary, and it wasn't until I transferred my care to an NCI hospital that they got it under control.

I only mention this because in the beginning we, as patients, don't know any better and we trust our doctors. I hope that my experience can at least help to warn other young women about this.

As for lumpectomy vs mastectomy - it is such a personal decision. In the absence of a clear medical reason to do one or the other, it often is up to the patient. I would tell your girlfriend to look deep within herself, take time to consider it, and choose the surgery she feels most at peace with. Best wishes to you both.

Hopeday

i am in similar case with you.

After target and chemo therapy, petscan shows it is close to Pcr: the original 3cm tumor shrink into 1 cm flat residue so I was offered either lumpectomy or MX. Or lumpectomy with frozen section test first, MX if such test failed.

I was informed the difference is mainly local reoccurrence. I hate extra surgery (and chemo most) but conserving breast is definitely an advantage.

And if local reoccurrence happen a few years after lumpectomy, do I have to go through chemotherapy again.

I really don't know what to choose.