My surgical oncologist gave me the choice between a lumpectomy and mastectomy also. As your doctor did, he explained both procedures, what was involved with each, and plusses and minus of each.  I asked for his recommendation, and he refused, saying it needed to be my choice.  My MRI showed only the one small tumor.  Knowing that, in addition to all the other information he gave me, I decided on the lumpectomy.  His response was "I'm glad.  While I would do the mastectomy, and even a double if you wanted it, I think it would be over-treatment for your situation."

My margins were clear, so I only needed the one surgery.  Sentinal node biopsy was done at the same time as my lumpectomy and through the same incision.  I almost 5 years out from surgery/treatment and am comfortable with my decision to have the lumpectomy.  My oncotype score was very low, so I did not need chemo.  I did have radiation.    

Don't choose your treatment based on what some else did and their reaction to the treatment.  We are all different.  Get all the information you can and choose the treatment that will give you the most peace of mind. 

I was dx'd with multifocal IDC in 2011, in my left breast. My breast surgeon said she couldn't do a lumpectomy because she would have to take such a large wedge of tissue, my breast would look deformed. She suggested a unilateral mastectomy.

At the time, I had huge, saggy, fibrocystic breasts. (I always wanted a lift.)

My Radiologist was never certain something wasn't hiding in the right breast. My mom was dx'd at the same age I was: 60. She had a radical mastectomy on her left side with no reconstruction, because it wasn't available then.

I made the decision for a bilateral mastectomy (with immediate reconstruction) for several reasons: 1) uncertainty about what changes were taking place in the right breast, 2) family history, 3) unlikelihood that the surgeon could do a simple lift on the right and make it match the left. It was totally my choice, and my surgeon agreed.

Going into the surgery, I didn't have a clue whether or not I would need chemo or radiation. Even though the initial biopsies showed small tumors, they often turn out to be bigger once the surgeon can actually see them. And she needed to make sure that she got good margins, and that nothing was too near my chest wall.

If you do not have reconstruction, the recovery from mastectomy is much easier (from what I've read here). I decided that if I couldn't handle recon, I'd just go flat.

I ended up having a relatively smooth procedure and recovery, and after the final pathology report, did not need either chemo or radiation. Size and location of the tumors did not require it. The MO did prescribe 5 years of an Aromatase Inhibitor, but I ended early.

I don't regret for a moment having my BMX and recon with implants. Because I did not have to go through treatment, I made getting healthy a priority, and lost weight, and got new breasts that are as much a part of me as the Original Girls were.

My friend was diagnosed not long after I was. She made the decision to go for lumpectomy and radiation. She is still very happy with her decision.

One thing you will find is that regardless of our diagnoses, we are all different here when it comes to choices.

That link from Barred Owl was hugely helpful to me in making my choice. I was most interested in simply whatever was going to be easiest in the short term: I didn't want to spend much time in the hospital and didn't want to have many procedures. I ended up with a lumpectomy, sentinel node biopsy, and radiation. I am a year out and very happy with how it all worked out. I'd definitely read Beesie's words of wisdom!

I was diagnosed 3/8/2016 with DCIS. My first general surgeon recommended a lumpectomy but advised me to meet with a PS because I have implants. I wanted a second opinion before meeting with the PS. I met with a breast specialist on 3/17 and she went over all the results with me. She spent over 2 hours talking with me. She recommended a mastectomy on the left breast because the implant is so large and I have very little breast tissue. She said a lumpectomy would leave a huge hole in my breast and most likely it would require a second surgery. My doctor said I might not need radiation but it depends on what they find once they start surgery. I am choosing to have the right breast removed too because I would be very lopsided! I am having TEs placed in during the surgery to begin the reconstruction process. I meet with a PS on Tuesday to talk about the process of reconstruction. Some of my friends and family I talk to are shocked and think this is very radical. But it is a decision I am comfortable with. I am a little worried about the recoup time/healing/ possible pain. Can anyone share there experiences with a double mastectomy? Thanks

I was diagnosed with stage 1 BC in my left breast. A lumpectomy was an option. However, there was family history (including my mom) that strongly suggested that I go for a bilateral mastectomy and just be done with it. I am very happy that I did b/c, in my case, tissue samples of the right breast (the supposedly healthy one) showed pre-cancer cells. So, I would have been right back in the thick of it in a few years had I opted for a lumpectomy. One nurse also told me that many who have lumpectomies become anxious about their next mammogram and schedule their lives around it so as not to miss it. I also think that you will have to undergo MRIs in addition to the mammogram but ask your doctor about that. When I asked about the recovery time, I was told that a lumpectomy and a mastectomy both take around 6 weeks the difference being that you cannot raise your arms after a mastectomy (if you are having reconstruction.) My surgeon said my husband would have to wash my hair for me. I rolled my eyes (my husband was in the room making funny exaggerated stylist moves). My surgeon said not to make my decision based on whether or not I could wash my own hair! Was nice to have some humor interjected into the situation.

