whats better a lumpectomy or mastectomy for a her2+ breast cancer

prexter1305

I was just diagnosed 10/12/2015 with stage IIB breast cancer my tumor being about 6cm. and I'm HER 2 +

I start my chemo next friday then surgery and possibly radiation. the question I wanted to ask was...Is it better to have a lumpectomy or a mastectomy and if the mastectomy do I do both breasts or just the one?  I fear the reoccurance %, plus I'd like my breasts to look as normal as possible if thats not too much to ask.

button2

I had the same diagnosis as you

First of all, welcome to the site. There so many things to consider. Personally, as I am happily married and not terribly young, I got a one sided mastectomy with no reconstruction. My only concern was staying alive for my family, so I asked the doctors for every treatment available. I would expect that with a tumor as large as yours, it would be hard for them to do a lumpectomy. Maybe your tumor is in an easier area to remove than mine was. Also I'm pretty sure you will need radiation treatment. Talk to your doctors, it's early days for you and it is very hard to process everything all at once. Another consideration is whether BC runs in your family. If I had tested positive for the BRCA gene, then I would have gotten a double mastectomy for sure. If you are worried about your appearance, there are several different surgery options to consider and the results these days can be excellent. Let us know what you decide to do. This disease can seem overwhelming, but once you start making decisions and getting thru each treatment obstacle, one at a time, you start to get some degree of control back. Good luck going forward, Anna

Jan11

Choice

I was a stage 2  A with a 2.1 lump- I choose lumpectomy - because it was in the 5:oo position and almost a D cup,  so I had enough breast and location seem to indicate that it would be ok.

My margins were clear and my nodes where negative.  I am 63.  It turned out well but with your size of tumor and including the margin it may be that they will take over 25% of youer breast with

a lumpectomy and the results may not be good.  Then there is the radiation if you go with a lumpectomy. If my nodes were positive I think I would have preferred tihe masectomy.

As it turned out - I was lucky with  the nodes but was it really worth the risk, speak with your onocologist and surgeon - tell them your having a hard time with this and ask them what they would advise there family member.  

My oncologist was leaning I think for masectomy, surgeon felt she could do a good job with lumpectomy and radiologist believes that it was worth saving the breast and is very confident about reoccurence not happening with my lumpectomy.  If you have been a smoker please no that they cannot avoid all the lung and sometimes cannot avoid the heart but complication rate is low because very little is actually hit with radiation.  If my nodes had been positive I would have wished I had done a masectomy, I feel I was just lucky.  Good Luck

bevaschia

I was diagnosed in July and

I was diagnosed in July and triple positive for her2, progesterone and estrogen.  My mass was initially 3.2 cm.  I did chemo first and it shrunk to 1.7 x 7mm.  I did double mastectomy because I was not wanting to have to go through this again with the left breast should it come back which is more possible being her2 positive according to my oncologist.  I'll do chemo here in a few weeks on the back end after surgery, and my sentinel node 4 nodes, were negative.  Recovering from the surgery has for the most part been pretty easy, and I am happy with my decision.

prexter1305

lumpectomy vs mastectomy

I'm 40 yrs old and newly divorced with 2 kids at home one 15 one 11 and I'm a non-smoker. I've been tested for the Brca gene and it came back negative. I've also had 2 of my lymph nodes biopsyed and they came back clear. The dr. is hoping to shrink the tumor with 2 different rounds of chemo before surgery. I just can't figure out which surgery to have. What is my best option for normal looking breasts and least likely for reoccurance?

VickiSam

prexter1305 said:

lumpectomy vs mastectomy

I'm 40 yrs old and newly divorced with 2 kids at home one 15 one 11 and I'm a non-smoker. I've been tested for the Brca gene and it came back negative. I've also had 2 of my lymph nodes biopsyed and they came back clear. The dr. is hoping to shrink the tumor with 2 different rounds of chemo before surgery. I just can't figure out which surgery to have. What is my best option for normal looking breasts and least likely for reoccurance?

