Can't decide which surgery

Suebak:

Deciding on which type of surgery is a very, very personal decision.  When I was DX in August I had ILC which has a tendency to be bilateral so it made the decision easier for me. Also, I have 2 tumors so a lumpectomy was out of the question.  I decided on a DMX and never looked back.  I went with the implants which I just got 2 weeks ago. So far, doing well. You also need to get the whole picture of your cancer. How big is the tumor, are you ER/PR positive, will you need rads or chemo, are you a candidate for oncotype test?

All these weigh in your decision.

Good luck

Jan

I agree, it's a very personal decision. I was one with a small tumor (1.8cm) and opted for a double mastectomy based off family history, my profile tells the story.

My decision I feel was right for me. I think you need to research the heck out of it and decide which option you feel is right for you. Even my breast surgeon wouldn't tell me what he thought I should do. I think that's what made it the hardest. I would've almost preferred someone TELL me what to do. Now that I look back I am very happy with my decision I made at the time, I wouldn't have been happy any other way.

Good luck and sorry you had to join us.

suebak I did not see an oncologist till 2 weeks after my surgery. Some folks do chemo first but that depends on lots of factors (larger tumor, spread to other organs etc.) In that case you would need to see an onc before surgery.

As far as what to do I think you need to get more information from your BS. At least you know that lumpectomy is an option (I didn't have that option). Ask about the pros and cons of both. I don't know your age but if you are younger (under 50, under 30) this also should be discussed.

Hang in there. The beginning is the worst part. 

It is such as personal choice. I had a lumpectomy and am very, very glad that I went that way. It was the least invasive option, and allowed me to get back into my life with no future surgeries (yes, I had radiation, but having a mastectomy does NOT guarantee that you won't have radiation either). I don't think I would be happy with no breasts, and yet when I read all the potential problems with reconstruction....not to mention the additional surgeries, recovery time etc....I don't know if I could deal with that either. A a friend of mine who is a surgical nurse and 30 year breast cancer survivor (mastectomy with delayed reconstruction), so she knows breast cancer from both sides of the operating table, gave me this advice without a blink of an eye, "If they give you the choice, have the lumpectomy!" Best of Luck! Ruth

edited to add: if you have a lumpectomy and change your mind, you can always have a mastectomy later. But once your breasts are gone....they're gone. If you are truely undecided, I would go for the lumpectomy.

Absolutely.

suebak I have read similar posts of women with children having concerns about not being able to hold them. Not  crazy at all. You might not be able to do as much but you would be surprised. I had my surgery late on Tuesday and by Saturday I was going out to dinner. A week later I was getting my hair washed and styled at the hair dressers. (because of course I couldn't do it myself). I was more tired though.

Just remember that this down time is not forever. It actually goes fast. Life always throws us some inconveniences but we make it through. You need to do what's best for your long term health. That's the most important for you and your family.

I am sorry you joined the club but at least you have a wonderful group of ladies to support you. I would fully understand the recurrence rates for both MX and lump+ rads..  Also completely understand the survival rates for both and compare them.  I too am pre menopausal and am only 45 so for me I chose BLMX with no regret.  I am also doing reconstruction and am looking forward to my permanent implants (hopefully in June!).  I also know that you can make the decisions you think are right, but sometimes during the process the diagnosis changes a bit.  I had a lumpectomy (eventhough I was already going to do BLMX - my doc saw the tumor when I had my sentinel nodes removed and just decided to remove it and get the final pathology).  Once I got the pathology from the lumpectomy, my grade on the tumor was graded up from grade 1 to grade 2.  I had the mastectomy and then there was another area small area of invasive cancer found.  I did not know that until 2 weeks after the mastectomy.  I am glad I had a BLMX.  It was the right decision for me.  So I guess all I am saying is be prepared as some things change after the surgeries as more information becomes available.  This is very much a personal choice and what is right for one person is not right for another.  You need to decide what is the right thing for you personally and feel ok with your decision.  As far as the follow up treatment, many medical oncologists won't even meet with you until after your surgery so you still may not even know if additional treatment will be needed.  I wanted to know before so I pushed for appointments and it was hard to get them.  Depending on your diagnosis, you may even want to read about oncotype score tests. It will help determine how much of a risk your specific tumor is of coming back.  Not all patients qualify for the test...there are certain perameters.  I can tell you that I had lumpectomy/SNB, BLMX and now am half way through chemo and it has been easier in some ways than I ever thought it would be.  Best of luck to you...hugs too!

Has your surgeon mentioned doing an MRI prior to surgery to be sure a lumpectomy is all that is required? 

After my MRI, additional things were found and unilateral mastectomy was required; I was glad to know that BEFORE a lumpectomy with "dirty margins" and having to go back in for more tissue was necessary.

It's a very personal decision, and of course making a decision is a timely thing, but don't let yourself be rushed to the point that you don't have time to read & research your options.  

Do you have a copy of your biopsy pathology report?  Do you know the grade of your IDC?  Is it ER/PR+ or -, HER2 - or +?  These things factor into decisions as well, with family history and an undetermined BRCA test many women decide for unilateral or bilateral mastectomy, it just depends.  But the MRI gives a lot of helpful information oftentimes in addition to the mammograms. 

BTW even if you do an MRI you may not get the full story. Some people end up with a smaller tumor, some larger and some find additional tumors.

The latter happened to my neighbor. She went in for a lumpectomy but the BS found more once he got in. He didn't have permission to do an MX so he had to close her up. The following week she had the MX. This might be something to discuss if you decide lumpectomy. I'm sure this isn't common but you don't want to have to go under twice if not necessary.

Suebak, I understand about not being able to hold your grandkids, that was a big worry for me. I have a grandbaby that was only 10 months old at the time of my BMX and that was probley the worst part, but my daughter would put her on my lap or beside me so I got thur that part ok. I picked her up on week 4 after my surgery and did alright. If you look at my profile you will see my story , I wish my lumpectory had worked out but it wasnt meant to be. I am doing ok with the BMX. But everyone must make there own decision. Good luck on whatever you decide. Remember to take one day at a time, Things will get easier. HUGS to you.

Nancy

Suebak, reading your post sounded so familiar!  When I had my biopsy just a couple of months ago I was told there was only about 20%  chance it would be anything to worry about...... so when I went for my results a week later & was told I had cancer, I was in such shock!  Then the doctor basically said that I was a good candidate for either a lumpectomy or a mastectomy.  And she said to let her know what I decided.  Huh?!?!!!

 I had no idea how to make that kind of a decision!  I was numb for days, then realizing I had to make some kind of decision, I called my gynecologist (who told me to go with my gut), and I made an appt with an oncologist for a consulation -- just to get some info.

  After much research & thinking things through best as I could, I decided that I would go with the mastectomy. Personally,  I didn't want to take the chance of having a lumpectomy and then later having to go back in for more surgery.

 As it turns out, for me, this did turn out to be the best decision.  The surgical report came back that not only did I have invasive ductal, but DCIS & LCIS as well.  I just found breastcancer.org a few days ago.  Wish I had found it sooner!

You've made your decision based on the knowledge you have thus far so it's the right decision.  Things may change and so do decisions but you don't have a crystal ball and have done the best you can.  Good luck with your surgery.

Gentle hugs.

Right before I made my decision on whether to have a lumpectomy or mastectomy someone told me to remember 2 things:

 A - You are not Alone

B - Don't look Back once you have made your decision.