lumpectomy vs. mastectomy/update

ohilly · February 2008

Hi, it's ohilly. I have been on this board almost constantly since I was first diagnosed about two weeks ago. I have been diagnosed with invasive intraductal carcinoma with a 1 cm tumor. I am going to Rush Presbyterian St. Luke's, a teaching hospital in Chicago. For a long time I was going back and forth about whether or not to have a mastectomy or lumpectomy. Well, something happened today that made me make up my mind: I had been originally diagnosed at another hospital, and Rush wanted to do their own mammogram. When they did the second mammogram they found that in addition to the 1 cm tumor they already know about, there were small calcifications behind this tumor contained in the duct (in-situ). They do not yet know if the additional calcifications they found are cancerous, but that was enough for me: I made up my mind to have a mastectomy. I have read on the net that the risk of recurrence is slightly higher with a lumpectomy than a mastectomy, although it does not affect the survival rate. The thought of going thru the rest of my life worrying if it will come back in the same breast terrifies me: my surgeon told me it could still come back in the breast wall, but that it was rare. Anyway, I am at peace with my decision to have a mastectomy, although scared. The surgeon told me the decision is still up to me, but that if she did a lumpectomy, she could not guarantee that she wouldn't have to go in again to clean up the margins. Does the group have any feedback on my decision to get a mastectomy, and also about these additional calcifications they found. My surgeon said she couldn't say that much until they go in, but at this point, the fact that they found the calcifications doesn't affect my prognosis. I am very scared about them though. Please let me know what you think and thanks for your support. Ohilly

mgm42 · February 2008

Ohilly - they found calcification in my right breast when they did my mammogram. My tumor was in my left breast. They recommended a sterotactic biopsy of the right breast, to which I agreed. The biopsy came back negative. Now the calcifications may have to be addressed at a later date - I'm not sure. But, the fact they there were benign and in the opposite breast caused me to stay with my original decision of lumpectomy. I think I told you that I'm in a trial which will tell me my odds for recurrence of breast cancer. If the numbers aren't good, I will have chemo and may, at some point in the future, have to opt for mastectomy. But for right now, I'm still satisfied with my original decision. I have two other friends who opted for mastectomy. They are not sorry that they did. So, each of us has our own reasons for doing what we do. I'm an eternal optimist, hence my decision. Don't get me wrong, I labored over this decision. It wasn't made in haste, but for me it was right. Hang in there kiddo. By deciding to go with the mastectomy you may be sparing yourself some emotional trauma. I know that mastectomy is BIG decision which can't be changed, but it may give you some peace of mind - which is extremely important. See what the other gals have to say. I'll be watching. And, if there is anything else I can share with you, just ask. Take care kiddo.

3cbrca · February 2008

Ohilly
You said it all = you are at peace with your decision and that's what matters. Congratulations. Your next step = if you are planning reconstruction is to ask them about whether they can do it at the time of mastectomy. With your early stage diagnosis, they will likely be able to. Please don't be too scared. I had calcifications in my left breast that were all benign. You've made it over a big hurdle just making the decision. Now you can take a deep breath and accept it and start thinking about having the cancer out of your body. You might want to ask them about whether you are likely to need chemo therapy and if so, would you be a good candidate for neoadjuvant (chemo before surgery). More doctors are moving towards chemo before rather than after.
Nows the time you can begin to take comfort in the idea that you made a decision and you are starting on the healing journey.
Congratulations
Sheilah

ohilly · February 2008

mgm42 said:
Ohilly - they found calcification in my right breast when they did my mammogram. My tumor was in my left breast. They recommended a sterotactic biopsy of the right breast, to which I agreed. The biopsy came back negative. Now the calcifications may have to be addressed at a later date - I'm not sure. But, the fact they there were benign and in the opposite breast caused me to stay with my original decision of lumpectomy. I think I told you that I'm in a trial which will tell me my odds for recurrence of breast cancer. If the numbers aren't good, I will have chemo and may, at some point in the future, have to opt for mastectomy. But for right now, I'm still satisfied with my original decision. I have two other friends who opted for mastectomy. They are not sorry that they did. So, each of us has our own reasons for doing what we do. I'm an eternal optimist, hence my decision. Don't get me wrong, I labored over this decision. It wasn't made in haste, but for me it was right. Hang in there kiddo. By deciding to go with the mastectomy you may be sparing yourself some emotional trauma. I know that mastectomy is BIG decision which can't be changed, but it may give you some peace of mind - which is extremely important. See what the other gals have to say. I'll be watching. And, if there is anything else I can share with you, just ask. Take care kiddo.

Marilyn, your posts are helping me a lot. Thank you for all your support. I wanted you to know I am thinking of you too and that I hope your trial comes out good indicating low odds of a recurrence. I am interested: how did you get into this trial and what exactly does it entail? Is that the oncotype thing you referred to? Best of luck and thinking of you, Ohilly

jackiemanz · February 2008

Hi Ohilly! I've been in your shoes and the decision you have to make is a hard one and should not be made lately. My cancer was LCIS and it was stage 0 the choice I had to make was to wait until it got worse, which there was no telling how long that could be or go ahead and have a bilateral mestectomy. The Doctor said if I decided to wait it could be six months from now or 75 years from now I could be going through all this. Well I decided on the bilateral cause I didn't think I could live that way and I wanted that peace of mind know it was gone. So I feel you made that right decision a hard decision but the right one.

Hugs and Good Luck
Jackie

cruf · February 2008

Hi! I was Dx in 2000 with DCIS, Stage 0. I was told at that time I was to have a lumpectomy and so, that's what I had. When the pathology report came back, the margins weren't clear. I was given the choice to leave well enough alone and have radiation and hope it got any cells that were still there, or to have mastectomy, and know they were gone and no radiation or chemo needed. I chose the mastectomy w/o a second thought. I wanted it all out!I had immediate Tram Flap and have never second guessed my decision. The reconstruction is relatively good. I am very comfortable with what was done and if I had to do it again, I would have another mastectomy. Good luck with your decision. Let us know how you are doing. HUGS!! Cathy

lzeena · February 2008

I also agree, it is more about how you feel on your decision vs. what any of us feel is 'the' right decision. I had stage II breast cancer 5 years ago. My tumor was just slightly larger than yours and I had 4 positive lymphnodes. I chose a lumpectomy and do not have any regrets (and I had to go back because I did not have clean margins the 1st time). I also found out I am brc1 positive and still feel comfortable with my decision. I did, however, need to make a decision on removing my ovaries because of the significant increased chance of getting ovarian cancer with BRCA1. I chose to remove them (a very difficult decision) after giving birth to my daughter last february (during a c-section). Again, a very difficult decision, but in the end my family convinced me that it was better for me to be around vs. the risk of getting ovarian cancer. So all I can say is you need to do what feels right for you, because really there is no right or wrong decision here. It is about what gives you peace of mind.

lumpectomy vs. mastectomy/update

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