I have not regretted it. I HATE the tissue expanders but they will be out by June. Again, in my case, there was a strong family history that helped be to make this decision. It is not easy. However, you are facing a significant challenge and you are doing the right thing - looking for advice. Neither decision will be wrong. You will make the right decision for yourself. I know this is hard. My surgery was just last December 2015 so the memories are fresh. You will be fine. We are all here for you.

- Kathleen

I wouldn't describe the recovery from lumpectomy as 6 weeks, either. I was back on the treadmill (walking, not jogging) the next day. There were some things that I let my husband do for a while around the house but I was quite able to shop for groceries, go back to work, etc., pretty quickly.

I had the same dx as ChiSandy. 1.3cm tumor w/ dcis 1c some benign lumps, too. I was a D cup. My PS recommended Oncoplasty for me. After a lumpectomy with clear margins I was scheduled for another surgery. During the 2nd surgery the BS came in and removed the cancer and then the PS came in and did a reduction on both breasts.

The way I see it, after much consideration, is that, in the event that I ever had another issue, I can choose mx. But I can't do it the other way around.

I feel that I made the best decision for me. Everyone has to choose what they think is good for them. For me, I chose the Oncoplasty reductions.

Good luck!

Here is Beesie's post:

"Some time ago I put together a list of considerations for someone who was making the surgical choice between a lumpectomy, mastectomy and bilateral mastectomy. I've posted this many times now and have continued to refine it and add to it, thanks to great input from many others. Some women have gone through the list and decided to have a lumpectomy, others have chosen a single mastectomy and others have opted for a bilateral mastectomy. So the purpose is simply to help women figure out what's right for them - both in the short term but more importantly, over the long term.

Before getting to that list, here is some research that compares long-term recurrence and survival results. I'm including this because sometimes women choose to have a MX because they believe that it's a more aggressive approach. If that's a big part of someone's rationale for having an MX or BMX, it's important to look at the research to see if it's really true. What the research has consistently shown is that long-term survival is the same regardless of the type of surgery one has. This is largely because it's not the breast cancer in the breast that affects survival, but it's the breast cancer that's left the breast that is the concern. The risk is that some BC might have moved beyond the breast prior to surgery. So the type of surgery one has, whether it's a lumpectomy or a MX or a BMX, doesn't affect survival rates. Here are a few studies that compare the different surgical approaches:

Lumpectomy May Have Better Survival Than Mastectomy

Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer

Twenty-Year Follow-up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer

Now, on to my list of the considerations:

