You Mean You’re Not Going to Fix It?!?!

I live in a small town. We have ONE dedicated breast surgeon in town. I met her today & left her office thinking I’d rather do no treatment at all than all the hoops she regurgitated in monotone. I’m two weeks out from dx & I’m just devastated. I’m small breasted with 3 lumps so I’d prefer lumpectomy but she said there’s no reconstruction with a lumpectomy (vs mastectomy)!!! I’m sorry, WHAT?? WHY?? You mean you’re not going to fix it??? I know I sound vain but I’m 48 & single & like my body & my bikini & I just want to look okay. I keep thinking I’ll look like a disfigured freak & then who will love me or how will I love myself anymore. It seems silly but damnit with all the advancements why can’t they make it look ok?? And how do I find a surgeon who doesn’t think I’m a jerk? Ty everybody. I’m heartbroken

I had two lumpectomies. I am large breasted but, the way the surgeon did my surgery you could not tell a difference after the surgery. I was amazed. I had a huge chunk taken out with three tumors. After the second lumpectomy there was a definite indentation along the surgery line, but it was not really noticeable.

Get a second opinion, I traveled almost two hours away to have my surgery done as there was no dedicated breast surgeon available where I lived.

LoriH -I am so sorry you are here and in the beginning of all this. Because the beginning is the hardest part in a sense. Lori what are your stats? I was 47 at diagnosis....I had a 6cm tumor in one breast and 3cm in the other..while I get where you are about saving what you have, and being single and liking your bikini, what are dealing with tumor wise....? There are a lot of options, seriously, you may have to travel, but they are out there...but then it also boils down to your cancer and the risks you are willing to take....

Lorih555....I would suggest getting a second opinion at a major university teaching hospital. Good luck and keep us posted.

I would recommend taking one step at a time. I had two lumpectomies and they didn't get clear margins either time so I ended up needing a mastectomy anyway. (I ended up getting bilateral, for symmetry, with immediate direct-to-implant reconstruction.)

If you are going for lumpectomies, do those first. See if they get clear margins and if any other treatment is deemed necessary (e.g. if you need radiation, which can affect the remaining tissue and skin). Worry about reconstruction later, once you're cancer free. The first step is to get rid of the cancer.

On the other hand, you could get a mastectomy and immediate reconstruction at the same time.

what state are you in?

There is no federal law mandating reconstruction for a lumpectomy defect - this is why insurance is not required to cover it. The WHCRA law passed in 1998 only covers reconstruction for mastectomy. That said, some have insurance coverage available for an oncoplastic surgeon to do their lumpectomy with rearrangement of tissue at the time of lumpectomy which results in a better aesthetic outcome in many cases. Important to remember that radiation will follow a lumpectomy and may change the appearance of the breast regardless. The ratio of tumor to breast may dictate the type of surgery needed to provide the type of outcome you want. I would agree with the above posters - see a breast surgeon/plastic surgeon team in a larger area, or several, to get a better assessment of techniques and surgeries available to you. These would include lumpectomy, oncoplastic lumpectomy, direct to implant mastectomy with/without nipple sparing, expander to implant with/without nipple sparing, or autologous reconstruction using your own tissue. Be aware that not all plastic surgeons offer all of these options, so depending on what you prefer you may have to look for a provider who offers what you want.

Maybe she is unable to fix your breast after the lumpectomy to make it look normal? I too have small breast (34a maybe lol) and had the option of a lumpectomy or mx. My breast surgeon would have fixed any defects after the lumpectomy, since she also does some ps, but we decided to get a plastic surgeon to do my reconstruction after she did the lumpectomy. My concern was more about not getting clean margins, and having no choice but having to go in and get a mastectomy since I didn’t have enough breast tissue to get a 2nd lumpectomy. So she went in and took out the tumor and then when back in and took out more tissue.The PS came in behind her and did my reconstruction. My insurance paid for it all, and will pay for my breast lift on the other side plus I will eventually have to get nipple done. That said, it was good that we did take out more, since I had DCIS that we didn’t know about! These are hard decisions that we have to make, but you need to be happy with them. I don’t know how far you are from a city’s that might have better options, but I would definite look into it.

thank you everyone im so depressed. I just don’t want to do any of this!!

Lorih, I've been there. Not wanting to do any of it. I wish there a better treatment option than cut, burn and poison medically of course.

meow13 I see you’re from Tampa. I’m headed there sept 1. I think actually Clearwater. Wd u say there’s good care there? I think I may need to move there *first* to find someone to help me. I just can’t believe I’m still wo a surgeon & I found the lump may 9th. So depressed

lori - it me that lives in Tampa, and yes, this area has lots of options for care. There is both university based care and an NCI center, and also private docs. I would not wait until Sept though to seek care if you have a cancer diagnosis now.

Take a deep breath.

And another.

One step at a time. I think you need to ignore what that first surgeon told you and prioritize getting that second opinion. Stop thinking about gross disfigurement and all the worst case scenarios (I know it's hard, and if you can't stop thinking about it, consider talking to someone in person or getting some meds to get you past this point). Right now you just need to know what your actual options are. You are strong, and you can get through this, but as another single person I say, if you need help to get through these steps, ASK! If you can't face researching doctors, ask someone to help—family member, friend, whomever. Keep moving forward, but focus on what you can see in the headlights, don't strain to see what's in the dark.

thank you so much!!! Exactly what I needed to hear. I have an appt with a dr in Harrisburg (UPMC pinnacle) Lisa Torp MD & her video is like she’s speaking directly to me. I feel better already. Still need to biopsy the third lump found on mri Thirsday then meet dr & schedule surgery. Things take longer & are more arduous when living far from good medicine. I’m trying to get past the disfigureMent but i shd be able to get rid of the cancer *and* have my body look decent in 2018. Hopefully it’ll all b ok. Tysm! great reply 🙏🏻

I’m in Dunedin. Sent you a pm.

Hi Special K!