Need help to make a treatment choice

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nybc2013
nybc2013 Member Posts: 13
edited June 2014 in IDC (Invasive Ductal Carcinoma)

I Need help to make a treatment choice quadrantectomy vs. unilateral mastectomy. I had a lumpectomy for 4mm grade 1 IDC, some DCIS and atypical hyperplasia.  Clear margins, no nodes.

I do not want RT. Depending on which MD I speak with...the numbers for recurrence vary from

3% to 25% if I do the quadrantectomy.  Uni puts me at 2% recurrence. ER/PR Pos. BRCA neg.

There would be 2 surgeries for the unilateral and I am very scared.  All the MDs that gave me these numbers are equal in experience.  Medical oncology numbers were 10%, 15%, 25%. breast surgeon was 3% to 15%. I am 46 yrs old so this matters but there is a part of me that wants to just do the quadrant? 

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  • Lily55
    Lily55 Member Posts: 3,534
    edited March 2013

    A quadrantectomy will leave you very mis shapen so you will still be losing your breast....if you see what i mean - why two surgeries for UMX?

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  • nybc2013
    nybc2013 Member Posts: 13
    edited March 2013

    unilateral to expander then expander to bilateral implants.  Does that make sense?

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  • Angi1111
    Angi1111 Member Posts: 4
    edited April 2013

    I would say to you to try and research as much as you can before you make the decision and have peace about it.  I had peace but I just wanted it out before it spread so I feel if I'd known all the options like I do now, I might not have had the mastectomy.  I was stage 2A, no lymph node involvement and even tho dr. said I was not a good candidate for the partial mastect. or even nipple sparing..i realise now it probably was due to location of cyst..i just needed to find a dr. who would do it...do research on the quadrant...esp. Suzanne Sommers, u can go back and get implants, or other options that will look just as good later, but you will be disfigured alot at first, i only had the one breast removed, and i am doing great now. the expander hurts but i am starting to get my shape back and it looks good, however, i will have another surgery to put implants in and lift the other side.  I would have done nipple sparing mastectomy or the quadrant and then either implant or what Suzanne Sommers did,  if had to do all over again...but do your research...it will depend on location of cyst esp. but just wanting you to get all info so you are not regretting any decisions you make.  I know it is very hard to make a decision cuz there are so many options but options are blessings, take a deep breath and a little time to decide what is best for you after you have researched all the options to the best of your ability. 

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  • ribz99
    ribz99 Member Posts: 5
    edited December 2013

    Hi Angi

    I just read your post about having regrets with your choice of a mastectomy.  I am struggling with this now and your thoughts would be helpful to me. I have DCIS, high grade, 0, ER+PR+. My doc at Sloan-Kettering wants to do a lumpectomy on me, my instinct is that I will be one of those girls going back multiple times for additional lumpectomies. The more I read about the mastectomy or BMX I am getting terrified. I am getting more and more confused. My left breast is dense tissue but cancer-free. 

    Any thoughts?

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  • Jayaytea
    Jayaytea Member Posts: 63
    edited January 2014

    Some choices, hey ladies!  I was DX with IDC just over a year ago.  You get such little time to decide.  I could have had a lumpectomy, but no nipple sparing, and I'm so small breasted that i would be disfigured anyway.  They make immediate reconstruction sound so simple.  Who wouldn't opt for that???  In reality, you are looking at 2+ surgeries.  They keep offering revision surgery - fat grafting here, lift other breast there...

    Ultimately, we end up different.  I felt mutilated, disfigured by my UMX, but at least I had a "mound" when I woke up.  Yuk, I hate that word.  It's amazing what a person can get used to, as now I can look at myself without crying.  I have the permanent implant now, and just had fat grafting to fill in "divots" a month ago.  I still will have the opposite breast lifted, and then i don't want anymore surgery! (I had one emerg. surgery 5 days after MX to remove a huge clot).

    I don't think a decision can be made on how you will appear after surgery, as no matter what, I don't think anyone could be happy with what they see.  You have to decide what you think is the best for your situation.  And what you are comfortable with.

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