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Lumpectomy vs Mastectomy

trsmith0104
Posts: 35
Joined: Jul 2012

I met with my surgeon on Wednesday and she has told me that I have to have a lumpectomy instead of a mastectomy. While I am pleasantly surprised by this, I am also wondering if it means that later on if I will eventually have to have a mastectomy anyway. She is also going to do a lymph node dissection because level 1 is suspect but level 2 seems normal.

She has told me that I most likely will have to have both chemo and radiation. In the back of my mind I wonder if a lumpectomy is enough?

New Flower
Posts: 3915
Joined: Aug 2009

After radiation skin does not heal well for some time, it is more challenging to have mastectomy after radiation. Everybody's case is unique. Please Talk to your doctors and ask a these questions. Second opinion is always beneficial

DebbyM's picture
DebbyM
Posts: 3295
Joined: Oct 2009

I had a lumpectomy and am very grateful for that. I was told that a lumpectomy with rads, which is what I had, is equal in survival and recurrence rate as a mastectomy as they can never get all of the breast tissue with a mastectomy.

Good luck with whatever you decide to do!

lynn1950's picture
lynn1950
Posts: 2567
Joined: Jun 2008

Follow your instincts. I've never heard of a doctor saying you HAVE to have a lumpectomy. It was suggested that I have a lumpectomy, but I chose to have a bilateral mastectomy and I am glad that I did. My surgeon said afterward that I had made a good choice. I would get more information and a second opinion. My best to you. xoxoxo Lynn

Lynn Smith
Posts: 1265
Joined: Mar 2011

My friend had Stage 3 breast cancer.3 nodes were involved.She had a lumpectomy and her doctors said it's about the same as far as survival.Pretty much what Debbie told you. My friend had chemo and radiation after surgery.She is a 18 year survivor. She's doing fine.

It's a hard decision.I was Stage 0 DCIS.No nodes involved.I didn't have chemo or radiation.My doctors said with my dx all I needed was to take tamox for 5 years I'm a 3 year survivor this month.

Lynn Smith

EveningStar2's picture
EveningStar2
Posts: 494
Joined: Jan 2009

I had a lumpectomy with rads for DCIS, no problem. But now that I have had a reoccurance, I had a bilateral mastectomy and radiation is a BIG problem. I don't know if the doctor didn't emphasize it or if I ignored it but if you need later surgery on radiated tissue it's a problem. I am in that situation now.

But you must decide for you--not the doctor. If mastectomy is what you want for your peace of mind-go for it. They did NOT want to do a bilateral on me but I pushed. And I am glad I did-healing on that side has been great.

Maureen

trsmith0104
Posts: 35
Joined: Jul 2012

Thank you all for your advice, I really do appreciate each and every one of you. Not just for what you say but for even sharing your experiences. It is helping me to get through this and somehow make it easier for me. My surgeon told me that even if she did do a mastectomy, it would not change anything. She said that in the end it is how the cancer is treated is what helps the most. I suppose that each area of the medical profession has their opinion and we have ours. I know that I didn't go to med school - lol. I am starting to feel better about the lumpectomy and know that by Friday I will be at peace with this decision. I am just not a peace with cancer. Nasty little bugger.....

Alexis F's picture
Alexis F
Posts: 3604
Joined: May 2009

I am happy to read that you are feeling better about your decision. Like the others wrote and I will just say it too, it is your body, your choice, your life. I had rads after my lumpectomy and am still doing great!

Good luck on Friday!

Lex

Noel's picture
Noel
Posts: 3101
Joined: Apr 2009

Wishing you good luck with your appointment this week. Come back and let us know how it goes.

Hugs, Noel

trsmith0104
Posts: 35
Joined: Jul 2012

I received bad news today. Even though my surgery is scheduled for Friday, I have to go back to the Surgeon's office. My MRI showed more tumors than what they had expected. She called them satellite tumors. So now she is wanting to discuss either mastectomy or chemo first then surgery later. I guess I haven't really ever been posed with these types of decisions before but extremely overwhelmed at what to do.

EveningStar2's picture
EveningStar2
Posts: 494
Joined: Jan 2009

about this news! Try to listen to the options and try to make sense of it all. We are always here to listen to you.

Maureen

New Flower
Posts: 3915
Joined: Aug 2009

i am sorry that you have been through roller-coaster and overwhelmed. please read your own post and comments about lobular. it has been very unfortunate for several of us here, that lobular was not detected on mammogram. that is why many with lobular have had mastectomies and were re-staged after the surgery & pathology reports, and had a different treatment plan than at initial diagnosis. MRI will help your surgeon to use a right strategy for you. please know that we are here for you.
Hugs
New Flower

AnnieTherese's picture
AnnieTherese
Posts: 67
Joined: Aug 2012

It seems to me that almost every oncologist has a different opinion on the same thing...depending on who you see. It can certainly be very confusing....best of luck

Noel's picture
Noel
Posts: 3101
Joined: Apr 2009

I am so sorry about your news. We're here for you so come back and post to let us know what's going on and how you are doing.

