Deciding between lumpectomy and mastectomy

Egankeevan
Egankeevan Member Posts: 17
in Breast Cancer #1

I was diagnosed with grade 3 invasive ductal carcinoma, stage 3b with at least one lymph node involved. Due to the size of the tumor and the lymph node involvement, I am having chemotherapy before surgery. I've had 13 rounds and have 3 more to go. My oncologist says if the tumor is small enough after the last chemo, I may be able to have a lumpectomy instead of mastectomy. Either way, I will need radiation because of the lymph node involvement. My understanding is that history has proven that mastectomy does not give a better survival rate than lumpectomy with chemo and radiation. How do I make this decision? I've asked several women who have been through this and they've said it's very much a personal decision. They just felt "safer" going with a mastectomy. Is there a reason (other than personal feeling of security) to put myself through a double mastectomy with reconstruction when the doctors say a lumpectomy is just as effective? 

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Comments

  • tufi000
    tufi000 Member Posts: 745 Member
    #2
    2B3C

    Get a second opinion. I went for doublemast. 2003

  • Teach76
    Teach76 Member Posts: 354 Member
    edited October 2017 #3
    Partial

    I was grade 3 PR+/ ER+ / Hers 2 - with no lymph node involvement.  Like you I had chemo first which thankfully shrunk my tumor.  Surgeon decided on a partial mastectomy ( about half).  Clear margins at surgery and I had 25 rounds of radiation after.

    A second opinion is always welcome - I was glad that I had gone for that.  The initial thought was to treat hormonally for 6 months.  I was glad second surgeon was more aggressive and consulted with onco for an overall plan.

     

    blessings!

    Kathy

  • HapB
    HapB Member Posts: 527
    #4
    Egankeevan

    Hi, when I was first diagnosed, my first impulse was to have a double mastectomy because I thought it would improve my chances of survival and lessen my worries of recurrence. I got two opinions and both doctors agreed that a mastectomy was not warranted and would  not improve my chances at all.  in making these decisions, we can only go by the numbers that exist right now. I don’t know what your doctors are telling you. Turns out, there are regional differences in the USA and there are more mastectomies performed in certain parts of the country. In the northeast, the rates of mastectomies is low. My surgeon explained that the only time they perform mastectomy is when the tumor is inaccessible and cannot safely be removed or when the cancer is so widespread that it is the only option.  it is so hard to make a rational decision when we are terrified by the diagnosis, but try to look at the numbers and understand that there are often complications with mastectomies that require multiple surgeries and have lifelong side effects. I had a lumpectomy with radiation. It was a one day surgery, relatively simple recovery, and healed very quickly. Nobody would ever really be able to tell by looking at my breast. There are no scars. The radiation was pretty uneventful and healed very quickly. Good luck making your decision. 

  • Beepositive
    Beepositive Member Posts: 259 Member
    edited October 2017 #5
    Hello Egankeevan

    Everyone is telling you the right thing...get a second opinion it you can!  Everyone's body and situation is sooo different and what may help for one person may not for another...

    Prayers and Hugs to you and your Family!

    and to everyone on this Network!!!Smile

    continue to BEEpositive

  • WLButterfly
    WLButterfly Member Posts: 1
    #6
    Breast cancer

    Hello everyone. I was just diagnosed with invasive ductal carcinoma. The doctor siad it looks like it was caught early. It doesn't look like it has gotten into my lymph nodes. I have been needing a breast reduction and have decided to have the reduction at the time of my lumpectomy. This doctor seems to think this would be a good time since after radiation I may have issues healing. Have any of you gone this route. My tumor looks small. When they do the surgery they will test the tissue under my arm right before the lymph nodes to see if there are any cancer cells. I am also having an MRI before the surgery to make sure there isn't any cancer in other areas of my breast. I do have a nodule that showed up on the other side but they don't really think it is cancer. They just want to make sure. I feel like this is the right route for me. It's all really scary. Any imput would be appreciated. Thank you.