• Do you want to avoid radiation? If your cancer isn't near the chest wall and if your nodes are clear, then it may be possible to avoid radiation if you have a mastectomy. This is a big selling point for many women who choose to have mastectomies. However you should be aware that there is no guarantee that radiation may not be necessary even if you have a mastectomy, if some cancer cells are found near the chest wall, or if the area of invasive cancer is very large and/or if it turns out that you are node positive (particularly several nodes).
• Do you want to avoid hormone therapy (Tamoxifen or an AI) or Herceptin or chemo? It is very important to understand that if it's believed necessary or beneficial for you to have chemo or take hormone therapy, it won't make any difference if you have a lumpectomy or a mastectomy or a bilateral mastectomy. (Note that the exception is women with DCIS or possibly very early Stage I invasive cancer, who may be able to avoid Tamoxifen by having a mastectomy or a BMX.)
• Does the length of the surgery and the length of the recovery period matter to you? For most women, a lumpectomy is a relatively easy surgery and recovery. After a lumpectomy, radiation usually is given for 6 weeks. A mastectomy is a longer, more complex surgery and the recovery period is longer.
• How will you deal with the side effects from Rads? For most patients the side effects of rads are not as difficult as they expected, but most women do experience some side effects. You should be prepared for some temporary discomfort, fatigue and skin irritation, particularly towards the end of your rads cycle. Most side effects go away a few weeks after treatment ends but if you have other health problems, particularly heart or lung problems, you may be at risk for more serious side effects. This can be an important consideration and should be discussed with your doctor.
• Do you plan to have reconstruction if you have a MX or BMX? If so, be aware that reconstruction, even "immediate" reconstruction, is usually a long process - many months - and most often requires more than one surgery. Some women have little discomfort during the reconstruction process but other women find the process to be very difficult - there is no way to know until you are going through it.
• If you have a MX or BMX, how will you deal with possible complications with reconstruction? Some lucky women breeze through reconstruction but unfortunately, many have complications. These may be short-term and/or fixable or they may be long-term and difficult to fix. Common problems include ripples and indentations and unevenness. You may have lingering side effects (muscle pain, spasms, itching, etc.) on one side or both (if you have a BMX). If you don't end up with symmetry (symmetry is not a sure thing by any means, even if you have a bilateral mastectomy with reconstruction done on both sides at the same time), will you regret the decision to remove your breasts or your healthy breast? Are you prepared for the possibility of revision surgery?
• How you do feel about your body image and how will this be affected by a mastectomy or BMX? A reconstructed breast is not the same as a real breast. Some women love their reconstructed breasts while some women hate them. Most probably fall in-between. Reconstructed breasts usually looks fine in clothing but may not appear natural when naked. They may not feel natural or move naturally, particularly if you have implant reconstruction. If you do choose to have a MX or BMX, one option that will help you get a more natural appearance is a nipple sparing mastectomy (NSM). Not all breast surgeons are trained to do NSMs so your surgeon might not present this option to you. Ask your surgeon about it if you are interested and if he/she doesn't do nipple sparing mastectomies, it may be worth the effort to find a surgeon who does do NSMs in order to see if this option is available for you (your area of cancer can't be right up near the nipple).
• If you have a MX or BMX, how do you feel about losing the natural feeling in your breast(s) and your nipple(s)? Are your nipples important to you sexually? A MX or BMX will change your body for the rest of your life and you have to be prepared for that. Keep in mind as well that even if you have a nipple sparing mastectomy, except in rare cases (and except with a new untested reconstruction procedure) the most feeling that can be retained in your nipples is about 20% - the nerves that affect 80% of nipple sensation are by necessity cut during the surgery and cannot be reconnected. Any breast/nipple feeling you regain will be surface feeling only (or phantom sensations, which are actually quite common and feel very real); there will be no feeling inside your breast, instead your breast will feel numb. For some, loss of breast/nipple sensation is a small price to pay; for others, it has a huge impact on their lives.
• If you have a MX or BMX, how will you deal emotionally with the loss of your breast(s)? Some women are glad that their breast(s) is gone because it was the source of the cancer, but others become angry that cancer forced them to lose their breast(s). How do you think you will feel? Don't just consider how you feel now, as you are facing the breast cancer diagnosis, but try to think about how you will feel in a year and in a few years, once this diagnosis, and the fear, is well behind you.
• If you have a lumpectomy, how will you deal emotionally with your 6 month or annual mammos and/or MRIs? For the first year or two after diagnosis, most women get very stressed when they have to go for their screenings. The good news is that usually this fear fades over time. However some women choose to have a BMX in order to avoid the anxiety of these checks.
• Will removal of your breast(s) help you move on from having had cancer or will it hamper your ability to move on? Will you feel that the cancer is gone because your breast(s) is gone? Or will the loss of your breast(s) be a constant reminder that you had breast cancer?
• Appearance issues aside, before making this decision you should find out what your doctors estimate your recurrence risk will be if you have a lumpectomy and radiation. Is this risk level one that you can live with or one that scares you? Will you live in constant fear or will you be comfortable that you've reduced your risk sufficiently and not worry except when you have your 6 month or annual screenings? If you'll always worry, then having a mastectomy might be a better option; many women get peace of mind by having a mastectomy. But keep in mind that over time the fear will fade, and that a MX or BMX does not mean that you no longer need checks - although the risk is low, you can still be diagnosed with BC or a recurrence even after a MX or BMX. Be aware too that while a mastectomy may significantly reduce your local (in the breast area) recurrence risk, it has no impact whatsoever on your risk of distant recurrence (i.e. mets).
• Do you know your risk to get BC in your other (the non-cancer) breast? Is this a risk level that scares you? Or is this a risk level that you can live with? Keep in mind that breast cancer very rarely recurs in the contralateral breast so your current diagnosis doesn't impact your other breast. However, anyone who's been diagnosed with BC one time is at higher risk to be diagnosed again with a new primary breast cancer (i.e. a cancer unrelated to the original diagnosis) and this may be compounded if you have other risk factors. Find out your risk level from your oncologist. When you talk to your oncologist, determine if BRCA genetic testing might be appropriate for you based on your family history of cancer and/or your age and/or your ethnicity (those of Ashkenazi Jewish descent are at higher risk). Those who are BRCA positive are very high risk to get BC and for many women, a positive BRCA test result is a compelling reason to have a bilateral mastectomy. On the other hand, for many women a negative BRCA test result helps with the decision to have a lumpectomy or single mastectomy rather than a bilateral. Talk to your oncologist. Don't assume that you know what your risk is; you may be surprised to find that it's much higher than you think, or much lower than you think (my risk was much less than I would ever have thought).
• How will you feel if you have a lumpectomy or UMX and at some point in the future (maybe in 2 years or maybe in 30 years) you get BC again, either a recurrence in the same breast or a new BC in either breast?Will you regret your decision and wish that you'd had a bilateral mastectomy? Or will you be grateful for the extra time that you had with your breasts, knowing that you made the best decision at the time with the information that you had?
• How will you feel if you have a bilateral mastectomy and no cancer or high risk conditions are found in the other breast? Will you question (either immediately or years in the future) why you made the decision to have the bilateral? Or will you be satisfied that you made the best decision with the information you had?

