Lumpectomy for stage III???

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h444
h444 Member Posts: 1
edited August 2014 in Stage III Breast Cancer

Hello,

I am stage 3 with one confirmed node and had neoadjuvant chemo (ACT). Now I have a date for surgery in July but I still can not decide if I should go for mastectomy. I have one surgeon recommending mastectomy and another recommending lumpectomy. Am I crazy to be even considering lumpectomy in stage 3? From the signatures it appears most stage 3 ladies went with mastectomy. 

Comments

  • mary625
    mary625 Member Posts: 1,056
    edited July 2014

    I went with mastectomy because I had no other choice due to tumor size.  I'm sure that most or many of us here in Stage III had tumors that were too large to be removed with mastectomy.  But since there's no evidence that mastectomy increases survival over lumpectomy, if your tumor size permits a lumpectomy, I'd say go for it.  I do miss my breasts a lot.  You will have to have rads, so that's something to take into account.  I had to have rads even with the mastectomy.  BTW, how are you sure that you are Stage III?  Your situation sounds a lot like mine going into surgery...I have neoadjuvant chemo and had one confirmed node with an estimated 7 cm tumor.  At surgery, they found 10 nodes and a 2 cm tumor.  Prior to surgery, they kept telling me I'd be Stage II.  

  • Denise-G
    Denise-G Member Posts: 1,777
    edited July 2014

    I, too, was Stage 3 had a huge tumor 6 cm and had no choice but to have an MX.  I had 9/14 nodes.  No reconstruction because of a lot of chemo and Herceptin complications - like heart attack and major valve damage. I miss my breast.  In fact, 2.5 years out, I miss it more now than I did while going through everything.

    My 80 yr old mom just had a Lumpectomy for Stage 1 BC.  Couldn't believe we are doing it all again, but that is another story.  There was just no comparison -- her Lumpectomy and my Mastectomy.Even at her age, she sailed through everything.  Her breast looks perfect.  And she is only 2 weeks out. 

    My philosophy is they can always cut it off.  If I would have had the slightest chance to keep my breast, I would have. 

  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited July 2014

    I had a 0.8 cm tumor on ultrasound, and had a lumpectomy and sentinel node biopsy, which was positive.  My surgeon made a 1.5 inch incision under my arm to do the axillary node dissection.  If this had been the extent of it, I would have kept my breast, but a skin biopsy found some tumor emboli in the skin of my breast--a small "umbrella" of lymphatic involvement right over the lump.  Because of this, I was advised to do the mastectomy. 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2014

    From what I understand, stage has nothing to do with the probability of local recurrence or second primaries in non-BRCA patients. I think Stage IIIers are more likely to end up with a mastectomy because we're more likely to have a large tumor, but that's not 100 percent. You could have a Stage 0 lady with large tracks of DCIS or a Stage I lady with multifocal disease and they would both be good candidates for mastectomy. On the other hand, you could have a Stage III lady with one small but aggressive tumor who would be a good candidate for lumpectomy.

    I had a large tumor and was told that a partial mastectomy was possible because the tumor had shrunk and I'm busty enough that there would've been a decent cosmetic result. I ultimately decided on full mastectomy because a) I'm young (<30) and have many years to get cancer again b) since I am young, I feel confident that my body can handle major surgery and subsequent reconstruction surgery c) I'm Her2+ so a local recurrence, even if caught early, would most likely mean more chemo and Herceptin and more disruption to the life I so desperately want to get back on track.

  • madeditor
    madeditor Member Posts: 25
    edited July 2014

    I had a lumpectomy and 6 lymph nodes removed just nine days ago. My surgeon gave me all options even after we found out about the lymph nodes. I chose lumpectomy. No matter what route I took, I still face chemo and radiation. Since the outcomes are really no different, I chose the less invasive surgery. By the way, I also had a complete hysterectomy immediately following the breast surgery. Lots of cysts and fibroids there, but I am happy to say there was no cancer there. So now I can fully concentrate on my breast cancer treatment. Good luck. It's a very personal decision.

  • katyand4
    katyand4 Member Posts: 171
    edited July 2014

    I had lumpectomy with 19 nodes removed and I'm glad I kept my breast.  

  • Moissy
    Moissy Member Posts: 550
    edited July 2014

    I was given the choice to try lumpectomy, which I did. Unfortunately, they were not able to get clear margins with the lumpectomy and so had to schedule a second  surgery after pathology report came in for mastectomy. Still glad that I tried the lumpectomy first. I'm now 10 years out from diagnosis. No recurrence. Good luck!

  • crabbiepattie
    crabbiepattie Member Posts: 108
    edited July 2014

    I had a lumpectomy at stage III.  You're not crazy at all!  Good luck!

  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2014

    The deciding factor for me to go the mastectomy pathway was family history more than anything.   Two aunts, two cousins with BC at fairly young ages.  Also surgeon said it may be hard to get normal "even up" breasts after lumpectomy.  You need to think it through a while.  

  • Josiekat
    Josiekat Member Posts: 85
    edited August 2014

    Hi.

