Lumpectomy or Mastectomy - I only want to do this once!

S12Clear · June 2017

Hello everyone, I need your input. I was diagnosed on May 22 with a 2.1 cm tumor in my left breast. MRI shows nothing else, and both MRI and Ultrasounds show clean lymph nodes. I tested negative on the genetic tests, and am HR/PR +, HER2-. Next week, I have my surgery consultation - the first real meeting with the breast doctor except for the needle biopsy. Here's the deal. I had multiple surgeries on my breasts for breast implants and finally removed them years ago...2 years after that I had extensive surgery to clean out the debris left behind. Since then, mammograms have been pretty much normal, just some silicone left behind and some microcalcifications. I am so over boobs, and all the worry and painful surgeries. The nurse practioner who has been my delightful quarterback is strongly urging lumpectomy but I am 68 years old and so totally not attached to my breasts. They will do BMX if I insist, but does that really reduce the danger of cancer recurring? Thanks so much for any input you can give me before the cons

edwards750 · June 2017

According to my BS the survival rates are the same for lumpectomies and mastectomies. Hard to comprehend but true. My BS was all about saving the breast. I had a small tumor and I was Stage 1b, Grade 1. Small micromet in SN. I had the lumpectomy and 33 radiation treatments. Piece of cake for me and better than chemo. 5 years of Tamoxifen. I'm 6 years out this August.

I'm in your age group so I wasn't about to have reconstruction and while the scar isn't pretty it's no big deal considering plus my breasts don't look distorted either.

Whatever you decide let it be what you want. After all it's your life.

Diane

S12Clear · June 2017

Diane, thank you so much for that feedback. I think that is what the nurse is trying to say to me - she said lumpectomy is easier on my body and that with radiation and ARI, she feels I am pretty good to go, whereas BMX is harder surgery. It helps to hear someone else's BS say what I THINK I'm hearing, that survival rates are the same. Did you have any issues with the radiation treatments?

Best, Linda

LisaAlissa · June 2017

Hi Linda,

That decision is a difficult one, but whichever you choose will be the right one for you.

However there are a lot of things you may want to take into consideration. Beesie (a member who is a really good researcher/writer) has put together a list of considerations which people in your situation might want to think through. Note that they are not intended to push you in one direction or another, just help you think through some of the things that might be important to you.

You'll find Beesie's post here:

https://community.breastcancer.org/forum/91/topics...

HTH,

LisaAlissa

Nancy2581 · June 2017

I had a fairly big tumor at 2.8 cm and still has a lumpectomy. My surgeon did a great job. Glad I went the lumpie route, but everyone is different. Good luck

Nancy

Lula73 · June 2017

One thing that's not been pointed out is that if you opt for mastectomy you likely won't need any radiation. Check with your Dr on your particular situation.If you choose to do mastectomy with reconstruction, know that implants aren't the only option. They can do natural tissue reconstruction at the same time as mastectomy.

Rufhewn · June 2017

My surgeon said the same, there was no survival benefit going directly to a mastectomy. If the cancer returned locally later (2% chance per year for ten years) then a mastectomy would be in order. I chose a lumpectomy, radiation was a cakewalk for me and two years later I had some minor reconstruction on my breast. I am now 61 and wasn't too concerned about keeping my breasts but also wanted to minimize the changes in my life due to a breast cancer diagnosis. No regrets at all but each person needs to do what they feel most comfortable with. Sending you good thoughts. Pam

Rufhewn · June 2017

My surgeon said the same, there was no survival benefit going directly to a mastectomy. If the cancer returned locally later (2% chance per year for ten years) then a mastectomy would be in order. I chose a lumpectomy, radiation was a cakewalk for me and two years later I had some minor reconstruction on my breast. I am now 61 and wasn't too concerned about keeping my breasts but also wanted to minimize the changes in my life due to a breast cancer diagnosis. No regrets at all but each person needs to do what they feel most comfortable with. Sending you good thoughts. Pam

Icantri · June 2017

I am sorry you are here! But this is a great place to get support, glad you found us.

I think there is so much more than survival rates to consider when making this decision, but docs can't be our counselors for all the other issues, their job is to provide treatment guidance based on statistics. We then need to weigh the other considerations into the mix. Beesies compilation is awesome for that.

Except for age and your breast surgery history, our situations are pretty similar so here are my thoughts:

As Lula said, if you choose a mastectomy, and they get clean margins and nodes are clear, you shouldn't need rads. This was part of why I went with a mx. Radiation has its share of issues and side effects.

The other thing for me, as you also mentioned, was that I wanted as few surgeries as possible. I didn't want to have a lumpectomy and find out there was more going on and need more removed later. Turns out this was right for me as they did find multiple tumors and LCIS. But that isn't always the case, just lucky for me I did what I did in spite of the lumpectomy they were suggesting.

You mentioned a bilateral mastectomy, but have you considered just getting the one breast done? My initial plan was a bmx too, but then talked myself down to a unilateral. Much easier recovery having one good arm to be able to use. Also, it is very likely that the other breast will never need to be treated

Best wishes, whatever you decide.

lrwells50 · June 2017

I'm 66, and my BS also said the recurrence rate was the same regardless of what I chose. MX wasn't really a choice for me, because I was a G cup, and a prosthetic I thought would be really heavy and uncomfortable. I ended up doing a BMX, due to not wanting to go thru the surgery again (maybe) and the fact that my mother had breast cancer twice. Turned out there were precancerous changes in the other breast, so I'm glad I did what I did, but I went back and forth for 6 weeks trying to decide. I'm also doing reconstruction, because I'm sensitive enough about my fat body, and I thought being flat would be something I wouldn't handle well. My OncotypeDX also turned out to be a lot higher than any of the docs predicted, so I'm halfway thru chemo, and will have the exchange surgery about 6 weeks after that.

edwards750 · June 2017

No I didn't Linda. Fatigue halfway through treatments as expected and a bit of burning that's it - nothing major. Techs were awesome. Very efficient and compassionate.

Good luck whatever you decide.

Diane

msphil · June 2017

hello sweetie I found lump in shower I was making wedding plans for Our 2nd marriage decided Lmast instead of lumpectomy Now Praise God a 23yr Survivor. msphil idc stage2 Lmast 0\3nodes 3no chemo before n after surgery got married then 7wks rad 5days a wk n 5yrs on tamoxifen

Lumpectomy or Mastectomy - I only want to do this once!

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