Serious subject and choice

First of all Welcome to our site - of PINK Warriors, and Kindred Spirit.

please ask your Oncologist for research or information Regarding this subject, as this is a most important decision.  My opinion- and my choice was for a "double" mastectomy and reconstrution.  Again, my choice and my decision-- if I had to do things all over -- I would make the same choice . i researched and talked to fellow PINK Warriors - and made my decision.

I wish you Luck, and peace with your decision.

Vicki Sam

twnkltoz

Have you had genetic testing

Have you had genetic testing done? Does BC run in your family? That will be a big factor in whether it could come back.

They recently did a study that showed there is little difference in survival rates between people who do lumpectomies and double mastectomies. You're going to have scars regardless. With a lumptectomy, you can retain some sensation whereas with a mastectomy, even if they are able to spare your nipples, you'll probably have none. 

But really, we're strangers on the internet. Your medical team know you and your history and disease and should be able to help you weigh the options. We could talk you into a lumpectomy, and they'll say you're not a candidate for it...we just don't know.

Best of luck in making your decision! A lumpectomy was not an option for me, but I decided to go with a UMX and save the other breast. I'm BRCA negative, so there's no genetic reason it could come back. And if it does, I'll remove the other breast when the time comes. To me, it's worth it to have one breast for as long as I can than none, and the surgery is much easier.

disneyfan2008

Each person and circumstance

Each person and circumstance is different. I had two lumpectomies on the same side! Radiostion followed.

 

Can you get a 2nd opinion?

 

Denise

TPegues

I was diagnosed HER2+ at

I was diagnosed HER2+ at stage IIb in September of 2013. After two lumpectomies without clear margins, and a wide axilla dissection with 2 positive nodes, I did have bilateral mastectomies. Although I would do the same thing again and also had a rigorous chemo and radiation regimen, I was diagnosed with a recurrence within six months of finishing treatments. The recurrence is in the skin covering the reconstructed breasts, so... I guess my advice to you is to be aggressively treated for this and hope for the best results. This is a tricky disease.

Talo

I had an almost identical

I had an almost identical diagnosis back in May. I am 6 weeks post surgery. I had the same concerns early into my chemo treatment about what surgical option was best. I think you have to wait and see how your tumor responds to the chemo. That will determine what your options are. I had 18 weekes of chemo followed by a partial mastectomy. My tumor was GONE after chemo. I also had large breasts which gave the doctor plenty to work with. She removed 1/2 of my affected breast and then did a reduction on the the other breast so I would match. After radiation and Herceptin my chance of reoccurrence is 2%.  

cdwatterson

bevaschia said:

I was diagnosed in July and

I was diagnosed in July and triple positive for her2, progesterone and estrogen.  My mass was initially 3.2 cm.  I did chemo first and it shrunk to 1.7 x 7mm.  I did double mastectomy because I was not wanting to have to go through this again with the left breast should it come back which is more possible being her2 positive according to my oncologist.  I'll do chemo here in a few weeks on the back end after surgery, and my sentinel node 4 nodes, were negative.  Recovering from the surgery has for the most part been pretty easy, and I am happy with my decision.

lumpectomy vs mastectomy

Hello,

YOu mention that the recovery from double mastectomy has been pretty easy.  I am so happy for you, I know this must have made it a little easier on you.  Can you share with me what you mean by pretty easy?  How long have you been down?  How long before you can return to work?  Do you have a hard time lifting your arms?

 

Thanks

 

HapB

cdwatterson said:

lumpectomy vs mastectomy

Hello,

YOu mention that the recovery from double mastectomy has been pretty easy.  I am so happy for you, I know this must have made it a little easier on you.  Can you share with me what you mean by pretty easy?  How long have you been down?  How long before you can return to work?  Do you have a hard time lifting your arms?

 

Thanks

 

Cdwatterson

I hope that you realize that the post you are responding to is years old.  

I am triple positive and had a lumpectomy.   I was told that there is no difference in disease free survial rates and surgery poses the risk of complications and repeated surgeries. Also, losing a body part is not necessary if there is no benefit. Some women just feel better having the breasts gone. It depends on where the tumor is and how the surgeon can access it.  Most cancer centers highly discourage mastectomies unless it is necessary.