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Lumpectomy vs. Mastectomy

DoodleLover
Posts: 3
Joined: Aug 2012

Hi. I was diagnosed with Invasive Ductal breast cancer at the end of June. I had a lumpectomy about 4 weeks ago. My tumor was only .7 cm and the nodes that were removed were clean. I am Estrogen and Prog. positive, and HER-2 negative. BRCA test was negative. Oncotype was a 14. My onco said that I will not need chemo, but wants me to start radiation right away. As I am getting ready to start the radiation in the next week or two, I am having a lot of anxiety about whether this is the right path to take. I know the chance for local recurrence is the same with lumpectomy and radiation as it is with a double mastectomy, but I am still having second thought on whether or not to have both breasts removed. As it stands right now, as the swelling is starting to go down from my surgery, my left breast is looking totally different than my right.

I am 44 and have a lot of positives about the cancer being caught early, being small, not in the nodes, etc.

One of the reasons I am scared of radiation is this: I have a friend who was diagnosed with the same cancer when she was 44. She had a lumpectomy, chemo and radiation. After 6 years, her cancer just came back this last February. She has now had a double mastectomy and reconstruction. It has been quite a process. What made her reconstruction so difficult was the fact that she had radiation in her left breast, so the process to reconstruct that breast was entirely different and more difficult than the other. Her breast are completely different in size and shape and that is because of the radiation treatment she received six years ago.

I know this may not be the norm, but I can't help but wonder if I would be better off just getting both breasts removed now and be able to have an equal reconstruction done, than having to possibly go through such a procedure when I am older and have had the radiation.

I feel like I am running out of time to make this decision because I only have about a 2 week window until I have to start radiation.

I am trying very hard to have faith and trust in my doctors, and at some point I am going to have to be comfortable with whatever decision is made, but it is so hard to know what is the right thing to do.

Thank you for listening.

Annette.

SIROD's picture
SIROD
Posts: 2172
Joined: Jun 2010

Dear Annette,

I have just pass my 18th years since being diagnose with breast cancer. I have been participating in online forums/discussion boards since 1997 as well as taking part in a local one back before there was the internet. I have read a lot too.

One thing I have learned about this disease is that there are no guarantees that you won't have a recurrence no matter what one does. All you can do is listen to your oncologist, radiologist, surgeon and primary care doctors recommendations and make your decision. I have read where some women with stage 0, no node involved would go on to be stage IV and women who were stage 3C with many nodes that were malignant never have a recurrence (at least when they were posting).

You make the best decision you can and then you hope for the best. I know this isn't much help but remember that 70% of women never have a recurrence.

Best wishes,

Doris

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

I would never tell you what is right or wrong for you Annette, as, I have no idea. I can tell you that I had a lumpectomy and rads. I was very lucky that I had clear margins and a clean node, so, chemo was not needed.

I just want to say good luck and I know you will do what is right for you.

Hugs, Diane

trsmith0104
Posts: 35
Joined: Jul 2012

My tumor was 3.5 cm and I have invasive lobular carcinoma. I am ER AND PR +. HER2 -. My surgeon steered me in the direction as having a lumpectomy. I am currently waiting for the ONCOTYPE test to come back to decide whether or not I will need chemo. My oncologist is on the fence. I was like you. Worried..... What if it comes back and I have radiated the area? I asked the surgeon and she did not seem too concerned about this coming back or having to do it again. I do understand your concern because I am sort of in the same boat as you. But at the same time....I think that always looking over my shoulder worring about whether it will come back is not helping me heal (I just got the drain out). I just know I need to move forward and get my treatment too (I am 43 years old). I wish you well and hope that you find peace in making your decision.

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

to know what is the "right" decision. The best that any of us can do is what feels right to us guided by the information we receive from out doctors. I was diagnosed in Jan 2009 with DCIS and had a lumpectomy and radiation. I was reluctant to have the radiation but hubby was pretty adamant about it. Fast forward to April 2012. Reoccurance of DCIS and we could have had another lumpectomy but I'm done--bilateral mastectomy. I've problems getting the radiated side healed--I'm 6 weeks postop and still having issues. I really wish I had not had radiation. But who knew? You may never have a reoccurance and this will all be ancient history.

