Please help me decide lump w rad or double MM

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Faith1111
Faith1111 Member Posts: 46

I have 5 mm inductive BC, estrogen/progesterone positive, negative on the other thing and negative for any cancer genetics.

I have 15 year silicone implants, 550/500. My retired PS who only does injectibles now examined me and said he thought a double M with implants would be best bet.

I have Kaiser and the PS there said she agreed but she couldn't do nipple saving on me. I wear 32DDD and she said she couldn't guarantee any size, not a b or a c because it depends on what cuts the cancer doc doesn't on me and she will do tbr best she can do. She said large implants might not hold. I told her I wanted full c or c.

I am afraid of radiation burns and hardening. But all this uncertainty is scaring me. My PS knows my PS at Kaiser and he said her work is very good.


I'm also scared if I do a lumpectomy and rads the bc might come back. The mamo I had last month and last year showed nothing. I found the lump myself. I have dense breasts so mamo doesn't seem to work on me.

My oncologist that I consulted with said reconstructed breasts don't feel like real breast. But how much worse can it be than the impants I already have? Those aren't natural either.

I am so tormented. Any advice I would appreciate.

I’m 48 and divorced. Hoping to keep my boyfriend. He says he loves me for me but I still want to look nice for him and myself.





Comments

  • Ingerp
    Ingerp Member Posts: 2,624
    edited June 2019

    You're probably aware that mastectomy and lumpectomy + rads have similar recurrence rates. And radiation is nothing to be afraid of--many women go through it with minimal SEs. I had the expected reddening and a little fatigue but that's it. I'm not sure what hardening you're referring to--there is scar tissue at the surgery site but that's it. Many of us have had to go through the lx/mx decision. You need to arrive at a decision that you can be at peace with.

  • Salamandra
    Salamandra Member Posts: 1,444
    edited June 2019

    If you have good surgeons and plastic surgeons, I think you can look nice no matter what route you take - although it may take some time (and trouble) to get there depending on how treatment unfolds. There will be plenty of things that you don't really have control over. I hope that you can believe your boyfriend that he values you for your whole self. That is the kind of partner you deserve. My understanding is that post-mastectomy really does feel different than implants, but hopefully someone who has had both will come along and be able to speak about it. You can also use the search button or the browse function to try to find threads.

    On the positive side, it's fantastic that you have doctors you have confidence in, it was found early, and you have a supportive partner. Wishing you all the best!


  • edj3
    edj3 Member Posts: 2,076
    edited June 2019

    Hi there,

    I forget which wise poster said this, but the nice thing about a lumpectomy is that it's the least invasive surgery. And you can always have the mx done if your pathology report indicates it's needed OR you end up realizing that hey, for me take it all off.

    But an mx doesn't guarantee you won't have a recurrence. Cells are tiny, they go where they want to go and the surgeon cannot get everything. That's why radiation is a good option. It kills cells in the radiated area.

    I'm on the last week of my radiation treatments. I had a lumpectomy on May 6. While my skin is definitely red and a bit pissed off, and I do have the fatigue, it's been pretty easy.

    I'll also add in, regardless of which surgery option you choose, remember that how things look the day after surgery isn't how things will look once you're fully healed (and done with radiation, should you need that). You probably had the same experience with your implants, it probably didn't look so great the day, week or maybe even the month after. So be sure to give yourself time to heal.

  • Faith1111
    Faith1111 Member Posts: 46
    edited June 2019

    Thank you to those who replied. My cancer surgeon and PS both stood by my bed the day of surgery and basically talked me out of the double M because they thought I would be upset with how much smaller they would look and the fact that we didn’t know if lymph nodes would be involved.

    Had my surgery on Wed. The cancer was 2.5 mm, the margins clear and no node involvement. So far we only did the lumpectomy but I could still ask for the double M with immediate reconstruction.

    I’m just scared the radiation will harden my implant and make it ride much higher or a a lot smaller. The PS said radiated breast tissue becomes a huge problem to operate on should we ever need to. My whole goal was to avoid radiation but now I’m too scared to get rhe double m.