    WLButterfly

     

     

  • HapB
    HapB Member Posts: 527
    #7
    WLButterfly said:

    Breast cancer

    Hello everyone. I was just diagnosed with invasive ductal carcinoma. The doctor siad it looks like it was caught early. It doesn't look like it has gotten into my lymph nodes. I have been needing a breast reduction and have decided to have the reduction at the time of my lumpectomy. This doctor seems to think this would be a good time since after radiation I may have issues healing. Have any of you gone this route. My tumor looks small. When they do the surgery they will test the tissue under my arm right before the lymph nodes to see if there are any cancer cells. I am also having an MRI before the surgery to make sure there isn't any cancer in other areas of my breast. I do have a nodule that showed up on the other side but they don't really think it is cancer. They just want to make sure. I feel like this is the right route for me. It's all really scary. Any imput would be appreciated. Thank you.

    WLButterfly

     

     

    WL

    I think you need to wait to get pathology results before you know what is next. 

  • bkjljones
    bkjljones Member Posts: 2
    #8
    WLButterfly said:

    Breast cancer

    Hello everyone. I was just diagnosed with invasive ductal carcinoma. The doctor siad it looks like it was caught early. It doesn't look like it has gotten into my lymph nodes. I have been needing a breast reduction and have decided to have the reduction at the time of my lumpectomy. This doctor seems to think this would be a good time since after radiation I may have issues healing. Have any of you gone this route. My tumor looks small. When they do the surgery they will test the tissue under my arm right before the lymph nodes to see if there are any cancer cells. I am also having an MRI before the surgery to make sure there isn't any cancer in other areas of my breast. I do have a nodule that showed up on the other side but they don't really think it is cancer. They just want to make sure. I feel like this is the right route for me. It's all really scary. Any imput would be appreciated. Thank you.

    WLButterfly

     

     

    I to have invasive ductal

    I to have invasive ductal carcinoma. My lump was almost 4 cm. I am in the middle of six rounds of chemo and have to decide on a lumpectomy or a mastectomy. If I have just a lumpectomy then I have to go through five weeks of radiation. Radiation really does scare me. If I do a mastectomy even with one breast I don't have to do radiation.My surgical oncologist said that she can do a full mastectomy and leave me with maybe enough tissue for an a cup. I'm not really worried about having breast I'm just worried and concerned about making the right choice and if I need to have a full Mesec to me. But it is also a mind over matter type thing if they're not there then you can't get breast cancer but then there's always the chance of getting something else down the road, or not getting anything else. It's like spinning the roulette wheel.

  • Apaugh
    Apaugh Member Posts: 850 Member
    #9
    be kind to yourself..

    It is your personal choice.  Getting a lumpectomy or a full mastectomy will not change your outcome. If your cancer comes back, it will.  simple as that.   I had a double mastecctomy followed by chemo.  I dont regret that.  It was tough.  The SE are awful and life long.  I did not have radiation, but I heard from many it is tough too and it too can have SE.   

    Get a 2nd opinion.  Dont rush into it.  Get a third even.  Then make your choice.  

    Let us know how you do.

    Hugs,

    Annie

  • meadowglade
    meadowglade Member Posts: 39 Member
    #10
    My choice

    I had triple negative stage 2a or b depending on who you are talking to. I had a lumpectomy, I had just two lymp node involved and I think a totoal of 11 removed. My doctors said that a mastecotomy was not nessasairy. I did have intence radiation because mine was very aggrecive and hard to treat. My radioalogst didn't leave anything to chance, he did the full treatment. I also had it in my left breast so they had to be sure the heart woundn't be involved. It wasn't. It really is a personal choice, I just couldn't see the advantage of the mastecotomy over the the lumpectomy. 

  • Candy123
    Candy123 Member Posts: 2
    edited January 2020 #11
    bkjljones said:

    I to have invasive ductal

    I to have invasive ductal carcinoma. My lump was almost 4 cm. I am in the middle of six rounds of chemo and have to decide on a lumpectomy or a mastectomy. If I have just a lumpectomy then I have to go through five weeks of radiation. Radiation really does scare me. If I do a mastectomy even with one breast I don't have to do radiation.My surgical oncologist said that she can do a full mastectomy and leave me with maybe enough tissue for an a cup. I'm not really worried about having breast I'm just worried and concerned about making the right choice and if I need to have a full Mesec to me. But it is also a mind over matter type thing if they're not there then you can't get breast cancer but then there's always the chance of getting something else down the road, or not getting anything else. It's like spinning the roulette wheel.

    I have the same kind of br

    I have the same kind of br east cancer and decided on a lumpectomy and have just finished radiation.  The only side effects I have are fatique and red tender skin which is supposed to improve with time.  Doctors want me to start hormone blockers next which also have side effects so I will have to decide.