    It's been a while since I posted.  I was diagnosed 3C in 2011. My first and second opinion agreed, not only was a mastectomy medically not recommended,  it would push back rads, which was concerning.

    I had many nodes taken, but my lump was small compared to my large(ish) breasts.

    The hard part in the beginning for me, was the amount of people who told me I was making a mistake. These people were untrained, and often strangers.

    Listen to yourself and your docs.

    Good luck!

  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited August 2014

    Someone said to me, early on, "if you had a small lump of cancer on your thigh, would you get your whole leg cut off?  That brought some perspective.  Of course, it's not the same thing, but for me, my mind went first to "get it off, get it off!"  After I calmed down and looked at the science, I would have gladly stayed with a lumpectomy if my doctors would have allowed it.

  • peacestrength
    peacestrength Member Posts: 690
    edited August 2014

    Thanks for posting, Josiekat.  Glad that you came back to share.

    Sbelizabeth - I like what you said...I had a large tumor and my breast surgeon said she could do a lumpectomy but my intuition said no.  Good thing because the breast was full of DCIS.  

  • Crazywabbit
    Crazywabbit Member Posts: 563
    edited August 2014

    so good to hear positive comments on lumpectomy in stage 3. In the Dec chemo group almost everyone stage 3 had mastectomies. I am now 5 weeks out from finishing Rads. I was worried about being stage 3 a?c and not having a mastectomy.  my initial US showed a 0.9 cm lump, bx IDC, after the lumpectomy the final path showed the  tumor was 1.9 cm with mixed ductal and lobular cancers. I knew going in at least 2 abnormal looking LNs on MRI and core  biopsy of one was positive for IDC.  After the final path report mixed IDC and ILC in 7/13 LNs. MRI also showed  IM nodes visible on the tumor side but not the other.  PET scan had a lot of active brown fat so not clear if the IM nodes were positive or not. Rads were directed there just in case.  

    Full c cup on the good side and now a B cup on the treated side. Afraid it will shrink more with time after rads.  Guess I will just have to sick a sock in  the bra.

  • Sarahlou50
    Sarahlou50 Member Posts: 33
    edited August 2014

    Hi Crazywabbit.  I had a lumpectomy back in 1999.  My tumour of 1.8mm and my bra size is 32dd.  At the time I asked if I should have my breast removed and my consultant said no, it wasn't necessary as I had a relatively small tumour and a relatively large breast, so I went with what he said.  I waited 6 years to have surgery to my other breast to 'even me up' as I was slightly lopsided.  However, at the time of my diagnosis, it was thought I would have had mets somewhere in my body as the cancer had spread locally, but that was not/is not the case!  So in my case I think the right decision was made.

  • Meow13
    Meow13 Member Posts: 4,859
    edited August 2014

    I would have chosen lumpectomy but had 2 tumors and a suspicious area. They talked me 

    Into a mastectomy.  I didn't have to have radiation really wish I could have DIEP at the same time. At stage 3 would you have radiation anyway on lymph nodes? If you can do lumpectomy you may not need any cosmetic surgery. I think the lumpectomy/radiation is just as effective as the mastectomy.

  • annika12
    annika12 Member Posts: 433
    edited August 2014

    Im also a stage lll that had a lumpectomy !! My tumor in my breast was small but I had two 3cm lymph node tumors !!! I'm not far out but trust my doctor/surgeons and went with there recommendation. Had a lumpectomy in june-13 and then she went back in Dec -13 to remove lymph nodes, make sure margines were clean and also a tail end lymph node. 

  • Crazywabbit
    Crazywabbit Member Posts: 563
    edited August 2014

    Annika, closest margin was 3 mm and there were 6 neg node past the involved ones. I hope that means the involved one caught all the cells and the remaining ones were the "blockade" 

    I was going to get a second opinion at Sloan Kettereing in NYC but my insurance denied it, out of network. I may still go this fall and self pay since I could not have surgery for a few months anyway, post rads due to healing issues. 

  • Lori1967
    Lori1967 Member Posts: 66
    edited August 2014

    So glad I read this post.....I am stage 3, my tumour was 5.8cm and 2 nodes removed but probably going back for 1-2 more...

    I had a lumpectomy and I kept reading everyone having mastectomy and thought maybe I made the wrong choice. My Dr. recommended lumpectomy, I have G cups and he felt he could be agressive.

    Surgery was on the 11th, I'm still sore. He removed the tumour with large clean margins, for that I'm grateful, but I was still worried.

    Waiting for chemo to begin now...

  • Kay_G
    Kay_G Member Posts: 3,345
    edited August 2014

    I had 3 tumors, all in different quadrants of the breast, so the surgeon said I had no choice but mastectomy.  I did only the right breast though, and did get a lot of comments from people that I should have opted for a bilateral mastectomy.  I stuck with the doctor's recommendation and am glad I did.  I am glad I still have one natural breast, I pretty much have no feeling in the reconstructed breast.

  • Kayrem
    Kayrem Member Posts: 164
    edited August 2014

    At first I had a lumpectomy and rads.  But later I tested BRCA 1 pos so then I had a double mastectomy. If I had not tested pos the lumpectomy would have been the end of it for me. 

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