Surgery options

Bray02

I have been diagnosed with TNG Invasive ductal cancer. I am currently undergoing chemo and have 12 treatment to go before having surgery. everything I have read suggests recurrence is higher risk more so outside. Obviously that doesn't help when making decision for local recurrence and which option to do. Brca gene is neg though did have a undefined mutation which doesn't do much for the now. No family history. Lymphnodes were negative. Tumor was just over 2cm. Curious which option and factors taken into account by others with TNG cancer

Moderators

Dear Bray, we're sorry you had to join us, but glad you found our Community! We hope you find support and information here along with your medical team that helps you make the best decisions on surgery and treatment. We know sometimes it's not easy, but we're all here for you!

In addition to our forums, you may like to read up on our main site content about the Triple-Negative Breast Cancer.

Hope this helps! Looking forward to hearing more form you soon.

The Mods

MountainMia

Hi Bray. None of us can give you recommendations but we can tell you a bit about our experiences.

You didn't share details of your diagnosis like tumor size, apparent lymph involvement, etc. I assume you're doing chemo before surgery because your tumor was larger. What surgery you pick might depend on how good of a response you get from the chemo. If you have a pathologic complete response (pCR, or the tumor is essentially gone,) you have more options than if not.

My IDC was 1.5cm, and I also had DCIS of about 3cm. I didn't have neoadjuvant (pre-surgery) chemo. I had surgery first. I chose a lumpectomy, chemo, then radiation. For me, that was the right choice.

If you have a lumpectomy, you will have radiation. Having a mastectomy doesn't necessarily keep you from needing radiation, too. That depends on a lot of other things. Lumpectomy, though, is simpler surgery and for me gave an easy recovery. The radiation, also, was fairly easy for me.

There are a lot of different factors to consider in choosing surgery. With 12 more chemo cycles to go, you have some time to make that decision. Good luck.

Bray02

I know no recommendations. Just curious about others experience. My tumor was little over 2cm. The lymphnod were neg. I'm just more concerned with recurrence and limiting my chances there. The Dr currently is hoping for lumpectomy. But as you say time will tell. I've had two friends who each did different surgeries. One regretted her decision the other just went with it. So I was just curious what factors played a role when ultimate deciding. Followed dr recommendation or kind of doing what you felt was right.

MountainMia

If recurrence is your primary concern, my understanding is that lumpectomy + radiation is equivalent to mastectomy, in terms of statistical probability of recurrence. If the doctor is hoping for lumpectomy, that is a good sign of not expecting other problems to come up.

So, what factors go into deciding? What's most important to you?

• recurrence risk
• ease and time of recovery from the surgery itself
• your pain threshold
• after surgery aesthetics (how do your breasts look)
• total time span of treatment -- mastectomy with reconstruction will take much longer, and if it crosses multiple years, can make you pay more in out-of-pocket, etc
• what else is going on in your life, family, jobs, hobbies, etc

I never actually saw any list like this. If anyone else commenting has seen such a list, maybe recreate or link it, or just add items in your comments.

Maryjv

another thing to consider is future scans...I am 35 and I worry and stress very easily so I knew since diagnosis BMX was my plan! Now I don’t have to worry about breast scan anxiety...but like everyone mentioned you have to consider so many factors when choosing your plan of action! I love your list mountain mia

NorCalS

Hi Bray02.

I had neoadjuvant chemo, surgery, radiation, then Xeloda. My initial tumor was large and spread to lymph nodes (stage IIIc officially), so neoadjuvant chemo was necessary and recommended before surgery. Based on the MRI taken before surgery, the chemo seemed to have worked well (there was no evidence of disease in the images). So for me, lumpectomy was the way to go at the time of surgery because MRI result was so positive. We were hoping for a PCR after surgery, but the pathology report showed some cancer in the tumor bed and one sentinel node with cancer. Since I did not get a PCR, I had additional oral chemo to reduce the risk of recurrence. The recovery from lumpectomy surgery was very easy for me. I was able to cook dinner after I left the hospital.

Another consideration for lumpectomy was the location of the tumor. My tumor was near the left armpit, so the surgeon believed (and she was right), the lumpectomy would not make a difference in appearance. So far, with the exception of the surgery scars, the left breast looks the same as before surgery