I have to decide lumpectomy or mastectomy and am loss

We are all different in our perspective on things.  My situation is a lot like the other lady who left you a message.

I made my decision for a bi-lateral because I really did not want to have to do this again.  Just do it, I told myself.

Years ago, when I had a mass of tumors that meant either a myanmectomy (like a lumpectmoy) or hysterectomy, I chose a hysterectomy.  I did that because the DR had said that once they actually got in the area and saw what was there, they might have to do a hysterectomy regardless.  Even though I was just 31 at the time, I opted for the hysterectomy.  It seemed easier than waking up and finding the DRs had to do more.  I was able to start preparing myself ahead of time for the loss.  As it was, when they got in there to see what there was, they would have had to do a hysterectomy anyhow. 

I had surgery last February, chemo, and then rads.  Now I am on tamoxifen.  Things right now are looking good for me, although I am still not at 100% -- although I am not too terrible far off.

I hope that you will be able to come to a decision quickly and feel it is the right one.  An older lady friend of mine -- her daughter and I were best friends, until she succumbed to cancer two years ago -- said to me not to second-guess myself when making decisions about what to do as I have dealt with cancer.  We do the best we can with the information/knowledge we have.

Nellie,

     BTW that was my grandmother's name. You have to do what is right for you. The only decision I had was if it was a bi-lateral or not. I have at times

regretted losing both breasts but then It doesn't bother me now. My surgeon said, it would probably occur in the other breast hence my decision. I had surgery

with expanders put in at the same time. Noone can tell you what to do, you have to decide. There is no right answer except the one you make. I hope this helps.

Janie

telecomjd said:

No Right Answer

Hi, Nellie,

My situation was different.  First they did a lumpectomy, but were not able to get everything.  So, the choice was a re-excision or a mastectomy.

I went with bilateral mastectomy with reconstruction.  In my case, it has helped me to avoid radiation.  I am very comfortable with my decision.

I'm 35 years old, and I knew I wanted reconstruction.  I lost about a third of my breast in my lumpectomy, and I was lopsided.  I currently have expanders in, and they're not the most comfortable things in the world, but it's livable for the moment.  Hoping for my exchange surgery for my implants in April/May.

I know breast preservation is big for some folks.  And, I would love to have my breasts back.  Things just feel differently.  But, I am happy with how things look cosmetically -- I don't feel self-conscious.  And, if I had known just how dramatically different I would have looked post-lumpectomy, I would have just gone for the mastectomy to begin with.  Although it may have been a blessing that I did not -- they needed to remove pectoral muscle to get clean margins, and we may not have known that without the lumpectomy.

Perhaps the best answer for you is to ask yourself what you are hoping for from the surgery (other than the whole cancer removal thing -- let's agree that is priority number one).  Are you looking for the least amount of surgery with the lowest risk of needing to go under the knife again?  Are you concerned with how you'll look cosmetically?  Are you interested in breast preservation?  Are you concerned about recurrence long-term?  How is the rest of your health -- and is one surgical choice better than the other with your health profile (i.e., will one give you a shorter or less extreme recovery time)?

Hope you come to the choice that works for you.  I'll be thinking of you.

Megan

When I first met with the surgeon, he started talking about mastectomy.   I don't know why.  I had to stop him and ask about lumpectomy.  I honestly don't know why he thought I'd be having a mastectomy - my tumor was tiny and grade 2 on biopsy.  I had standard "old lady ER+ breast cancer".

 I had a lumpectomy and my cosmetic result is really good, but that isn't always the case and it's something I think they fail to mention and something that should be considered as part of the decision making process if one has that option.  Of course, aleviating the cancer should be the first and foremost consideration.  "Lucky" for me, my breast with cancer was significantly larger than the other breast and we planned oncoplasty as part of my surgery.  Had it been in the other breast, the results may not have been so nice.  And - it was only by happenstance that I had oncoplasty in the first place.   I didn't even know it existed.  I was being flippant and made a remark to the surgeon about that breast being larger anyway and he suggested oncoplasty.   He basically did a mini breast reduction at the time of lumpectomy.  

