masectomy vs. lumpectomy

Here is an article regarding this study, with comments by the doctor involved:

http://health.usnews.com/health-news/news/articles/2013/01/28/for-early-cancer-lumpectomy-beats-mastectomy-for-survival-study

This study does not take into account the general health of the patients involved, or what factors drove the surgical decision.  It also combines stage 1 and 2 together, when there is a difference between the two stages in regards to nodal status.

You posted this in the Her2neu forum - are you Her2+?  One of the reasons I chose bi-lateral mastectomy was because of the aggressiveness of Her2+ breast cancer.

girlstrong - I am not quite to my 3-year point yet, I was diagnosed at the end of September, but did not have surgery until Nov. 1.  At that time they discovered a positive SNB, so I had ALND where another, much larger, positive node was found. and that surgery was in Dec. of 2010.  I count from there because that is when the last known cancer was removed.  Are you having rads because of the location of your tumor, or is it just a generalized recommendation?  I asked both my BS and MO each twice and both felt that I did not require rads - possibly because of the BMX and ALND.  I was actually a lumpectomy candidate who self-elected BMX, I am glad that I did because I had undiagnosed ADH and ALH in the non-cancer breast.  I had some recon issues, as you can see by my sig line, but I have no regrets.  My personal feeling was that since mammography failed to see my 2cm mass, I could not trust it going forward - MRI failed to see my positive nodes, and my breasts had proven they knew how to make cancer, so I wanted a BMX to help eliminate future risk.  On the other hand, some people feel that they will do the lumpectomy first, and that they can always opt for a MX/BMX down the road, but you can't undo a BMX if you have regrets.

Here is some additional food for thought.  Check the post with the links by Beesie - post is June 22nd at 1:41 p.m.  Also check the post by Beesie again on June 20th at noon for an excellent dissertation on the lunmpectomy versus mastectomy discussion:

http://community.breastcancer.org/forum/5/topic/806541?page=1#post_3600791

http://community.breastcancer.org/forum/91/topic/806452?page=1#post_3598134

girlstrong - I had a pre-chemo PET scan, but it was done after BMX with TE.  I had a pre-surgical mammogram, ultrasound, bone density (not a bone scan) and MRI.  The PET was done because of the Her2+ and positive nodes (which were unexpected, since they had not been apparent on any imaging) for staging purposes.  I also had a post-Herceptin PET, and then one done about 8 months ago.  Scans and tumor markers are something that seem to be specific to your oncologist - I happen to have one who does both, but I know others who are similar stage and their docs don't do either.  This is a question that should be asked at the beginning of treatment, or when you are doing consults - how will I be followed?  There are a lot of people who are frustrated because they have non-scanning docs.

girlstrong - the reason I mentioned asking about the methods for following is that often we are so consumed with getting the treatment plan in place at the beginning that we are not at all focused on what will happen at the end of active treatment.  I have seen many on this site who wish they had docs who scanned and did markers - these folks seem to be more nervous going forward after treatment feeling they are not "being watched" as closely as they would like.  It also goes to the argument over whether to look for recurrence or mets, or wait until you experience symptoms.  It seems that oncs fall into those two schools of thought and it is important to determine which kind of doctor you want to end up with just so you know what to expect.

girlstrong - excellent!  Good luck!

Girlstrong,

There was a very good article published in the Journal of Clinical Oncology which concluded that post-treatment blood marker, liver function etc. testing was NOT recommended.  The sad truth is that, once our cancer has metastasized, how early it is detected has no relation to either treatment or survival.  This is a situation when the standard mantra of "the earlier the better" is not correct.  The article stated that many of the tests given by oncologists were inconclusive and/or even false-positives for metastasis, false results which led inevitably to unnecessary surgeries, pain and considerable emotional stress.  Journal of Clinical Oncology, Vol 21, No 9S (May 1 Supplement), 2003: Doc, Shouldn't We Be Getting Some Tests?   If this is outdated, I'd appreciate learning where I can find the new material.  Thanks!