  • guitarplayer
    guitarplayer Member Posts: 3
    edited February 2020 #12
    If you are going to have

    If you are going to have lymph nodes removed, having radiation increases your chance of developing Lymphedema.     I agree about getting a second, third, or even a fourth opinion! 

  • ts72
    ts72 Member Posts: 5 Member
    edited June 2020 #13
    meadowglade said:

    My choice

    I had triple negative stage 2a or b depending on who you are talking to. I had a lumpectomy, I had just two lymp node involved and I think a totoal of 11 removed. My doctors said that a mastecotomy was not nessasairy. I did have intence radiation because mine was very aggrecive and hard to treat. My radioalogst didn't leave anything to chance, he did the full treatment. I also had it in my left breast so they had to be sure the heart woundn't be involved. It wasn't. It really is a personal choice, I just couldn't see the advantage of the mastecotomy over the the lumpectomy. 

    I also have triple negative

    I also have triple negative stage 2A in my left breast. I'm told it's the size of breast and location of lump that might affect the breast after radiation. I was told a lumpectomy would make my breast smaller and radiation might shrink it further amd may misshapen it. My lump is small but in the "bad" location of 6:00. Can I ask where your location was and if you're happy with your outcome after radiation? I'm scared of a misshapen boob but also of a mastectomy.

  • Missesmm
    Missesmm Member Posts: 6
    edited October 2020 #14
    Did you get Genetic Testing?

    For me personally, my decision was based on the results of my genetic testing.

    I am negative for any of the 35 "cancer genes"...also the Dr. told me that on TCHP therapy, there is a 95% chance it will never return.

    Therefore, I have decided on a lumpectomy.  Whatever you decide, I wish you the best.

  • Sadie2020
    Sadie2020 Member Posts: 1
    edited October 2020 #15
    Lumpectomy or Mastectomy

    Early October I was diagnosed with invasive DC E+ on right side grade 2 3cm and an MRI found on left small invasive DC/L E & P+ grade 2 .6 cm. They recommend lumpectomy with 4-6 weeks radiation & 5 years hormone blocker. My concern is if it is in both breasts, which is unusual, maybe my best route would be bilateral mast & pass on radiation. How many women have had a lumpectomies and then ended up going back in for a mast? Not sure how to make this decision. 

     

  • wallis2
    wallis2 Member Posts: 56 Member
    edited October 2020 #16
    Sadie2020 said:

    Lumpectomy or Mastectomy

    Early October I was diagnosed with invasive DC E+ on right side grade 2 3cm and an MRI found on left small invasive DC/L E & P+ grade 2 .6 cm. They recommend lumpectomy with 4-6 weeks radiation & 5 years hormone blocker. My concern is if it is in both breasts, which is unusual, maybe my best route would be bilateral mast & pass on radiation. How many women have had a lumpectomies and then ended up going back in for a mast? Not sure how to make this decision. 

     

    Hi Sadie2020

    It's almost similar to my surgery.  I had a lumpectomy (only in one breast), and decided to have bilateral mastectomy months later.  I had 6 -8 weeks of radiation and now 5 year hormone blocker and no reconstruction.  I have known some people having surgery and opted out of radiation and hormone pill.  I decided the bilateral mastectomy months later because some have to go thru the same thing years later in the other breast (but not all people, only some).  I do understand you said both breast.  Some people like me just wanted to get it over with and not be cut again down the road.  Some people chose lumpectomy because they need to return back to work soon, while others chose bilateral mastectomy for no reoccurrence.  You make your own choice according to your situation.  I had my lumpectomy and return back to work in 3 weeks .  Months later I had my mastectomy and return back to work less than 3 months.  November 2020, it will be 2 years since my surgery.  I have ups and downs, but I am still here.  When I started taking those hormone blockers, I had serious side effects and still do sometimes, but I have learned to managed.  Think carefully and ask your doctor a lot of questions.Laughing

  • LeahA78
    LeahA78 Member Posts: 2
    edited November 2020 #17
    Apaugh said:

    be kind to yourself..

    It is your personal choice.  Getting a lumpectomy or a full mastectomy will not change your outcome. If your cancer comes back, it will.  simple as that.   I had a double mastecctomy followed by chemo.  I dont regret that.  It was tough.  The SE are awful and life long.  I did not have radiation, but I heard from many it is tough too and it too can have SE.   

