new to all of this

So much to handle!
I'm so sorry to hear about your diagnosis--what a lot to handle all at once! I hope I can help you understand what you're facing a bit better.

The difference between recurrence rates for lumpectomy with radiation and mastectomy is nonsignificant--such a tiny difference, it really isn't one. However, if you do only lumpectomy with NO radiation, recurrence rates are higher than with mastectomy. Survival rates for lumpectomy with radiation and mastectomy are similar also. The thing that makes a significant difference is the radiation--if you don't do radiation with the lumpectomy, neither recurrence rates nor survival rates are the same or as good as for mastectomy in general.

The treatments are different because they generally don't need to do radiation with mastectomy, though apparently in a few cases they do. In addition, mastectomy is a more invasive surgery with different benefits AND risks from lumpectomy. Ask your doctor to name ALL of the benefits AND risks of both surgeries. I'd also encourage you to seek at least one second opinion from a doctor in a different hospital, or, if possible, a medical center where research is conducted. Even if you decide to stick with the first doctor, talking with another can give you useful information. Knowledge is Power!

Also ask for your pathology reports--you need to know what your hormone-receptor statuses are--i.e., are you estrogen-positive (ER+) or negative (ER-)? Progesterone-positive (PgR+) or negative (PgR-)? HER-2/neu positive or negative, and according to what test if you show HER-2/neu positive (FISH is a more accurate test, but IHC is commonly run first)? These are important factors that should be considered as you make your treatment decisions. If you are positive on ER and/or PgR, you'll be a candidate for hormone-blocking treatment, but if you are negative on those, you'll need more aggressive chemo.

Have they done an Oncotype DX? That provides good info, too, that might affect your decision about surgery and follow-up treatments.

A good book to help you understand all this stuff: _Dr. Susan Love's Breast Book (4th ed.)_.

Hang in there! We're all rooting for you! Sandy

LadyParvati said:

So much to handle!
I'm so sorry to hear about your diagnosis--what a lot to handle all at once! I hope I can help you understand what you're facing a bit better.

The difference between recurrence rates for lumpectomy with radiation and mastectomy is nonsignificant--such a tiny difference, it really isn't one. However, if you do only lumpectomy with NO radiation, recurrence rates are higher than with mastectomy. Survival rates for lumpectomy with radiation and mastectomy are similar also. The thing that makes a significant difference is the radiation--if you don't do radiation with the lumpectomy, neither recurrence rates nor survival rates are the same or as good as for mastectomy in general.

The treatments are different because they generally don't need to do radiation with mastectomy, though apparently in a few cases they do. In addition, mastectomy is a more invasive surgery with different benefits AND risks from lumpectomy. Ask your doctor to name ALL of the benefits AND risks of both surgeries. I'd also encourage you to seek at least one second opinion from a doctor in a different hospital, or, if possible, a medical center where research is conducted. Even if you decide to stick with the first doctor, talking with another can give you useful information. Knowledge is Power!

Also ask for your pathology reports--you need to know what your hormone-receptor statuses are--i.e., are you estrogen-positive (ER+) or negative (ER-)? Progesterone-positive (PgR+) or negative (PgR-)? HER-2/neu positive or negative, and according to what test if you show HER-2/neu positive (FISH is a more accurate test, but IHC is commonly run first)? These are important factors that should be considered as you make your treatment decisions. If you are positive on ER and/or PgR, you'll be a candidate for hormone-blocking treatment, but if you are negative on those, you'll need more aggressive chemo.

Have they done an Oncotype DX? That provides good info, too, that might affect your decision about surgery and follow-up treatments.

A good book to help you understand all this stuff: _Dr. Susan Love's Breast Book (4th ed.)_.

Hang in there! We're all rooting for you! Sandy

options for you
Hi there.

Good advice there, from Lady Parvati. If you have to have cancer, and I wish you (and all the rest of us) didn't have to, then I hope you can go forward with as much true and good information as possible.

Since we are in similar boats I will share my experience with you. In June I was diagnosed with DCIS (non-invasive, so no chemo needed). The results of the MRI showed 'iffy' spots in the other breast. If they had been malignent, I would have opted for a double mastectomy, but not without a lot of angst. As it turned out, the MRI biopsies showed I had only the one spot in one breast. So I had a lumpectomy. But because recurrance rates hinge on having clear margins after the surgery or not, I asked my surgeon to take as big a cavity as she liked. You see, I am a DDD too.

My scar is about 3.5 inches long and almost unnoticeable. However, the CAT scan done during radiation planning showed the cavity to be 10mm across (almost 5 inches). You may wonder how my bc breast looks, now, after brachytherapy (5 days) radiation. I must honestly say that the bc breast is a little smaller than the other. It always was the smaller of my two 'girls' but is even more so now. However, I wear the same bras as before the surgery and any difference in size is only noticeable when I am naked. There is no change in shape except for a small 'dip' in the area of the scar. But my breasts are so loose (I'm 58) that my husband can barely see it.

This is a horrible time for you, I'm sure, being surprised by this happening to you, and now, having to make all kinds of decisions about how doctors will treat your body. It's not easy but you will get through it. You are not alone. This is a great place to ask questions, since you have an audience of readers who have 'done it all' in one form or another. Plesae post again and let us know what's going on!

MyTurnNow said:

Rrogers, just wanted to
Rrogers, just wanted to welcome you to the group. I'm sorry you are here but you have come to the right place for support and answers to your questions. I don't have any additional information to offer but know that we will be here for you every step of the way. This is an amazing group of very supportive, caring, knowledgeable and just plain wonderful women. Take care and keep us posted.

Hi
Hi and Welcome, though sorry you are here for bc. I had a lumpectomy followed by radiation treatments. I felt lucky that my tumor was small enough that I could. I don't think I could have handled a mastectomy. As far as I know, the survival and the recurrence rate is the same with a lumpectomy followed by radiation as it is with a mastectomy. Even with a mastectomy, they can never get all of your breast tissue. Good luck to you!

Angie