mastectomy or lumpectomy?

Sorry you are faced with this decision. Not fun. I chose mastectomy because I didn't want radiation. It is a tough choice with pros and cons for both. Hopefully you will get lots of answers here to help you decide.

I'm so sorry you are here and faced with this decision. Its a difficult decision, but as you research your options and talk to others, eventually it becomes clear what option feels right for you. There is no right or wrong answer. It is very personal decision based on your unique circumstances and priorities. 

This forum is a wealth of information and insightful stories from others who have gone through this, so read through threads on topics pertaining to your situation. Its also a good place to talk when your family and friends don't seem to understand.

You do not have to decide immediately. Meeting with a plastic surgeon to discuss reconstruction options may be beneficial. Talk with a radiation oncologist to understand the side effects and risks. If you are a candidate for genetic testing, this may also help you decide. Go to a medical supply store to check out what prosthetics are like.

Understand that sometimes lumpectomy does not get "clear margins" and has to be done over. There is controversary as to the safety of rads to heart & lungs, especially when radiating the left breast. Not trying to sway your decision, just letting you know the factors that many consider when facing this decision.

If you chose mx, you open the door to even more difficult decisions. One or both breasts? Reconstruct or go flat?  Implants vs. "flaps"?  (There are lots of before/after photos available online.) 

To me, an informed decision is the easiest decision to live with. Take a deep breath, keep an open mind till you have all the facts and don't let others tell you what to do, it has to be the option that feels right ro you.

For me, I chose double mx because I wanted symmetry of appearance and I did not want radiation. I chose DIEP reconstruction, which involves harvesting fat from the tummy area to make new breast mounds. There are other types of flaps available too. I will have a stage 2 surgery soon to make nipples and then the nipples and areola color will be tatooed on. There are lots of other options here too such as nipple sparing surgery and 3-D tatoos. 

I wish you good luck.

Regarding the pain after mx, mine was not so bad, but everyone is different. There's lots of good pain medication available if you need it. For me, the worst pain came from the surgical drains. I could not wait to get them out!

Because I had DIEP recon I was cut from hip to hip (like a tummy tuck). I thought that would really hurt, but surprisingly it didn't.  Not to say the ordeal was easy, but it wasn't as bad as chemo.

In comparison, my husband just had hemmroids removed and he had much more pain than I did.

Hi there -- I am leaning towards a mastectomy of my left breast which has multi focal cells (three).  Good prognosis. For those of you who had a single mastectomy, how long before you could put some kind of a bra or camisole on.  My BS said that my hospital gives you a form to take home and then after everything has healed, the hospital has a fitter for a prosthesis.  I am between a C and a D cup so sure would look lopsided without any kind of support.,  Any information would be v ery much appreciated. 

Thank you Ariom for your prompt reply I printed out your post.  Looks like we're the same size which really helps.

I was ready to go a fitter before surgery so I would feel comfortable and see what my options were.   My bs told me that before I go home after surgery I get a form and it's nice to hear from you that you weren't lopsided during the weeks before you are able to go the fitter. I am going to do some research on the camisole. I love wearing camisoles so that shouldn't be a problem.   It's taken me a long time to come to this decision but I am feeling better and better about it as I do more research.   I don't have a date yet because I have to stop smoking  before and right now am attempting to do that.  I am on he smoking support board here and am getting some other help.  What an awesome site this is.  Again, thank you. Great country you live in by the way. 

Shirl

Hello bridgegal and mysunshine, I am sorry you are both doing the waiting and decision making. It is a tough time.

Shirl, I answered you on another thread about the location of scars, so i won't repeat any of that here, but if you already like camisoles, I think you'll find the Valletta very comfy! I even just pinned the soft puffy form into a T shirt, right after my surgery and it worked quite well. You'll be surprised how you'll adapt!

I don't envy you having to give up smoking before your surgery. I was a smoker too, but gave up 8 years ago this month. I went to a guy who has developed the Allen Carr method for quitting, I had tried hypnotherapy and gum etc, nothing worked for me, till I did this 2 hour meeting and I walked out of there a non smoker and have never been tempted again. I wish you all the very best with that.

Hi Lynn, there are many women who find their cancer themselves where Mammograms fail to find them. Mine was found, only after I had a Digital Mammogram, my Surgeon believes it was there on my previous analogue films, but they couldn't see it. I shudder to think what may have been, if I had returned to the same facility again for the 2 year mammo and it was missed again.

I was 59 when I was Dx and I was out walking my dog, albeit a short walk, in the first week after my Umx. I must admit that my decision to have the Umx, was mostly driven by my desire to avoid rads, which as you point out was not an absolute given, but I was willing to take the risk. In saying that I did have to consider the SNB which I could have avoided if I went for the Lx. I felt that I was more afraid of having an Axillary Clearance if anything invasive was found in my final pathology, so I opted for the SNB. Nothing was found, but I have no regrets.