.I hope that this helps. And remember.... this is your decision. How someone else feels about it and the experience that someone else had might be very different than how you will feel about it and the experience that you will have. So try to figure out what's best for you, or at least, the option that you think you can live with most easily, given all the risks associated with all of the options. Good luck with your decision!"

I've had 6 lumpectomies and they take about 6 HOURS to recover from. Seriously. Anyone taking 6 weeks is milking the surgery and will have one hell of a time dealing with something later like a hysterectomy or mastectomy or a serious big surgery.

I don't care that everyone "responds" differently! There is no way in God's green earth that you need 6 weeks for a lumpectomy. I've gone back to work the next day each time. In fact, with my last one, I went on to a job interview immediately afterwards! (I got the job, too!)

If you are getting reconstruction - that's a different story. You are in it for the long haul, I've heard averages of 2 YEARS before you are done. How willing you are for constant surgeries and appointments may be a deciding factor on which route you prefer. Reconstruction involves muscles being manipulated which is very painful and each "fill" causes more pain. I needed to continue to work and just couldn't fit the constant medical appointments into my work schedule.

My BS did not give me a choice. She recommended lumpectomy. She told me that the survival rate for lumpectomy and radiation is the same as mastectomy. She never asked me to choose, and I was relieved that she did not recommend MX. Every person's situation is unique, and you have to decide what is best for you. Beesie's post is excellent, definitely a must read. I would also mention that having BMX does not guarantee that you won't have a recurrence. They can't get every Breast cell, so you could have the BMX and still get BC again

barbe1958, same here. Was back riding my bike, like 30 miles a day, just a few days after lumpectomy. Worst part was mine developed a seroma, sounded like I had a bottle of alcohol hidden in my bra with the way I sloshed. The sentinel node area hurt way worse than the lumpectomy area and it took longer for the zingers to go away. But neither area was particularly troublesome, for me at least. I think thr hangover from the surgery drugs impacted me the most, but even that was short lived

Maybe when the surgeon offers both it's a hint? I wonder....

My lumpectomy did have dirty margins and I had said if it was cancer I wanted a mast. I had a seroma that had to be drained a couple of weeks after my double mast - I had gone to work 2 1/2 weeks after surgery, and had to go to a walk-in clinic and have it drained. I didn't even feel it as the area was still numb.

I agree with StacySue about missing nipple sensation. You don't get that back with reconstruction which is yet another reason why I didn't bother. I did ask my surgeon where all those wonderful nerve endings went when they were cut and he said to have fun looking for them!

With a lumpectomy you need radiation. Although, depending on the characteristics of your tumor (size, stage, grade) and if you have lymph node involvement, radiation may still be in the cards even with a mastectomy (so I wouldn't make getting out of radiation as THE deciding factor in your choice). Whether or not you need to have chemo has NOTHING to do with the lumpectomy/mastectomy decision. Chemo is recommended if there is a higher chance that cancer cells have ALREADY left the breast and are circulating in your system.

I went with LX first. I ended up needing a umx after that due to extensive LVI which meant my BS could not get clean margins. Plus I had DCIS hiding in the nipple stem. My recovery from the LX was not as quick as some because I had two positive nodes so I had levels l/ll of my axillary lymph nodes removed. I had a drain for a week and then developed two large seromas. However since I knew I had to go back in for more surgery I just returned to work even though I did not feel ready. I went back as soon as my BS said I could which was about 10 days post op. For my umx I took 4 weeks off because I wanted some fills in my TE prior to returning to work. I was very self conscious about being lopsided. The recovery from the umx was pretty easy except for the TE and drain. Once my fills started the muscle spasms and pressure went away.

I went step by step through my surgeries and treatments. Mx with SLN, path report, meeting with MO, oncoDX, trying prosthesis, meeting with PS and discussing reconstruction options, opting for second Mx and TEs, exchange for cohesive gel implants. The entire process too one year from diagnosis to exchange. One reason I decided on the second Mx was that it would be done by the PS and no lymph nodes needed to be taken since no cancer was there. The difference between my BS and PS was huge. He (BS) did his job well but wasn't concerned with how things looked. She (PS) is an artist and fixed everything up so it looks good. Eight months after my exchange I had 3D tattoos and they truly finished me up. I tried not to jump ahead and make decisions until I gathered more information along the way. I took lots of notes to review at home. Hang in there - you will make the decision that is right for you.