HELP!!! Another Lumpectomy vs Mastectomy

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believe-recieve
believe-recieve Member Posts: 1
edited June 2014 in Stage III Breast Cancer

Im 48. Was diagnosed on 3/9/10 with Stage 3a, Grade 3, 6/10 nodes positive. I had 1.2 cm. tumor removed from my left breast with IDC At my post-surgical appt. the surgeon recommended I undergo a mastectomy. Was told I had extensive DCIS which spanned 5 cm(2 1/2 in). and extended to 4 margins. Therefore, I had 4 unclear margins. Was told since the depth was 5 cm my breast may look unproportionate and a slim chance to get clear margins if a 2nd lumpectomy were done.

When I went for a 2nd opinion, the surgeon told me he would do a 2nd lumpectomy(excision) to try for clear margins. I was told since my breast are 36c it could be done and if the margins weren't clear the with the 2nd lumpectomy I should consider mastectomy. Wonder if they have my best interest. Was told reoccurrence with that breast wasn't the concern. The concern is spreading. 

Has anyone had this encounter. I don't know if I should have a 2nd lumpectomy(excision) or mastectomy. I wonder if I have a another excision what are the chances of reoccurrence in that breast? Is reoccurrence less with a mastectomy? Are 2nd lumpectomies very common? If so, are the long term results usually good?  Does having extensive DCIS, Stage 3, Grade 3 mean odds are worse for reoccurrence with that breast? 

Please help if you can since I gotta make a decision!!  Thanks 

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  • lexislove
    lexislove Member Posts: 2,645
    edited April 2010

    If you have a mastectomy, your chances of local recurence is less than a lumpectomy. It's around 1-10%, depending where you read.

    If you want to know, what I would do...if in your situation/scenario? I'd do the mastectomy.

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  • maryannecb
    maryannecb Member Posts: 1,453
    edited April 2010

    The overall survival many years out is the same....neither is shown to prolong your life....BUT ...with a lumpectomy the chance of local recurrence requiring a mastectomy and perhaps more chemo is higher.

    If you can't bear the thought of losing your breast...a lumpectomy is the best choice and you may avoid the mastectomy all together.

    If you can't bear the thought of doing all this treatment again which may include a mastectomy and more chemo a few years down the road then a mastectomy is your best choice.

    Neither is "better", it is what is acceptable to you that is most important.

    Caution>>>>it is pretty distressing to go back to squre one for those that have done the lumpectomy and not got away with it....however for some losng their breast is pretty distressing too..

    Hope this helps....I had a large tumor in a small breast and did not want to do neoadjuvant so had a mastectomy.

    Good Luck with your decision and your treatment.

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  • pupfoster1
    pupfoster1 Member Posts: 1,484
    edited April 2010

    Tough spot to be in for sure.  I have a friend who's doc went back in 3 times doing lumpectomies to get clear margins.  My understanding this is unusual, that most docs will stop after 2 and recommend a mx.  Throwing the DCIS into the scenario, like lexislove, if it were me, I'd do the mx.  Ultimately that is what I did as they found multicentric disease in my right breast and were inconclusive about my left side.  I knew I'd worry nonstop about the left side so I opted for a propholactic mx of that side.  They found LCIS there.  Lillie Shockney the head of the Breast Center and the Coach on this web site read me my pathology report at Johns Hopkins and she said I did the right thing by removing the left too.

    Hope this doesn't make things more confusing for you.  Ultimately YOU are the one living with the result so YOU must make the decision you can be at peace with.

    Take care,

    Sharon

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  • CindyJ123
    CindyJ123 Member Posts: 5
    edited April 2010

    My story is almost exactly yours.I am also 48 years old,large lump,nodes etc. and had a lumpectomy.The pathology report is what you need to look at.Please find a good Oncoligist asap and let him/her help you with this decision.My surgeon wanted to go back in to SAVE my breast but suggested I see a oncologist first,I followed her advice and the oncologist took one look at the report and told me there was no breast to save,to much cancer.I am happy I saw the Oncoligist I feel I made a educated decision.Best of Luck.

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  • weesa
    weesa Member Posts: 707
    edited April 2010

    Can just tell you what it meant to me to have a mastectomy after two lumpectomies without clean margins.I had a large idc about 5 cm that had eluded annual mammograms=, so the surgeon had a hard time seeing where to cut, and kept coming up with dirty margins. Finally I insisted upon a mastectomy, and the pathologist found underneath the idc was some ilc that nobody knew was there. If I had just gotten clean margins after the second lumpectomy I would still be walking around with ilc.

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