For me, this was the right decision, but only you can make that decision for yourself.  Clear margins are very very important and having additional surgery is well, an additional surgery.  Scarey and not without risk.  It turned out that the margins around my tumor were not clear, but because of the planned oncoplasty, the chunk that was removed took care of that at the same surgery.  I don't know how it would have played out had we not planned oncoplasty.

Perhaps you should seek a second opinion to help you weigh the pros and cons of masectomy vs. lumpectomy given your circumstances. I just want you to be aware that neither surgery is without cosmetic ramifications and a lot depends on the size and symmetry of your breasts.  Maybe someone can chime in here who have had lumpectomy with less than good results.   In spite of what I consider my excellent results, I have a canyon in my breast where the tissue was removed and it's sort of flat bottomed.  My tumor was on the underside of my breast so this is really not at all noticeable, but I do notice it. 

Good luck on your surgery.  Let us know how everything goes and what you decide to do.

Suzanne

So sorry you're having to make this decision. I don't think any of those of us who have made it found it terribly easy - it's a very big decision to have to make and for once the doctors will only (at least in my case) advise - ultimately it's up to each of us to choose what's best for us. 

For me it was a choice that had to be made in light of several other severe health conditions I have which would have pretty much prohibited me from having chemo or radiation. I didn't need chemo (thankfully) as the cancer hadn't spread - but if I had it would have been life-threatening as I have a genetic immunodeficiency. Also I have Lupus - so this pretty well ruled out radiation (which they would have done after lumpectomy) - add to that the fact that there was too much cancer to get 'clear margins' with lumpectomy - and my decision was, while not easy, at least narrowed down - and I chose bilateral mastectomy (the cancer was only in one breast - but I did NOT want to go through it again being in such fragile health condition already - so I opted to get it all over with in one go & I do NOT regret it for a second).

So - i'm not sure if that helps or not but for me it boiled down to 1. what was healthiest for me (both physically AND emotionally) and 2. what was going to get the cancer out of me and leave me with a shot at recovering without major surgical or treatment complications.

Again - very sorry you're having to go through this - but it sounds like you're in good hands. I wish you all the best. Please let us know how it goes - i'll be pulling for you! I just had my bilateral mastectomy 3 weeks ago tomorrow and i'm doing really well. I wish you all the best.

Chris-

Thats what my decision was all about. It didn't even come to a trying to make a decision for me. I am 53, I have beautiful grand kids I want to dance at the weddings of. When I found out I had cancer (mine is triple negative and aggressive) I asked for a bilat. Mastectomy. I did my chemo, had my surgery. I went with immediate recon. but mine was unfortuantely halted and expanders removed when I developed a infection. So I am now 53, flat chest, big bellied memaw with chia pet hair and I am cancer free. Everyone is different on what is important to them. I hope you find peace with whatever decision you make. For me, I just didn't want to ever have to say what if.. if my cancer comes back. I threw everything I could at the beast and I pray I did enough.

I also think your surgeon is telling what she would do when she says Mastectomy is safest.

Good Luck and God Bless.

Sandy

Gabe N Abby Mom said:

Because my dx was triple neg

Because my dx was triple neg inflammatory BC, it was an automatic modified radical mastectomy for me.  My decision was just the left cancer side? or both?  I did chemo first, and spent the entire 4 months of chemo debating in my head, and discussing options with my hubby.  And I went back and forth...I eventually chose a bilateral.  It was more important for me to be even.  Frankly, my breasts sagged.  I didn't want one pointing at my toes and a concave hole on the other side.  I have not had any reconstruction.  Considering my situation, both now and then, I am content with my decision.

I know this doesn't help you make your decision.  But whatever you decide, you will get support here.  And there will be people here who can answer questions.  Best wishes.