Hugs, Noel

trsmith0104
Posts: 35
Joined: Jul 2012

The surgeon ended up doing the lumpectomy after all. She indicated that I had enough breasgt tissue to work with to be able to do the procedure. She also did the lymph node dissection. Although we have to wait for the pathology reports to come back, she indicated that the lymph nodes were soft which is evidently a good sign. I already know that I have to have radiation but chemo is still up in the air (dependant on my report, etc.)

Alexis F's picture
Alexis F
Posts: 3604
Joined: May 2009

Happy your surgery is over now and I will be praying for clean nodes for you. Hoping you won't have to do chemo.

Thanks for the update,

Lex

Mittensandmedwick
Posts: 85
Joined: Jul 2012

Hi I was stage 1 grade 2. I had a lumpectomy and 3 lymphnodes removed. I decided not to do chemo and have started 34rads treatment. I have completed 5 and have 29 more to go. As other people have said it is a personal decision that we are fortunate to be able to make. Some people don't have a choice. You go wih what you feel is right for you. Good luck to you and you will have support with whatever decision you make

Patricia

Noel's picture
Noel
Posts: 3101
Joined: Apr 2009

When will you get your path report? Adding prayers that your nodes will be clear!

trsmith0104
Posts: 35
Joined: Jul 2012

My path report says nodes are clear and margins are clear. My stage is IIA. Oncologist is on the fence about whether or not to do chemo. She is leaning towards chemo because I am 43, but we are going to wait for the oncotype test to come back. I am kind of leaning towards having chemo too, only because I want to lessen my chances of getting this back again.

Megan M's picture
Megan M
Posts: 3001
Joined: Dec 2009

Congrats on clear nodes and margins! That is great and what we all pray for! Good luck with the oncotype test! I hope you don't need chemo.

Hugs, Megan

trsmith0104
Posts: 35
Joined: Jul 2012

My path report says nodes are clear and margins are clear. My stage is IIA. Oncologist is on the fence about whether or not to do chemo. She is leaning towards chemo because I am 43, but we are going to wait for the oncotype test to come back. I am kind of leaning towards having chemo too, only because I want to lessen my chances of getting this back again.

Tonia

Noel's picture
Noel
Posts: 3101
Joined: Apr 2009

Congrats on your good path report!

disneyfan2008
Posts: 5259
Joined: Oct 2010

2008 I had lumpectomy and radiation..so far all is well...

I was not even given an option I was just told "Lumpectomy"

on tamoxifen starting 5th year next week..

Denise

Kylez's picture
Kylez
Posts: 3765
Joined: May 2009

That's such great news about your pathology report. Hoping that you will not need any chemo at all.

Hugs!

Faith1122
Posts: 46
Joined: May 2012

I had 70% DCIS & 30% IDC. Minimal stage 1 estrogen positive. The actual cancer tumor was only 1-2 mm. Only the DCIS showed on my mammography & I went in to have it biopsied. They told me they were pre-cancer cells but when they biopsied them they found the cancer tumor. That was part of my decision to have a double mastectomy. The fact that the tumor didn't even show up on a mammo & my strong family history of BC. I was afraid of rads & chemo & was told I wouldn't need them if I had the mastectomy I just need to take tamoxifen for 5 years. I also thought about how the radiation can damage the skin & if God forbid the BC comes back & you have the mastectomy, the reconstruction may not come out as nice. As nice as it can anyway :0/ Good luck with whatever you decide. Your decision is the right decision for you.

Alexis F's picture
Alexis F
Posts: 3604
Joined: May 2009

Thinking about you Tonia!

Lex

trsmith0104
Posts: 35
Joined: Jul 2012

Thank you - I am doing good. I did the lumpectomy because the girls were big enough to removed the 3.5 cm tumor without disfiguring me. I have clean margins and clean nodes, so I just need to wait for the oncotype test. That comes ba on the 12th. I am already looking on the web at wigs, went to the health food store to discuss how to boost my immunie system, etc. I am getting mentally ready for everything (getting ready for the other shoe to fall).

I'm sure it'll be fine, LOL.

DianeBC's picture
DianeBC
Posts: 3888
Joined: Jun 2009

Glad you could have the lumpectomy and great news about clean margins and nodes! If I may ask, why is your onco suggesting chemo for you since your nodes were clean? I thought usually you just have rads after a lumpectomy unless cancer shows up in your nodes.

