Need Help Deciding Lumpectomy w/ Rads or Mastectomy

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mimikitty
mimikitty Member Posts: 30 Member
Hello,

I am 41. My tumor is 1.4 cm and my docs told me I am a good candidate for lumpectomy followed by radiation therapy. They also say that most likely I will not need radiation if I choose a mastectomy based on the nature of my cancer and appearance and feel of my lymph nodes. So I'm currently struggling with the decision if I should get a mastectomy without radiation or a lumpectomy with radiation. I met with a radiation oncologist today who gave me a sales pitch for radiation. He told me all the risks I was worried about were "very low." I am very concerned about short & long-term risks of radiation therapy, especially if it's an optional treatment in lieu of mastectomy where I may not need it at all. One possible side effect I was told was that I may end up with some strange cancer (forgot the name) 15 years down the road.

On the other hand I'm concerned about the mastectomy and reconstruction would have on my body, because it's such a big surgery. I'm trying to weigh which option has the best long-term outcome for me. I don't qualify for the DIEP mastectomy because I am too thin, so my likely option would be mastectomy with silicon implants. I was told they put the implant behind the pectoral muscle and that my arm will become weaker as a result, which will impact my yoga practice (hand stands, etc.).

My active lifestyle including yoga is important to me as opposed to just surviving, so I am factoring lifestyle into the equation. I would love to get some input from folks who were faced with this decision and what they settled on, and if they have any regrets.

Thank you so much in advance for any input.

Comments

  • carkris
    carkris Member Posts: 4,553 Member
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    there is no right or wrong
    there is no right or wrong decision. Losing a breast is tough. it affects people differently. Then some people just want to remove the breast because they feel it optimizes their chances of getting all the cancer. This is not the fact just how they feel. I wasnt someone highly invested in my breasts, but have to say it isnt easy. I had mastectomies and I know I needed to to save my life but I miss my breasts.
  • KathyLQ
    KathyLQ Member Posts: 100
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    Many months going through reconstruction
    I’m 59. I kind of didn’t have the choice of just a lumpectomy followed by radiation. A University Medical Center diagnosed me as not having clear enough margins, and recommended the mastectomy. Including the initial biopsy, I had a total of 6 surgeries, seemed like they would never end. My DIEP was done 5 months after the mastectomy, followed later by a lift on the other side, and another one to fine tune the DIEP results including fat grafting to fill in a hollow. Even though everything now is “all me”, no implant, I do find myself still protecting my DIEP breast. I won’t lie on it, I try to keep from bumping it. Same with the other side where I had a lift. They just don’t seem to be totally like the original. I do ride my bike a lot, but I don’t do a lot of upper body work, at least not hand stands, LOL. The DIEP is in front of my chest muscles.

    Even with all the pre-surgery advice, I was not prepared emotionally for the mastectomy. It destroyed my feeling of self worth. The hour I woke from the surgery, I was devastated. Then 5 months with an expander, then the DIEP surgery, a week in the hospital. Thirteen months after the mastectomy was my last reconstruction surgery, the last fine-tuning. For the longest time, I couldn't see the end of the tunnel of knowing there was another surgery still coming. But they are now over. The end results are not perfect. Only because the reconstruction is finally done, am I glad I did it. It has helped to restore my feeling of self worth, of feeling like I am whole again.
  • disneyfan2008
    disneyfan2008 Member Posts: 6,583 Member
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    I was never offered choices
    I was never offered choices and ME being dumbfounded never asked..but I had lumpectomy and radition. I was never told size etc..I am very small breasted..(i gain some now ONLY THOUGHT is from TAmoxifen...no weight gain etc)

    IT must all depend on type of cancer I GUESS...like I said I never heard info I often see posted here.
  • ksf56
    ksf56 Member Posts: 202
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    Radiation wasn't bad
    I can only tell you about my experience, so here goes - I had a diagnosis of triple negative invasive ductal. My tumor was around 1cm. I had two lumpectomies to achieve a clear margin. The surgeries weren't bad - just the usual post-op stuff. I was surprised how much the change was to my breast. I had no lymph node involvement, luckily. My treatment was chemo then radiation. The radition was not a huge deal. I had skin reactions - reddness, itchiness and soreness. It all subsided pretty quickly when the radiation was done. A month out, I was almost back to normal. My breast is smaller but I really don't mind and neither does my husband. I can move my arm like I always have even though I had biopsies in my armpit. I'm taking exercise classes and doing fine.

