Lumpectomy or Mastectomy Decision Time

If you are considering a mastectomy, I would encourage you to reading some of post-mastectomy and reconstruction threads here on BCO so that you have a realistic idea of what you would be getting into.

I had chemo and radiation over 1.5 years ago for lymphoma so when I found out I had BC last month and that I could get either a 'lumpectomy + rad' or a 'mastectomy', and that I could inform the surgeon of my decision up to the day before the surgery, I freaked out.....because I wanted the least invasive surgery but I also didn't want any more radiation in my body. In fact, I didn't want cancer, period. I had 2 weeks to decide.

I ended up talking to my surgeon over the phone for half an hour the first week to get more information and then I met him in the office 2 days before the surgery. If this was my first rodeo, I would have easily taken the lumpectomy + rad, but I knew that I didn't want to do radiation again unless my stats were really bad. He agreed that I could do a lumpectomy now and choose a mastectomy later if needed. After going through a lumpectomy several weeks ago (and experiencing 'seroma' swelling that no one warned me about), I can tell you now that the sentinel lymph node dissection was not a piece of cake and I would have not handled a bigger surgery well. My hat goes off to all you wonderful ladies who have endured so much and more.

What is BCO? How do you make a decision about a lumpectomy vs a mastectomy?

Dianeaslm,

If you choose bmx are you considering reconstruction? If you are you may want a tissue expander placed at the time of surgery to save your skin.

I agree that a uni may be problematic for you, not sure if you could find a comfortable prosthetic to match your other side. You can make an appointment with a medical supply store to to learn about prosthetics in advance so you'll know your options. This may help you make your decision.

The decision making process is so difficult. Once you have a plan it gets better. Good luck to you.

I am not sure if this has been discussed here, but having one breast removed will leave the other side heavier and taxing on the spine leading to scoliosis.

Trvler, if you have positive nodes or if the tumor is close to the chest wall rads will be recommended, even with an mx.

We are here for you, Diane.   There is a quit smoking thread,, an exercise thread,,, eating healthy thread,,, anything you want to talk about,,, you got it here!

You can do this Diane.  Quitting smoking is the first step in the right direction to a healthy lifestyle.  Keep us informed, we are your biggest cheerleaders!!!! 

Dianes: I couldn't have said it better..totally feel the same way about the self centered part. It is my daughter's 11th birthday today and I was so afraid I would forget something…like a cake…or somehow she would be let down. We took her to Benihana last night and she LOVED it, so that's good.

Take a breath. I went through exactly what you are going through and made my decision. I will tell you my process.

Age of implants: For years I have heard that implants have a limited shelf life of 10-15 years. Mine are 30 years old. My original BS said no problem. He can do a lx and radiate and then another surgery to remove scar tissue resulting from the rad. Nope. No thanks. Not happening. Also, my natural breast tissue is very small anyway. What's the point of saving that?

As a correction, it doesn't make the actual implant hard. It changes the tissue around the implant which can cause capsular contracture and scar tissue to make your breast feel hard. It won't compromise the actual implant unless it made the implant break. I don't know what the odds are of that.

If you decide to have a mx, they will put in a temporary implant. They will then radiate and then do whatever recon you decide on at a later date after the skin has healed. THAT made me feel better. I was scared to do the mx and the recon at the same time on both. You absolutely CAN put in new implants after the rads and people often do that.

If it makes you feel more comfortable, do what I did and meet with a RO to discuss. I just met with one last week and went through it all with her. She was great and cleared up every question that I had.

Also, I don't know what your dx is since you don't have it in your sig. But for me, my natural breasts are very small and I know if they pull out a 2.9 cm lump, I will be pretty disfigured. I was told there are plastic options to correct this but again, why bother? I do not want implants anymore anyway.

Lastly, what put me other the edge for having a mx was the fact that I sought a second opinion because none of what my original BS told me was at all considering my preferences like getting the old implants out and not having them back. The BS was recommending a lx and rad. I sought a second opinion and they did much more thorough imaging on the cancer breast. AFter finding 2 more areas they are pretty sure ARE cancer, 2 areas that might and one node, I am convinced that original BS would have done the lx and then come out and said i needed a mx anyway. Also, they think the original tumor is much bigger than the 2.9 cm, more like 4.6. The second BS was much more thorough in her process by ordering that extra imaging. Her goal is one surgery.

The last thing I want to say is, please, if ANY doctor makes you feel uncomfortable or is condescending as doctors can sometimes be, find another doctor. It makes me a little sick to think I could have just taken that first surgeon's word for everything which could have caused an additional surgery for me. And THIS was the highly recommended surgeon.

What is your dx?

If you have ANY questions, please ask. It sounds like I am a few weeks ahead of where you are in all of this.

You didn't say how big your tumor is? Did you have an MRI. Get a different surgeon. Unless you have a huge tumor, who is telling you that you HAVE to make a decision this week? When were you dx? Places will put pressure on you to make a decision so you don't go somewhere else. Please don't make a rushed decision you might regret later.

Also, my first BS said to me basically, you should worry about saving your life 'getting rid of the cancer' and not your appearance. Easy for a MAN to say. If I had been stage 4, I could see him saying that to me. But saying the same thing at stage 2 means to me, HE isn't concerned about my appearance at all. I want the guy who understands and cares about BOTH. And they are out there. You just have to find them.

Thank you! You are so right. These doctors can say all they want and tell you what they think you should have, but it is my body and my breasts and appearance is very important to me. If that is being vain, then that is what it is. It is so easy for a doctor.....especially a man to tell you something because it is not his life or his body. Once he does the surgery and gets paid, he moves on to the next person. I am hoping this next surgeon, who happens to be a woman, is more understanding.

I need to make a decision because I want to get on the other side of surgery. No one is pushing me, but I do know that I should not let a lot of time go by. Right now, my MRI showed no lymph node involvement, but how do I know when those creepy little cells are going to move. Ohhhhh, I hate this!