    Get a 2nd opinion.  Dont rush into it.  Get a third even.  Then make your choice.  

    Let us know how you do.

    Hugs,

    Annie

    SE

    What kind of SE did you have from your chemo and double mastectomy, may I ask? I'm finishing up chemo and making this very decision right now. I'm likely going to have radiation either way, I'm told.

    Thank you. :-)

  • LeahA78
    LeahA78 Member Posts: 2
    edited November 2020 #18
    meadowglade said:

    My choice

    I had triple negative stage 2a or b depending on who you are talking to. I had a lumpectomy, I had just two lymp node involved and I think a totoal of 11 removed. My doctors said that a mastecotomy was not nessasairy. I did have intence radiation because mine was very aggrecive and hard to treat. My radioalogst didn't leave anything to chance, he did the full treatment. I also had it in my left breast so they had to be sure the heart woundn't be involved. It wasn't. It really is a personal choice, I just couldn't see the advantage of the mastecotomy over the the lumpectomy. 

    Lymph nodes

    Do you know why they took out so many lymph nodes if only two were involved? I ask because I had possibly two involved before chemo and now I'm looking at surgery in December. Having more than a couple of them out didn't occur to me. I'm also triple negative and have been told I'll likely get radiation no matter the surgery I decide on.

  • Catkim
    Catkim Member Posts: 1
    edited December 2020 #19
    Sadie2020 said:

    Lumpectomy or Mastectomy

    Early October I was diagnosed with invasive DC E+ on right side grade 2 3cm and an MRI found on left small invasive DC/L E & P+ grade 2 .6 cm. They recommend lumpectomy with 4-6 weeks radiation & 5 years hormone blocker. My concern is if it is in both breasts, which is unusual, maybe my best route would be bilateral mast & pass on radiation. How many women have had a lumpectomies and then ended up going back in for a mast? Not sure how to make this decision. 

     

    Hi Sadie2020

    I was recently diagnosed in June with early stage DCIS yet a very aggressive cancer in my left breast.  I chose to have a double masectomy.  I have a friend that chose to have a lumpectomey with treatment and 5 years to the day her cancer was back.  She then opted for a double removal with treatment and never looked back.  So, when I was told I had a choice, and with the lumpectomy I would have to have treatment, the decision was very easy.  I am 66 and I did not want to have to go back into surgery or worry about it returning and I did a double masectomy, DIEP reconstruction and no treatments were needed.  But let me tell you the big surprise I had in the end.  When I went in for my follow up, my doctor told me I had another type of cancer LCIS, early stages and very aggressive in my right breast and it was not ever detected in advance! They had no idea I had cancer on that side and had I decided to just have the one breast removed, I would have certainly been back for surgery, treatments or Lord knows what else in the future.  It is TOTALLY a personal decision.  In my mind, there was no question and I did not need to discuss it any further.  For some it is not so easy to make this decision.  I had great doctors that did amazing work.  I feel blessed by God for His protection, for such great physicians and for the miraculous procedures they can now do to get us through such a devastating event.  You have to listen to your "knower" deep inside and once you make the right decision for you, the peace will follow!  Take care and let us know how it goes for you!

  • laurajt1060
    laurajt1060 Member Posts: 1
    edited February 2021 #20
    Lumpectomy reexcision

    I am trying to make an informed decision. I have idc er+pr+her2- 1.7cm . I had a lumpectomy plus a lymphosintigraph on Feb 5th. I have to go back on March 10th for a reexcision. I'm still waiting on the ocotype score to come back to help determine if I will need chemo and to decide if I should have a mastectomy instead of the lumpectomy again. Praying for guidance on the right treatment. Im worried I will not get clear margins again and stll have to get a mastectomy.

  • LeahP
    LeahP Member Posts: 2
    edited March 2021 #21
    laurajt1060 said:

    Lumpectomy reexcision

    I am trying to make an informed decision. I have idc er+pr+her2- 1.7cm . I had a lumpectomy plus a lymphosintigraph on Feb 5th. I have to go back on March 10th for a reexcision. I'm still waiting on the ocotype score to come back to help determine if I will need chemo and to decide if I should have a mastectomy instead of the lumpectomy again. Praying for guidance on the right treatment. Im worried I will not get clear margins again and stll have to get a mastectomy.

    following

    I have been following and wondered what you decided.  I don't have a date yet for my re-excision.  Prayers for your upcoming surgery.

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