  • Faith1111
    Faith1111 Member Posts: 46
    edited June 2019

    Also, they want to give me 3 weeks of rads but the radiologist said giving me 6 weeks at a lower dose might be better for my impmants. Anyone have experience with this?

  • Spoonie77
    Spoonie77 Member Posts: 925
    edited June 2019

    I don't personally have experience with implants, Faith, but I have seen a number of threads on the boards here in the past about this. Hopefully members will stop in and offer their two cents soon. In the meantime, maybe this thread, "Anyone have breast implants prior to radiation?" might be helpful. There is mention of Singulair being given to help prevent capsular contraction. Sounds interesting. Wishing you the best outcome on your journey. There are wonderful people here so remember you are never alone. Congrats on making it through your surgery and having clean margins and nodes! Wishing you a speedy recovery.


  • dd1973
    dd1973 Member Posts: 13
    edited July 2019

    I've been doing research on fat-grafting and had a consultation. Based on what I read, fat grafting might be able to help with the scar after the radiation. Might want to ask your PS about this.

  • NJmom2boys
    NJmom2boys Member Posts: 31
    edited July 2019

    Hi Faith,

    Last year at this time I was having my lumpectomy. Left side. Last September I started radiation. Prior to any diagnosis I had under the muscle silicone implants. I was so worried that I would develop CC and that the skin would harden and the implant would ride up. So far so good. I am coming up on the year mark for radiation and I have no issues at all with the implant. I did not take Singular. I just was religious with using the Calendula cream. I am still using it twice daily. I had 4 weeks of radiation. The last week being a boost. My RO felt that doing lower doses at a longer stretch wouldn’t change anything with the implants as we spoke about that.I wish you the best of luck. I was at one of the top hospitals in the country, and had an excellent RO. And after listening to what she said, I was uncomfortable not doing the radiation.

    Best of luck to you!

    NJ

  • Faith1111
    Faith1111 Member Posts: 46
    edited July 2019

    Thank you, hearing you haven’t have any problems with your implant makes me feel better. The rad oncologist said since my cancer is so small he would let me skip the boost to lessen the chance of a bad cosmetic outcome. But that worries me too because I don’t want it to come back. I’m getting a 2nd opinion to be sure.


    Thank you to the other two posters as well!

  • Dm39
    Dm39 Member Posts: 32
    edited July 2019

    Hello. I was also very confused as what to do. I had multi focal invasive ductile carcinoma. I had cysts in non cancer breast. I had varying opinions. I wound up doing double mastectomy. I thought it would save me additional surgery and treatments. I wound up having 5 surgeries, chemo and on to radiation anyway. I had a recurrence a year after mastectomy because when they did the needle biopsy in the very beginning to diagnose me, it brought cancer cells to the surface of the skin. Because I did mastectomy, I had not gone through radiation or chemo. It ultimately gave the cancer in the skin an opportunity to grow and had to do additional surgeries and rads and chemo to combat recurrence. If I had to do again, I would have done lumpectomy with rads. I probably wouldn’t have had a recurrence and would have avoided multiple surgeries. I would also still have my breasts. I am a strong believer that a mastectomy should be a last resort. You can always have one later on. I think women are scared into doing it. The chance for recurrence is the same. I would do your research before you do anything that can’t be undone. I can appreciate your scared and I pray for your peace of mind. Good luck to you

  • Faith1111
    Faith1111 Member Posts: 46
    edited August 2019

    Thank you so much for replying to me and telling me your story. I didn’t get the notification until now. I’m sorry the biopsy made things worse for you and all that you have went through.

    My doctors (surgeon and plastic surgeon) told me on the day of my operation they thought the lumpectomy with radiaton was a better option. I felt very vulnerable and thought maybe I shouldn’t be stubborn and demand this double mastectomy with reconstruction. I went ahead with the lumpectomy. But since my June 26th surgery I’ve felt like I made the wrong decision. I saw my oncologist today and she told me the lumpectomy was best for me. Seeing your post just now makes me feel better about what ended up happening tome. Thank you.

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