I know this seems hard to believe right now, but you will find that most women will tell you that the surgery was nowhere near what they actually expected and had built up in their minds. Of course there are exceptions, but for me, there was no pain, strange sensations, yes, zinging zapping and raspy sunburn sensation, but I never needed any pain medication at all. I spent the night walking the halls and chatting with the Nursing staff after my surgery and was out the following morning. As ridiculous as this sounds, I went shoe shopping on the way home at a mall with my drain in a shoulder bag. There was extreme tiredness in the first few weeks, where I could literally dose off mid sentence, but all in all the recovery was far easier, than I ever imagined. I had a few hiccups along the way with an infection, a seroma and cording, but nothing major.

Take your time to make up your minds ladies, don't be swayed by what anyone else "thinks" your should do, it is your decision and you'll know what feels right for you.

Come here often and ask anything, we all understand how you're feeling and know how tough it is, to make this life changing decision.

It won't be long till you're both on this side of the surgery, sharing your experiences with new members!

I wish you all the very best!

edited to add, Thank you Briidgegal, have you been to Aus?

Hi Ladies,

Sorry that we have to go through this but thought this might help someone out.

I had my bilateral nipple sparing mastectomy with immediate implant reconstruction last 23 Feb, 2 weeks ago. I'm 31 years old. Diagnosed with invasive ductal carcinoma, 7mm, grade 1, ER/PR positive, HER2 negative. I'm definitely a candidate for lumpectomy too. I chose a mastectomy because:

1) Peace of mind - I hopefully have a lot more years in life to go and wouldn't want to worry about a huge probability of another cancer. Recurrence of this cancer I know is about the same with either surgery. But risk of developing new cancer is greatly diminished with mastectomy. I wanted that.

2) Regret as I may not have the surgery option for mastectomy that I want - If I get another cancer, I may regret not doing mastectomy now. I'm a candidate for nipple sparing mastectomy with immediate implants. If I get another cancer In the future and if I can't save my nipple or do immediate reconstruction, I may regret it and kick myself. Don't get me wrong, there are awesome ways of reconstructing the nipple. I just wanted to minimize the procedures I need to do. This may be shallow but definitely a big thing to consider. On the flip side, maybe a few years down the road, there will be more advanced ways of doing mastectomy and reconstruction. Something I was okay to live with.

3) I grew up on formula and hence have no emotional feelings towards breastfeeding. I'm single by the way.

4) I was okay to live with dating a guy and explaining to him about BC and what my choices were. This is important. I am comfortable being single for the rest of my life and would want to stay that way unless I meet the right guy for me. And the right guy for me should accept all of me, including my implants sans real breasts.

5) I have BRCA2 VUS. I know one should not make decisions based on VUS but my aunt passed away at 37 with breast cancer recurrence. Her first onset was in her late 20's. That's enough real life experience for me to try and err on the side of caution and manage this VUS head on.

6) I felt lumpectomy plus radiation will change how my boob looks like anyway. I'm 34A. My left side is already smaller than my right. I feel radiation will make my skin look bad. Don't get me wrong, I've read all radiation effects from a cosmetic perspective can be fixed. But I wasn't too sure it will be for me. Looking nice is important for me. I feel that mastectomy with implant recon will give me that.

7) My gut - This is important for me. I've done a lot of research. I know a lot about BC, surgery options, risks. I've read and heard first hand from people who went through both surgeries. I was against mastectomy when I first learned about my suspicious lump. But as I became more informed, I became more comfortable with mastectomy than lumpectomy. I'm also a Christian and I feel that my gut is God's still voice in my heart. Again, I'm not advising going for your gut without being informed.

It was not an easy decision. My oncologist was great and he had to make sure I was choosing the right thing. I asked him to question me and he did. I cried in his office while answering each question he threw my way. But we ended with him fully supporting my decision as he believes it's an informed one.

Did I second guess myself? Absolutely. Even right up to the day before my surgery and a few moments after my surgery. I listed down my pros and cons for mastectomy and have one great friend who knew every aspect of my decision. Whenever I second guess myself, I go back to my list and my friend, and will eventually be reminded this was the right thing for me.

I'm 2nd weeks post surgery. My PS is raving about my breasts but I am not yet seeing it. I can see the potential of it looking nice but I guess I have to wait and see when they settle. But it's been a while since I've second guessed my decision. It's also because every day, I see the breasts improving and the feeling of pressure, numbness is getting better and better.

Wish you all ladies the best through this journey x