Some results but still waiting...

Texasmamabear

I have a bit of an update about my diagnosis. My Breast Surgeon was excellent and explained most everything very well. The tumor is 1cm, grade 2, stage 1. I know I'm ER+ PR+ and HER- so I'm told I won't need Chemotherapy, which is great news. K167 is 27. I do need to decide on either a lumpectomy with reduction and lift or total mastectomy with reconstruction. The. There will be 4-6 weeks of radiation. I met with a plastic surgeon today who further explained these options and also opened my eyes to the damage that radiation will cause. I have fibromyalgia so inflammation is a big consideration. But, I really need to know my BRCA and MRI results before I can truly decide. The lab seems to have misplaced my blood sample so I may have to do the BRCA test over so we lost a week there.

My gut is leaning towards mastectomy with reconstruction using my tummy skin and tissue. I cannot do implants with fibromyalgia.

What helped you decide which path to take?

This journey isn't for the faint of heart! But I'm so glad to be here with your amazing support.

Beesie

Texasmamabear, this thread may help you with the surgery decision:

Topic: Considerations: Lumpectomy w/Rads vs. UMX vs. BMX https://community.breastcancer.org/forum/91/topics...

As for chemo, that's not the surgeon's decision. Surgeons operate. Medical Oncologists are responsible for everything else. With a 1cm ER+, HER2- cancer, it's likely that your Medical Oncologist will order an Oncotype test. This is a test that analyses 21 genes within the cancer cell itself. While an early stage ER+ / HER2- diagnosis more often doesn't require chemo, if the Oncotype score is high, reflecting an aggressive genetic make-up of the cancer cells, the MO will recommend chemo. Hopefully not, but with just biopsy results and no Oncotype score yet (I assume that the Oncotype test was not run on your biopsy tissue), it's too early to know.

moth

I'm glad things are progressing & you're getting a clearer picture.

I get irked at surgeons telling people they will not need chemo. It sets some many people up for disappointment later. As Beesie said, the medical oncologist will be making that recommendation after surgery and the final pathology report & Oncotype come in. Also, staging isn't final till after surgery - the sizing of the tumor can be off from imaging.

I went for a lumpectomy because that's what my surgeon recommended. Studies since have shown that not only is lumpectomy + rads is not inferior to mastectomy, some studies show it results in *better* OS (overall survival). It continues to be an area of debate but IMO a smaller less invasive surgery is preferred if possible. A plain lumpectomy is day surgery here. It really was easy peasy. A mastectomy can be done as outpatient as well but there are drains involved and significantly more pain and down time compared to an uncomplicated lumpectomy.

oh & yes, if you have a mastectomy & clear lymph nodes, you could avoid radiation. But if the nodes are not clear, you'd still need rads even with a mastectomy.