Overwhelmed: Have to choose MX or Lumpectomy

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felka11
felka11 Member Posts: 5
edited June 2014 in IDC (Invasive Ductal Carcinoma)

I was diagnosed on 12/20/12 with IDC, grade 3, her2neu+ (I think, waiting for FSH confirmation. My BRC test was negative. I have two tumors in the same breast, very close together. Each one is just under 1cm.



My doctors have said that it is up to me, that there is no wrong choice, etc. A lumpectomy would remove an area of 5cm to get both masses. I would have reconstructive plastic surgery in either case: a lift (and I suppose reduction) on both sides in the lumpectomy scenario, a DIEP with follow up symmetry surgery for an MX.



I am not a candidate to keep my nipple, so I would be looking at a fake nipple with tattooing. I have E/DD cup size now; I would maybe be a B cup post-lumpectomy. Don't know about post-MX.



I have read the lists of questions to ask yourself and I have no idea. I feel I would have anxiety in the years to come with MRI and mammograms in the lumpectomy scenario, but that is partly coming from my illogical but deep suspicion that my chance of living a long and cancer free life is better with a MX. And yes, I have read that survivor rates are the same. But I can't shake the feeling anyways. Plus I'm under the impression that I will be getting MRI's and mammograms every six months for the rest of my life. I am 40 years old and it is my hope that the rest of my life will be a long long time.



I have been traveling since the day after I got my diagnosis so I haven't been able to go to support groups back home. I am lost, scared, and I don't know how the heck I am going to be able to make this decision.



Thoughts...?



Beth





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  • felka11
    felka11 Member Posts: 5
    edited January 2013

    PS my cancer is ER/PR negative.

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited January 2013

    If, after having time to think, you find that you really are not sure, then I'd suggest you go with the lumpectomy. With that you can change your mind later; but once your breasts are gone...they are gone forever. I chose a lumpectomy because it is a much less invasive surgery, has a much quicker recovery etc. Also, I like having breasts but knew, after talking to people who had done reconstruction and also by reading some of the reconstruction threads here, that I would not be willing to go through all the time/expense/pain/hassle/uncertain results etc. of reconstruction....so I'm glad having a lumpectomy was an option for me. Also, after the first two years, I am back to yearly mammograms....no MRIs.

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  • SeattleMama
    SeattleMama Member Posts: 147
    edited January 2013

    Beth, glad you found this board.  It took me awhile to find it and was so glad when I did.
    I am 42.  Top heavy as yourself.  I wasn't given the option because mine was so aggressive growing and even though I had neoadjuvent chemo, and shrunk the initial tumor and infected lymph nodes IN HALF, a new mass came up at the same time.  I am e,p neg and her2 positive.
    In the beginning, before all this, in your scenario I would have done the lumpectomy.
    Now, that I've been in this journey a few months, I do not have a second thought about the mastectomy.  I would not want to go back for another surgery.  I also didn't and wouldn't have done reconstruction (as Ruth mentioned, the time/expense/hassle), so if you are set on reconstruction, just my opinion, I would go ahead and do the mastectomy.

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  • Obxflygirl1
    Obxflygirl1 Member Posts: 377
    edited January 2013

    I had the same decision to make. For me, it came down to peace of mind. Never mind, the survival rate is the same....but I knew with a MX, I wouldn't worry about another breast cancer. I'm a worrier and I didn't take 2 seconds to make up my mind. I haven't looked back. Everyone is different and their experience with BC is unique. There's no one size , fits all answer. Research, talk to others and choose what feels right for you. We are lucky we had a choice.

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  • PeggySull
    PeggySull Member Posts: 686
    edited January 2013

    Felka, I am ER/PR negative and things are more complicated for us. There is a separate forum called triple negative on this site as well as a whole other on-line site called "tnbc foundation."



    One difference, for example, is that negatives often have chemotherapy before surgery. This is what my surgeon recommended and I am glad I am doing that. I now have more information about how chemo effects me and therefore how I might deal with a recurrence. It's also given me time to think about surgery and reconstruction options.



    There is also a blog called "positives about negatives." The author has written a book called Surviving Triple Negative Breast Cancer.



    All that being said there are multiple decisions we all have to make along each part of this breast cancer journey and almost all are anxiety provoking. Ask for some anxiety reducing medication (Ativan is short acting and also helps with nausea). Decisions made under extreme anxiety are often not the best in the long run.



    Hope some of this helps.



    Peggy



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  • Moderators
    Moderators Member Posts: 25,912
    edited January 2013

    Beth, the main Breastcancer.org site includes the article Mastectomy vs. Lumpectomy that walks through the decoding factors, and the advantages and disadvantages of each option.

    This awesome community willbe here to support you, whatever you decide.

    • The Mods

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited January 2013

    Beth - I had a preventive mx last Feb, that turned out not to be preventive. I know few women like to hear my story, but I had all the screening - mammos, ultrasounds, MRI's, thermograms, and nothing showed the 1.1 cm IDC. The main problem was the extreme density of my "original" breasts. I did reconstruction and it was TOUGH. I think the fact that I have really strong pec muscles worked against me. My PS is awesome.. She basically said I would just have to endure the pain. That was wise counsel. I had TEs for five months. The end result is great. I really like my new breasts. I'm glad I had it done. I have no nips, but that is OK with me. I'm also glad I had implants behind the pec muscles and what little breast tissue is left is right up front. The implants don't feel the same, but they feel OK, and I am so glad to be done with the heavy duty screening. (I just had my first annual post surgery MRI, no big deal). BTW , my husband was the one who basically insisted on the the recon, and I am so glad he did. His attitude about the recon really helps.

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