Mastectomy after lumpectomy?

Welcome to BCO, although I'm sorry you have reason to be here.  I don't have experience with the situation you're facing, but I thought I'd stop and bump your thread in the hopes that more people will see it before it drops off the Active Topics list.  In general though, I would tend to think that with 2 positive nodes and LCIS throughout your breast, mastectomy -- if that's what your breast surgeon is advocating -- sounds like the more prudent option, although I know how difficult it can be to come to that decision.  (I had a mastectomy after a lumpectomy, but did chemo after my 2nd surgery.)

Weekends can be a bit slow here, but hopefully you'll get some input tomorrow.    (((Hugs))), and good luck with your decision.   Deanna

It is a very hard decision to make and my thoughts are with you. I actually was the opposite, I chose mastectomy so I would not have to have radiation or chemo, but my cancer presented differently than yours.

I did not choose reconstruction.

It all sure does hit us fast though, doesn't it? I think your doctor will have a lot to say about it and take someone with you so they can help you remember everything that is said. My biggest question in your case would be :how does the mastectomy affect the cancer? If it increases your chances of beating cancer, I would go for it. but in your case the radiation and chemo might have already killed the cancer. Your doctor will know.

Please post more and search around here, lots of women ready to help...

As far as rads I did chemo first, then BMX then rads so I do not see a problem if you decide to do a BMX before rads.

I know of people who did LX then chemo then BMX as you are asking.  I think that is very prudent.  

Some people actually avoid radiation with BMX if wide margins are obtained in the BMX.  

I took the path you are considering and I chose prophylactic BMX, it is not an easy decision but I'll just give you the highlights of what contributed to my decision…I had a lumpectomy with great margins so that was not an issue but I had dense breasts and lots of cysts and my lump was missed by annual mammograms (estimate of the surgeon was it had been there several years) so I could not rely on mammograms to catch future cancers. I met with 2 radiation oncologists and both said that I would need rads if I did not do mastectomy to prevent "local" recurrence but since I had wide margins that was not a big concern. They also cautioned that it was left side and although they would "be as careful as possible" it could impact my heart. My oncologist felt that mastectomy was the best choice for me to avoid recurrence. Since I had positive nodes she recommended chemo and antihormonals to prevent mets, which is my greater concern - she said that mastectomy, chemo and antihormonals could cut my risk to less than 15% but of course...there are no guarantees. I met with a plastic surgeon and since I did not have rads he said he could work with the breast surgeon to do immediate reconstruction with implants. It was a relief once I decided on a plan and I am pleased with the results. As others have said on these boards…you make the best choices you can with the information you have at the time and don't second guess yourself or look back:) good luck in your decision, feel free to PM me if I can answer any questions (((Hugs))) Maureen

I haven't been on here is a while; I had a LX 11/9/2012 (clear margins, one positive node), did chemo and rads. About three months after I finished radiation, I developed an infection in the breast that would never go completely away with antibiotics so my ONC recommended that my BS go in and clear things up. It was a abscess which she removed and then had a path on the mass. Well, lo and behold, they found three tiny separate cancer cells! After my shock, disappointment, fear, anger - I am getting scans done now; once we get all the results I am having a mastectomy but waiting on reconstruction. My ONC thinks I should do another short (4 passes) of chemo - (this time with Gemzar and Carboplatin); all agree this is not a recurrence but residual from first tumor.
I will do recon next year but with this latest news my primary driver is getting free and clear of cancer. Since I had radiation there isn't much they can do with my skin so I will have a DIEP flap from my stomach to create my new breast and then a reduction/lift to my right one.
As others have noted; no matter what we do you just really never know; in hindsight, the abscess was my friend. Without it we would never have known what was lingering in my remaining breast tissue.
Continue to gather information and good luck!

hi I just completed my chemotherapy six rounds of TCH plus P, yay and I've been having the same trouble trying to decide between lumpectomy vs mastectomy. I've got four weeks to decide I've spoken to plastic surgeon, radiation oncologist and my breast surgeon. Since my tumor shrunk to the point where they can't feel it anymore my breast surgeon and oncologist think I should get a lumpectomy plus radiation. I'm just so nervous about reoccurrence and having them checked constantly. Neither route is easy didn't want radiation but they've warned me that even if I get a mastectomy I could possibly still need radiation.  They won't really know until they go in to check your lymph nodes. Also worried about with implants and having to swap them out every 15 or so years. I've also been warned if I go radiation first w the lumpectomy and then end up having to get a mastectomy that hurts your chances for the best possible cosmetic outcome. 

And I see so many of the women on here get lumps and then later get a mastectomy. I'm hoping that my situation is different in that I had intense chemo before, shrunk the tumor, that lump and rads would equal 

Mastectomy. 

Ktrs- are you in the Los Angeles area?

Rosie- did you decide? And what of your right breast?

Marren - I AM in Cali - SoCa; you?
I see my new ONC this afternoon (one week post MX) still feeling OK, waking up early (work schedule hours!) and going for a short walk around my immediate neighborhood. Took a shower yesterday by myself - felt so good!
I will most likely do another round of chemo; I did chemo, rads after LX so the latest situation was a complete surprise to everyone. I have been doing some research and getting my questions lined-up. I am so much calmer this time because I KNOW that my emotions will not change anything unless I keep them positive.

I will be back on this board after my MO this afternoon and BS tomorrow afternoon with updates.

GRACE and Peace ladies