Trying to Decide - Lumpectomy or Mastectomy

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macdebbie
macdebbie Member Posts: 171
edited December 2021 in Surgery - Before, During, and After

I was just diagnosed two weeks ago with IDC in my right breast and am meeting with the surgeon on 8/16. I met with her PA a week ago and she went over everything with me.

I have Grade 2, 3-6mm tumor, age 63, ER+, PR+, HER2/neu negative.

They recommended a lumpectomy to me, as did my radiologist, telling me the survival difference was 2% and that I could still get a recurrence of cancer in the scar or breastbone if I elected to do a mastectomy. I know a mastectomy is also a much more involved and longer surgery, not to mention reconstruction.

It seems the only thing I'd gain by doing a mastectomy is potentially not having to do radiation, but I assume I would still need to go on hormone treatments. I've met with an oncologist who said unless the surgery shows something different, he would grade me as a Grade 1.

What other things do I need to think about? If you did a lumpectomy were you satisfied? Did you have wire-guided or Savi Scout?

Thanks.


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  • ctmbsikia
    ctmbsikia Member Posts: 1,095
    edited August 2021

    Hi Sorry you are here. Keep reading this section with different surgeries and others experiences, I trust you will find it helpful. You have a pretty small tumor so chances are if you choose a lumpectomy you should have good margins and good cosmetic result. I did a lumpectomy with a 4 cm tumor. BS (breast surgeon) did a wonderful job but I do have some issues now. Fat necrosis being there. I'm also not even, but that doesn't bother me in the least. I wanted the lesser invasive surgery thinking that if it came back, then I would cut the rest of it off. Remember too, with a lumpectomy there will be imaging done. I get a little anxious with that, especially if something comes up (like fat necrosis) and it's a 6 month cycle. Something to think about for future. Good luck with your decision. As you know, after surgery when you get that pathology back, that will determine your treatment path. I had the wire guided surgery.

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  • Beesie
    Beesie Member Posts: 12,240
    edited August 2021

    Read here, specifically the opening post and the last post (at the end on the second page): Topic: Considerations: Lumpectomy w/Rads vs. UMX vs. BMX https://community.breastcancer.org/forum/91/topics...


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  • HomeMom
    HomeMom Member Posts: 1,198
    edited August 2021

    Initially I had a lumpectomy, my tumor was right at 2cm. I didn't have clear margins and I don't have a ton of breast tissue (B cup) so it just made sense to remove that breast. I go get mammograms of the remaining breast and sometimes I think I should have removed them both so I wouldn't have to go anymore

    Those links look like good resources to look into

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited August 2021

    I had a lumpectomy, and did not have clear margins. The resection that was done about a month later was easier than getting a tooth filled - twilight anesthesia, in and out in just a few minutes. I was home by mid-morning, so even if you need a resection, it's usually not a big deal. The only thing I'd have done differently would have been to even up the other breast. I can easily go braless on the lumpectomy side, but big sister is still hanging large and low and I'd rather have two odd-shaped shorties. I did not have any problem with radiation, a few minutes out of each weekday for six weeks.

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  • macdebbie
    macdebbie Member Posts: 171
    edited August 2021

    Thank you. I'm sorry for what you've gone through (just saw your history). I'm not sure if you just didn't list it, but did they not put you on hormone therapy? Do you not need that if you have a mastectomy?

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  • macdebbie
    macdebbie Member Posts: 171
    edited August 2021

    Wow, thank you! The first post (which I believe you wrote?) was EXCELLENT. All the things I need to think about. Some I knew of, most I did not. Thank you so much.

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  • kksmom3
    kksmom3 Member Posts: 183
    edited August 2021

    I see you have a small tumor, so did I, at 3 mm. I didn't know it until pathology though, I originally was thought to only have DCIS. I chose a lumpectomy with radiation. I don't regret it. My surgeon said he could give me a good result and he did. My team all thought a mastectomy was overkill as the whole area involved was small, at least 6 mm, but I don't know exactly how big it was by the time it was diced up. They did tell me they took out about a golf ball size of tissue, which initially freaked me out, as this was in an A cup breast, but I can honestly hardly tell.

    What do your doctors recommend? Are they leaning towards lumpectomy or mastectomy? Either way, we all have concerns particular to only us. Good Luck!

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  • Ilikedogs
    Ilikedogs Member Posts: 55
    edited August 2021

    kksmom3, what did they see on your mammogram? Was it just calcifications?

    I had my biopsy today for calcifications and they aren’t seeing any masses/tumors and are thinking that at worst it is DCIS but I am worried. Because 3mm is pretty small….

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  • kksmom3
    kksmom3 Member Posts: 183
    edited August 2021

    Ilikedogs, yes, they only saw suspicious calcifications.

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  • Lucka
    Lucka Member Posts: 4
    edited August 2021

    I met with a plastic surgeon after meeting with surgeon and looked at before and after lumpectomy vs mastectomy photos and decided on nipple sparing mastectomy partly for cosmetic reasons and because I believe the more tissue around cancer taken out, the less chance of recurrence. Since my cancer was on left side, I did not want my heart affected by radiation.. I am happy with my decision, currently have expander to be exchanged for implant In October.

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  • ilenef
    ilenef Member Posts: 11
    edited December 2021

    Thank you for your post. Alice. I am having the SAVI clips placed on Thursday and left and right breast lumpectomy surgery a week later. I am aware that I may need to have a 2nd surgery if the margins are not clear. And I am concerned about radiation. Your post eased my mind.

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