I know I haven't helped you make your decision, all I can do is relate my experience and encourage you to listen to yourself, your doctors and your love ones.

Maureen

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

Annette, have you made your decision yet? I had a lumpectomy, followed by rads. That was the recommendation of my oncologist and breast surgeon.

Good luck in whatever you choose.

Hugs, Kylez

Goody100
Posts: 8
Joined: Aug 2012

Annette-
I have my surgery today and opted to go with the double mastectomy for several reasons. I'm stage one invasive. The first decison factor was the family history of the reoccurance of breast cancer, the second was piece of mind. Remember it's your choice and don't second guess the decision that you've made. Just work on your healing process and move toward that goal.

I was scheduled to have a lumpectomy and changed my mind to the double and I'm at piece with that decision, although people question me, they don't know about my family history, breast issues and other areas I have based my decision on. I guess what I'm trying to say is don't let others make up your mind. Do the research, talk to doctors and know in your mind that you have done the best you can.

I hope the best in your outcome and keep us posted.

Lisa

sdukowitz
Posts: 250
Joined: Nov 2011

I was diagnosed last year with dcis .....1.2 cm, clear margins, estrogen and progesterone positive ... I did the wire localized lumpectomy and was back to work and driving wirhin 6 days .... then i did a shorter term radiation ....4 weeks with no problems it was really only a few min each day lying under a machine .... you may want a second opinion from another oncoligist , but the fear of recurrence is always there no matter what you choose ..... do what you feel most comfortable with .....prayers and hugs i am on the hormone treatment now for 5 years which also is suppossed to cut down the recurrence factor ... so ask about that as well since you are estrogen positive best of luck Annette!, Keep us posted! Only you can make the decision! SUE D

Attygirl's picture
Attygirl
Posts: 121
Joined: Jun 2012

Almost everything about our diagnosis is similar: I was diagnosed with IDC in April at 48 years old. No significant family history. Tumor was 7mm. Stage 1. ER+. HER-2 Neg. Clean nodes. Onc score 21/no chemo. Lumpectomy in May. As you may remember from my thread on radiation to which you replied, I am finishing 36 rads next week.

For myself, I just couldn't see choosing bi-lateral mastectomy for such a small, highly treatable cancer. Between the rads and the Tamoxifen which I will probably take, or at least try, I am told my chances for recurrence can be down to under 5%. Is it a crap shoot? Sure feels like one, but I'll take those odds and deal with the what ifs IF they happen.

Having said that, I can see why you are torn and I know it must be agonizing. Whatever you decide for yourself, if it brings you peace than so be it. It will be the right decision because it is yours.

debsweb18
Posts: 190
Joined: Jun 2012

Only you can decide what's best for you, but here's my story. I had a lumpectomy and then had to have a mastectomy because my margins weren't clear. I did have a small tumor on 1 lymph node, but my onctotype DX was only 9 (and I'm post menopausal) so I didn't have chemo. I had a "permanent" silicone implant at the same time as my mastectomy. Then had 34 radiation treatments. 6 months after the mastectomy I had a nipple reconstruction and the other side lifted. Because of radiation, my implant shrunk enough that I felt my breasts didn't "stick" out the same. From what I understand, radiation can still shrink things for a while afterwards. So a few months later, I had my implant exchanged for a larger size. I'm much happier with the results. However, my nipple is now higher than the other because of the replacement and the other side still sags a little more than the implant. Again, it's because of radiation-my skin is tighter, holding up the breast (This baby will never sag!). I can have more surgery, but I don't think I will. My husband's happy and you can't tell with clothes on. I'm 59 and figure my other side will continue to sag again so maybe later....

I didn't have any problems with my skin having the replacement.I know the implant exchange is not the same as reconstruction, but I guess it would depend on your skin.

I think we have to make some of the most difficult decisions while having this disease, but I'm sure you'll make the right decision for you.

Deb

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