    This a very personal decision - between you and your doc and loved ones.

    I wish for you the very best and peace of mind with your decision.
    Karen
  • jnl
    jnl Member Posts: 3,869 Member
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    KathyLQ said:

    Many months going through reconstruction
    I’m 59. I kind of didn’t have the choice of just a lumpectomy followed by radiation. A University Medical Center diagnosed me as not having clear enough margins, and recommended the mastectomy. Including the initial biopsy, I had a total of 6 surgeries, seemed like they would never end. My DIEP was done 5 months after the mastectomy, followed later by a lift on the other side, and another one to fine tune the DIEP results including fat grafting to fill in a hollow. Even though everything now is “all me”, no implant, I do find myself still protecting my DIEP breast. I won’t lie on it, I try to keep from bumping it. Same with the other side where I had a lift. They just don’t seem to be totally like the original. I do ride my bike a lot, but I don’t do a lot of upper body work, at least not hand stands, LOL. The DIEP is in front of my chest muscles.

    Even with all the pre-surgery advice, I was not prepared emotionally for the mastectomy. It destroyed my feeling of self worth. The hour I woke from the surgery, I was devastated. Then 5 months with an expander, then the DIEP surgery, a week in the hospital. Thirteen months after the mastectomy was my last reconstruction surgery, the last fine-tuning. For the longest time, I couldn't see the end of the tunnel of knowing there was another surgery still coming. But they are now over. The end results are not perfect. Only because the reconstruction is finally done, am I glad I did it. It has helped to restore my feeling of self worth, of feeling like I am whole again.

    I know you are looking for
    I know you are looking for answers and all we can do is offer our own experience. You will make the final decision as to what is best for you.


    I am thankful that I could have a lumpectomy followed by rads. My tumor was small, so, a mastectomy wasn't even brought up. I really don't know if I could have dealt with losing a breast or both of mine. But, that is just me.

    There are so many on here that have had a mastectomy with or without reconstruction and will post more to you.

    Rads are doable, exhausting, but, very doable. I never thought about not having them.


    Good luck,

    Leeza
  • Margeaux
    Margeaux Member Posts: 84
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    Mastectomy vs Lumpectomy
    As some of the posts said, we can only offer our own experience. I had 2 lumps, one 3.5 cm and one .9 cm in the same breast, plus lymph node involvement. I was told I'd have to have a mastectomy. I was very unhappy about this, but resigned myself to the necessity of it, breast vs life, a no-brainer! Chemo was done first, 6 months of it, ugh!!!!!!! PET scan and mammogram at the end of chemo showed no visible cancer in the breast and lymph nodes. The doctors agreed a lumpectomy could be performed. Particularly at my age (76) lumpectomy + radiation has the same survival rate as mastectomy given my circumstances. lumpectomy was performed, 18 lymph nodes removed and no cancer found, clean margins. This was followed by radiation, and, as the old radiologist said - sofar-i, so good-y. When mastectomy was still the only option, the oncologist told me he did not want me to have any reconstruction done until one year had passed. I myself am glad I did not have to have another surgery and keep my fingers crossed. I had complete confidence in my oncologist and followed his advice. Tough decision to make.
    Wish you all the best and hugs
    Margeaux
  • DebbyM
    DebbyM Member Posts: 3,289 Member
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    I was never offered choices
    I was never offered choices and ME being dumbfounded never asked..but I had lumpectomy and radition. I was never told size etc..I am very small breasted..(i gain some now ONLY THOUGHT is from TAmoxifen...no weight gain etc)

    IT must all depend on type of cancer I GUESS...like I said I never heard info I often see posted here.

    I had a lumpectomy with
    I had a lumpectomy with radiation. I do not take any hormone therapy as of yet. Wishing you good luck in your choice.