Hugs,

Linda

 

 

Everyone is different, but here's my story.  A little over 3 years ago I was diagnosed with invasive ductal ca with 10 positive nodes (making it stage 3).  My surgeon recommended a lumpectomy with axillary node dissection, to be followed by aggressive TAC chemo and then rads.  I followed his advice because he is one of our top guys here, so why wouldn't I.  I was definitely happy with my choice. 

HOWEVER, about a year ago, it was discovered that I had bone mets (T-12, L-1) so I had more rads in those bones.  Then, in October of last year, following a bilateral breast MRI, it was discovered that the cancer had recurred in the same breast, different location.  I had an immediate mastectomy but could not have reconstruction because of all the rads and very, very tight skin over that area.

In retrospect, if my surgeon and I had a crystal ball, we would have done the mastectomy right away.  But, we hoped for the best and it didn't happen that way.  I do not regret any decisions I've made.  Regret is just a waste of time and no one can predict the future.

Do what you feel is right for you right now.  If things change, you can change course if you have to.  Good luck and come back here--we'll support you with whatever you choose to do.

Hugs, Renee

camul said:

It is a hard decision,

I chose a bi-lateral, but at the time insurance said no reason so it was a single of the right breast.  My breast surgeon did a lumpectomy and while I was out the pathologist said she did not get it all so she woke me up, and asked if I wanted her to take more or do a mastectomy?  I asked her for her opinion, and she said a mastectomy.  So one week later I had it done.  I was 44 and never regretted my decision. 

Only you can make this decision.  I just wanted to have it gone!  I wish you the best.

Carol

My onco and plastic surgeon recommended a lumpectomy with rads for me which is equal to having a mastectomy inre to survival terms.  I am very glad that I was able to save my breast.  You need to do what is best for you, after having all of the information you need.

Good luck!

Cannella said:

Thank you

Thank you to all for your input.  There is no time for a 2nd and I have total faith in this doctor and facility and kind of wish she didn't give me this choice to make.  Also afraid of the reconstruction and the time, difficulty of it.... I just don't feel I have enough information to make a good decision.  Long term survival is first and foremost so I am 80% decided.  If you could think of any other questions I should ask her before making up my mind that would be helpful.  I'll be meeting with the plastice surgeon as well but after the decision is made. thank you all for sharing your wisdom and your strength.  Nellie

Why isn't there time to get a 2nd opinion if you don't mind my asking?  A lumpectomy with rads is equal to a mastectomy for survival and in recurrence.  If you don't have to have a mastectomy, discuss this with your breast surgeon thouroughly. 

I think some women have a mastectomy not knowing those facts and with a mastectomy, there is no way at all that all of your breast tissue is removed, so, you always have some.  I don't think some know that either. 

Keep us updated on what you choose and how you are doing.

Rose

missrenee said:

Nellie

Everyone is different, but here's my story.  A little over 3 years ago I was diagnosed with invasive ductal ca with 10 positive nodes (making it stage 3).  My surgeon recommended a lumpectomy with axillary node dissection, to be followed by aggressive TAC chemo and then rads.  I followed his advice because he is one of our top guys here, so why wouldn't I.  I was definitely happy with my choice. 

 

HOWEVER, about a year ago, it was discovered that I had bone mets (T-12, L-1) so I had more rads in those bones.  Then, in October of last year, following a bilateral breast MRI, it was discovered that the cancer had recurred in the same breast, different location.  I had an immediate mastectomy but could not have reconstruction because of all the rads and very, very tight skin over that area.

 

In retrospect, if my surgeon and I had a crystal ball, we would have done the mastectomy right away.  But, we hoped for the best and it didn't happen that way.  I do not regret any decisions I've made.  Regret is just a waste of time and no one can predict the future.

 

Do what you feel is right for you right now.  If things change, you can change course if you have to.  Good luck and come back here--we'll support you with whatever you choose to do.

Hugs, Renee

Trust your judgement and your gut feeling.  I feel lucky that I could have a lumpectomy and radiation treatments, no chemo.  Your doctors will help to guide you to what is best for you.  We are all different.

Wishing you good luck!