Praying that you won't need chemo!

Hugs, Diane

trsmith0104
Posts: 35
Joined: Jul 2012

I am waiting on the Onccotype test first. The Oncologist at first said she was leaning towards chemo only because of my age, but wanted to see what the test numbers came back as before she made her final decision. I guess it is not normal to have someone at my age get Invasive Lobular Carcinoma because it is typically found in women over 50 (I am 43).

Megan M's picture
Megan M
Posts: 3001
Joined: Dec 2009

Did you get your results back yet?

trsmith0104
Posts: 35
Joined: Jul 2012

No Oncotype results yet - not until 9/12

lindan123's picture
lindan123
Posts: 11
Joined: Aug 2012

If you have early-stage breast cancer and are not offered at least two options, go to a different doctor and get a second opinion. Ask about survival statistics based on your diagnosis, and about your surgeon's expertise in breast cancer surgery procedures. Sometimes your health insurance may limit your choices, but if you want more options, ask how you can work out a financial compromise. If you're favoring a mastectomy, you should also be discussing your choice of breast reconstruction methods. If breast reconstruction is not mentioned before you settle on a mastectomy, consult a plastic surgeon to see what your options may be. Make sure you feel as confident as possible when you choose your breast cancer surgery procedure.

Sunrae's picture
Sunrae
Posts: 808
Joined: Oct 2009

Sorry to hear about your situation and all the decision options that are swirling around in your head. I was dxed in 09 as stage 2A, ER positive. My onc at first said I would only need a lumpectomy with rads, but after several tests found that I needed a masectomy because I already had 3 tumors in my breast and bc was found in the lymph nodes. My onco type test showed low range so I might not need chemo. After path report came back I was Stage 3A and also had 11 positive lymph nodes out of 17 nodes removed. I chose to have chemo and rads after the masectomy and also was given Femara to take for the next 5 years. I have since switched to Arimidex because of side effects from Femara. We all have to make the best decision we can based on what we know and feel. You will make the right decision for yourself. Keep us posted and we wish you the best.

BethBV
Posts: 1
Joined: Aug 2012

Saw the surgeon this morning. I went in with my mind fairly made up that the left breast has to go but was waffling on the bilateral. Now Lumpectomy is back on the table and awfully appealing.

What we know from needle biopsy and MRI:

Probable Infiltrative Ductal Carcionoma
2.5+ cm malignant mass in breast (at 12:00 near the nipple, not too deep)
3.5+ cm malignant mass in axial node (so at least one node very involved)
ER+, PR+, HER2- (this is basic, garden variety, IDC, very common)
MRI shows nothing on the right side
MRI shows no other nodes involved (but the doctor isn't convinced)

I had a Borderline Phyllodes Tumor on the left breast in 2009. Had lumpectomy and a second excission for wider margins. I have been repeatedly assured that this IDC is something totally unrelated to the Phyllodes but, truthfully, I'm kind of mad at my left breast right now. I want to banish it to the trash heap!

However, lumpectomy will be SO much easier that mastectomy. The surgeon says chemo, radiation and hormone blocking is not optional in my case, due to the lymph node involvement. So, should I just go for the bilateral and all the pain and recovery that involves? Should I just take the easy way out and gamble that it won't come back? 5-Year Survival rates for mastectomy vs. lumpectomy are identical (94%). Recurrance rates for mastectomy w/rads is 4% to 5%. Recurrance rates for lumpectomy w/rads is 12%.

I know no one can make this decision except my husband and I but we are stumped. What would you do? What should we consider?

Thanks for any input!

wirak
Posts: 22
Joined: Jul 2012

From my own personal experience, I would go with the mastectomy. My doctor told me I was a lumpectomy candidate, but I opted for a mastectomy just because I knew I would always be worried. Following the surgery, he told me had I had the lumpectomy, I would have been back in for a mastectomy because there was a second tumor they weren't aware of. I had had a mammogram, needle biopsy and MRI and all three missed the second tumor. This has made me so nervous, I am opting to have the other one removed this fall, even though it shows clear. Best of luck to you. I hate that you're having to make this decision.

MAJW
Posts: 2515
Joined: May 2009

I had a lumpectomy...surgeon said there is no greater survival rate z with a mastectomy vs lumpectomy as it's impossible to remove all breast tissue....
I had clean margins and no lymph node involvement....had chemo and radiation.....was in remission for 19 months....it came back in my lymph nodes...NOT in either breast...Been under treatment again,now for 14 months....it's been quite a journey being stage IV.... I am now in remission...words I never thought I'd hear again...

Wishing you all well in making your decision...everyone has to do what they feel is best for themselves....
Hugs Nancy

VickiSam's picture
VickiSam
Posts: 8220
Joined: Aug 2009

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