    Hugs, Debby
  • mamolady
    mamolady Member Posts: 796 Member
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    There is no right
    There is no right answer.
    Personally, I had three tumors the smallest of which was 1.5 cm. We knew before biopsy that the lymph nodes were involved. I had bilateral mastectomy with rads and chemo. I have not had recon and may never have it because it really isn't that important to me to risk the complications and recovery time. I was never large breasted any way. The tram flap isn't a great option because I don't have a lot of belly fat (I need 2 boobs), the implants present a challenge due to rads. Less so than some though because my skIn healed up well. I rarely wear prosthics and when I do they are actually fillers used to even one breast with the other. I wanted some thing to fill in a bit when I wear certain shirts but not as noticably different than with out. I wear scrubs most days so you really can't tell.
    Not sure if this helps that is just one percpectIve. You will make the right choice for you,
    Cindy
  • Tux
    Tux Member Posts: 544
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    mamolady said:

    There is no right
    There is no right answer.
    Personally, I had three tumors the smallest of which was 1.5 cm. We knew before biopsy that the lymph nodes were involved. I had bilateral mastectomy with rads and chemo. I have not had recon and may never have it because it really isn't that important to me to risk the complications and recovery time. I was never large breasted any way. The tram flap isn't a great option because I don't have a lot of belly fat (I need 2 boobs), the implants present a challenge due to rads. Less so than some though because my skIn healed up well. I rarely wear prosthics and when I do they are actually fillers used to even one breast with the other. I wanted some thing to fill in a bit when I wear certain shirts but not as noticably different than with out. I wear scrubs most days so you really can't tell.
    Not sure if this helps that is just one percpectIve. You will make the right choice for you,
    Cindy

    lumpectomy vs mastectomy
    I had no choice--I had lumpectomy followed by rads. Worked out great for me! My
    job adjusted my schedule & I missed no days of work for rads. So far, after 3 years, everything is OK. If I had had a mastectomy, I would have missed a lot of work & that would not have been good. No matter what you decide, I wish you the best!
  • Double Whammy
    Double Whammy Member Posts: 2,832 Member
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    mamolady said:

    There is no right
    There is no right answer.
    Personally, I had three tumors the smallest of which was 1.5 cm. We knew before biopsy that the lymph nodes were involved. I had bilateral mastectomy with rads and chemo. I have not had recon and may never have it because it really isn't that important to me to risk the complications and recovery time. I was never large breasted any way. The tram flap isn't a great option because I don't have a lot of belly fat (I need 2 boobs), the implants present a challenge due to rads. Less so than some though because my skIn healed up well. I rarely wear prosthics and when I do they are actually fillers used to even one breast with the other. I wanted some thing to fill in a bit when I wear certain shirts but not as noticably different than with out. I wear scrubs most days so you really can't tell.
    Not sure if this helps that is just one percpectIve. You will make the right choice for you,
    Cindy

    It sounds like our dx is similar
    I don't do handstands, however. My tumor was .9 cm, so smaller, but I was stage 1b, gr. 2. I had a "partial mastectomy" and oncoplasty. Then chemo, then radiation. If I'd had no choice but a mastectomy, I would have had no problem doing that, but I know I would have had a difficult adjustment period. I would not have had reconstruction simply because of my age (64) and the risks of more surgery. The lumpectomy and radiation went very well for me - chemotherapy not so much, but better than for many others. I would have had chemo regardless of whether I had a lumpectomy or a mastectomy. There can be serious long term side effects from chemo, too. Sigh.

    I did and do still have some concerns about the longterm effect of radiation, but my decision to go this route has been made and I don't regret it. It's been 1 1/2 years since I finished radiation and I still have considerable soreness in that breast, but no one has told me not to do anything with that arm except no blood draws or blood pressure.

    FYI, my lumpectomy boob looks really good. It was larger than the other one and my surgeon did a good job of reducing it along with removing the cancer. My tumor was on the underside of my breast, so even the scar doesn't show. It's a little flat on the bottom, but I have very good symmetry overall. "Lucky" me for being lopsided to begin with.

    The problem is that we don't know how we're going to react to any of this, either in the long or short term. There are simply no guarantees.

    Good luck with your decision. It's agonizing, but whatever you decide will be right for you.

    Suzanne