Lumpectomy

Boxingmama

My cancer was diagnosed last Monday and my surgeon heavily recommends a lumpectomy. I'm worried that if the post biopsy surgery shows more cancer I will have made the wrong choice. Very small tumor around 3-5 mm. Nothing showing in mri but who knows??

Beesie

A larger tumor doesn't mean that a mastectomy is necessary or better.

The size of the tumor plays into the lumpectomy vs. mastectomy decision only when the tumor is too large to remove with a lumpectomy, in which case a mastectomy is medically required. Otherwise, regardless of the tumor size, from the standpoint of metastastic risk, a lumpectomy + radiation is equal to or better than a mastectomy.

Local recurrence risk is different, but here there are many factors that can increase or decrease risk after a lumpectomy and even after a MX. In most cases the risk will likely be higher after a lumpectomy + rads, but with good surgical margins, the difference may be quite small, particularly after rads and anti-hormone therapy.

With a lumpectomy, you have the benefit of knowing the pathology results before you move on to rads. At that point, if there are any big surprises, you could opt for a MX. After a MX, there obviously is no going back.

With a 3mm - 5mm tumor, your tumor would have to significantly larger (eg. 10 times the size) before a mastectomy would be considered medically required. Of course there are many non-medical reasons why some patients choose to have a MX. That's a whole different discussion.

BCat40

As Beesie said, if the pathology shows something surprising you can always go back. If they don't get clean margins they will most likely require you to go back anyway. With a tumor that small they can also most likely go back for a re-excision without having to upgrade to a mastectomy. It would still always be your choice to "upgrade."

AliceBastable

Mine was around 2 cm and I had a lumpectomy. I had margin problems on one edge and had to have a re-excision, which was such a simple procedure.

farmgirl888

I had a lumpectomy done on a small tumor three weeks ago at UCSF with IORT. IORT (Interoperative Radiation Treatment) is a one time radiation done to the tumor cavity after removal while you are on the table. You may be a very good candidate for it, as your tumor is small and most likely early stage. Nothing showed in my MRI either. The advantage is that you don't have to go through weeks of radiation treatment. Like Beesie said you can always go back for a MX later. Best wishes.