which option to choose

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Irisheyes92546
Irisheyes92546 Member Posts: 4
edited December 2017 in DCIS (Ductal Carcinoma In Situ)

I have a 5.5 cm area of high grade DCIS and wear a B cup bra. So the size of a lumpectomy would be kind of big. My main reasons for not wanting a mastectomy are 1. That I would be left with a completely insensitive breast even with nipple sparing surgery and 2. It is a much more complicated, and 3. a sentinel lymph node biopsy would be done . My reasons for not wanting a lumpectomy are 1. that it would be difficult to get a good cosmetic outcome which such a huge lump and 2. I would need 3 to 6 weeks of radiation.

I am wondering if anyone who has had a lumpectomy has suffered complete permanent loss of nipple sensation. I think that if I would lose that anyway, the mastectomy might be considered.

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  • LAstar
    LAstar Member Posts: 1,574
    edited November 2017

    You can always try the lumpectomy and see how it goes. If your margins aren't clear or even if you just change your mind, you can still have the mastectomy. Then the cancer is out and you have more information and time to make your decisions. You might be surprised how unnoticeable the lumpectomy is under your clothes. Best wishes -- these decisions are grueling!

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  • aquilegia
    aquilegia Member Posts: 83
    edited November 2017

    I had 3 lumpectomies in the same breast and didn't lose nipple sensation, but I had more breast tissue (D cup) and the closest the surgery got to the nipple was about an inch to the outside. If the surgery leaves a dent, it can be filled with liposuction and fat grafting. Radiation could damage the skin, and you might end up with a smaller breast - mine got quite a bit smaller and tighter after - not a bad thing, in my case. Most doctors will want you to do radiation with a lumpectomy also.

    The current national recommendations are to not do sentinel node biopsy for DCIS alone - you could ask your doctor why she/he thinks it's necessary.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC48372...


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  • Irisheyes92546
    Irisheyes92546 Member Posts: 4
    edited December 2017

    I read the article on SLNB, and it says in the LAST SENTENCE that it is not indicated if Breast conservation surgery is performed. It is a little confusing. It sounds like it might be a translation from Dutch, which is what makes it a little easier to misconstrue.



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  • Irisheyes92546
    Irisheyes92546 Member Posts: 4
    edited December 2017

    Due to the size of a lumpectomy, I have decided to have a mastectomy. A 5.5 cm area plus margins (upper outside quadrant) would take 1/3 of my relatively small breast. And with such a large excision, there is no guarantee that nipple sensitivity would be retained. Lipofilling would not provide enough correction. Radiation would make reconstruction with an implant impossible, if I later needed or wanted a mastectomy, according to my plastic surgeon. I have decided I do not not want to go through radiation therapy just to conserve a small damaged breast.

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