Why get a mastectomy?

I had a choice, but with a 5 cm tumor, my surgeon thought that it would be a deformed looking breast if I went with the lumpectomy. However, that did not weigh in to my decision at all! I was 36 and I just couldn't stand the thought of leaving any cancer behind! I had 3 lymph nodes involved. I also chose to wait on the reconstruction because I wanted to heal as soon as possible so I could start chemo...which I know isn't a concern for you since you already went through chemo. The mastectomy was pretty much a "piece of mind" choice for me. I'll be thinking of reconstruction in about one more year. Good luck, and welcome!

Hi Elyse,

I had a 5cm tumor but opted for lumpectomy. If you are small breasted and have a large tumor, a lumpectomy can be just as disfiguring as a mastectomy but I did not have that problem.

Lumpectomy vs. mastectomy basically comes down to what you can live with and not drive yourself crazy. The survival rate is the same so that shouldn't factor into your decision. As I said, I opted for a lumpectomy at the recommendation of my surgeon and oncologist. For a few months after, I questioned my decision because it seemed like everyone women I talked to decided on the mastectomy rather than lumpectomy. Did they know something I didn't know??

My neighbor across the street had a very small tumor (.5 cm) yet opted for a mastectomy. She didn't want to mess with radiation and she was very fearful so for her peace of mind, a mastectomy was the right choice.

Elyse, it comes down to what will make you the most comfortable long term. If you think you will always be afraid the cancer will come back in the same breast, then maybe a mastectomy is the choice for you. If you can't bear the thought of loosing your breast and going through more surgery, then maybe a lumpectomy will be enough.

I hope this helped!

Blessings,
Karen

tlmac said:

Hi Elyse, I was diagnosed in January 2003 with a 2.5cm ER+ IDC in the left breast (no lymph node involvement) and 7mm benign mass in the right. Surgical team recommended two lumpectomies followed by four AC then 5 years on Tamoxifen. I did a lot of research and found that statistics for survival were nearly the same. My greatest concern was the danger of having a recurrance in the same breast or another cancer in the other. My mother lost her breasts 8 years apart and I watched her go through everything twice. I chose bilateral mastectomy to reduce the chances of going through what my mother had. It wasn't a survival based choice. I also chose Arimidex over the "gold standard" Tamoxifen because I liked the significant difference in recurrance rates and in overall survival statistics. I discussed my choices with surgeon and oncologist and they were supportive. A year and a half later, I've never regretted the mastectomies or the decision to take Arimidex. I remain cancer free and feel great.
Good luck with your decision.

tlmac...can I ask your age? I asked to take Arimidex over Tamoxifen and was told I couldn't since I am not post menopausal even though I haven't had a period since December of 2002.

Thanks,
Karen

I made BOTH decisions...when dx in March 2003, the docs were sure I had a small tumor (1 cm). We weighed all the info and decided on lumpectomy (R breast). Trouble getting clear margins AND discovered a larger-than-expected tumor (2.8 cm) and several smaller tumors as well. 2/8 lymph nodes positive. Had 8 rounds of chemo and then a re-excision at the original lumpectomy site to remove residual cancer found on breast MRIs. Thought I would be moving on to radiation when the medical team recommended a mastectomy...they had mapped all the tumors after the last lumpectomy and decided it was multi-focal (or multi-centric, I get the 2 mixed up) and mastectomy was the best medical choice at that point. I opted for bilateral mastectomies and the doctors all supported me.

I went with lumpectomy first because it was less "severe" and statistically has the same outcomes as mastectomy. My line of thinking was do the least you have to do that will be medically sound. That's why I also opted for the second lumpectomy. But I ended up with the bilateral mastectomies because my breasts were SO hard to image and even with mammograms, ultrasounds, and breast MRIs, the radiologists couldn't agree on what they were or weren't seeing, both in the R breast (the one with cancer) and the L breast (the one that didn't have any cancer, although several radiologists thought there were malignancies in that tissue, based on the breast MRIs). I didn't want to take a chance with the L side...we had thought we caught the cancer "early" on the R side, and I ended up to be Stage IIB. What if we were even less "early" on the left???

Two more things, and then I'll end this long post. First of all, I really struggled with having my breasts removed. Somehow, I felt that if I got through all the lumpectomies and chemo treatments and still had my breasts, cancer didn't win. But losing my breasts felt like cancer won after all. That was an emotional thing and I DON'T feel that way any more, but I had to work through that. I had to come to the realization that I lost my breasts so that I would win my life!!

Second--my first cousin had breast cancer and chose mastectomy over lumpectomy because she has extremely sensitive skin and was VERY worried about going through radiation. Different factors are important to different people.

jamjar62 said:

tlmac...can I ask your age? I asked to take Arimidex over Tamoxifen and was told I couldn't since I am not post menopausal even though I haven't had a period since December of 2002.

Thanks,
Karen

I was 54 at the time of diagnosis and had stopped having periods when I was 50. If I'd been premenopausal, I'd have taken the Lupron shots, without hesitation, to get Arimidex over Tamoxifen. Everything I've read tells me aromatase inhibitors offer the greatest protection against recurrance. A very close friend, who is 46, just recurred and is now stage IV. She's been on Tamoxifen for the last 2 years. It's such a personal choice, though, and each of us needs to make decisions that are best for us. I know of many women who have been on Tamoxifen with great succcess.
Read everything you can find on the latest studies, and discuss all options with your medical team. The function of the ovaries can be suspended, allowing premenopausal women to avail themselves of Arimidex or Femara. Only your medical team will know if this is an appropriate option for you. I'll keep you in my prayers.
terri

I was diagnosed with Paget's Disease(breast cancer of the nipple) in Feb.2004. I had one surgeon suggest a modifed mastectomy(just the nipple,areola and underlying tissue), while another suggested a full mastectomy. I opted for the full. My decision was easy. At the time I was 26 and I have two very small children. I didn't want to mess around with the possibility of not getting all the cancer. The surgeon who suggested the partial mastectomy said that if the margins weren't clear then they could go back and discuss possibly doing a full mastectomy. I didn't want to have another surgery, if it came down to it. You already go through enough. The decision is a personal one. You have to do whatever will give you that peace of mind, because if you don't follow your gut, you will worry about it. Take care and God Bless!
Gina

Hello my name is Marilyn and I chose mastectomy because I don't want any reacorrance.I had breast cancer 13yrs ago and went through six months of chemo treatments and last year in February a new breast cancer came back so I knew what I was up against so I chose mastectomy and I told Mom and my husband if it is any thing I want something done .I had a biopsy on the 26th of February of last year and a mastectomy on the 28th and I was in the hospital that weekend . It was a hard decision the first time when I was in my early 20's 13yrs ago and when they took me to my room 13yrs ago after surgery I slept the longest time because I did not want to face reality a nurse that worked at the hospital shared her secret with me and that is what helped me over come my cancer 13 yrs ago .I had know idea that I would get a new breast cancer .
Elyse you are a gift from God and right now you are going through a storm in your life you are in my prayers.
Marilyn