Lumpectomy with radiation vs mastectomy

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Jenneri
Jenneri Member Posts: 11
edited June 2014 in Triple-Negative Breast Cancer

Hi all,  I'm new to this board so here's a little background.  I'm 66 and was diagnosed in Dec with a 1.5 cm TNBC. 1 node tested pos with needle biopsy.  Did chemo first. 12 weeks of Taxol and then 4 AC.  My last AC is next week.  All things considered, I think  I came through it really well!  Now I'm facing the difficult decision of whether I should have lumpectomy and sentinel node biopsy, which is done as out patient.  Followed by 6 weeks of radiation.  I'm not sure why but the radiation seems to be concerning me a lot.  Or I can just say I want all the breast tissue gone and have a BMX with reconstruction done at the same time.  I would probably opt for implants rather than tram flap surgery.  And according to my surgeon probably no radiation.  I should add, my breasts are extremely small, a AA is a push!  I really don't care if I have bigger boobs,  as I said, it's about the radiation.  From what I understand the chance of recurrence is the same.  My bs votes for the lumpectomy.

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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2014

    Hi Jenneri, and welcome to our community. This is often a very difficult decision, and we are sorry that you are going through it. In case you haven't read anything on our site, you may find this section helpful: Mastectomy vs. Lumpectomy in the process. 

    We are thinking of you! 

    The Mods

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  • Jenneri
    Jenneri Member Posts: 11
    edited June 2014

    Thanks.  That was my first stop.  Got more and better info there than anywhere else on the web!

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  • BikerLee
    BikerLee Member Posts: 355
    edited June 2014

    I definitely think you need to carefully consult with your health care team...

    With one positive node - is your team thinking that rads might be a good idea, regardless of whether you choose mastectomy or lumpectomy?  

    I opted for mastectomy because I wanted to avoid rads if possible. I did not have evidence of cancer in my nodes, and I had clear margins.  The surgeon did not recommend rads based on the pathology after surgery. I was so relieved!  I'm an athlete and did not want to deal with potential lung damage as a side effect of the radiation therapy.  However, if there had been a positive node, this might have changed my treatment plan.  So, careful consultation with your team is definitely in order.

    I also had chemo first, which was great. Gave me time to feel good about my surgical plan, and I got post-chemo pathology information (complete pathological response).  I hope you receive similarly great news!

    And as another possibility - reconstruction is not necessarily required - this is, of course, a deeply personal decision. But, you can choose to opt out of reconstruction, if you want to.  I opted out of reconstruction, and I have no regrets about being flat and fabulous.  There are pages here about choosing reconstruction and opting out...  Hopefully, those can be helpful to you!

    Good luck! I hope your last AC goes smoothly!

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  • Jenneri
    Jenneri Member Posts: 11
    edited June 2014

    Thanks for the input.  I'm working very closely with my team.  The breast surgeon is a close personal friend and I have every confidence in him and his colleagues that will be treating me.  I had an ultrasound after my 12 weeks of Taxol and the tumor was almost gone and my lymph nodes looked normal.  My surgeon feels that since I responded so well to the chemo that it probably dealt with the cancer in the node too and I would "probably" not need radiation after mastectomy but we would have to wait for the lab results from the sentinel node to be sure. 

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  • Islandmama2
    Islandmama2 Member Posts: 163
    edited June 2014

    I have already had a lumpectomy and am waiting to start chemo, either later this month or early July. I too am curious about bilat mastectomy after chemo. I haven't met with the oncologist yet so not sure how much it would reduce my risk of recurrence. I had a "positive" node on immunostain only, which showed only a few tumour cells. I think I will need rads regardless.

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  • Jenneri
    Jenneri Member Posts: 11
    edited June 2014

    Hi Islandmama2, I finished my last chemo today! Whoopie! And, I have been doing much soul searching and have decided to have the dmx with reconstruction at the same time.  Just met another woman who had TNBC 2 years ago with lumpectomy and radiation and was just diagnosed with recurrence and will now have dmx and chemo.  It's always a crap shoot but I feel in my gut this is the right choice for me.  If you need anyone to talk to while you do you chemo journey, I'll be here.  Good luck and kick butt!

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  • Islandmama2
    Islandmama2 Member Posts: 163
    edited June 2014

    thanks Jenneri

    I am leaning towards the BMX. I see the oncologist next week so will discuss then. Chemo first though!

    Congrats on completing your chemo!!

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