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Deciding between lumpectomy and mastectomy

Egankeevan
Posts: 17
Joined: Jun 2017

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? 

tufi000's picture
tufi000
Posts: 755
Joined: Jun 2005

Get a second opinion. I went for doublemast. 2003

Teach76's picture
Teach76
Posts: 351
Joined: Jul 2015

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
Posts: 527
Joined: Aug 2016

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
Posts: 259
Joined: Mar 2017

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's picture
WLButterfly
Posts: 1
Joined: Oct 2017

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
Posts: 527
Joined: Aug 2016

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

bkjljones's picture
bkjljones
Posts: 2
Joined: Nov 2019

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.

Candy123
Posts: 2
Joined: Jan 2020

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.

Apaugh's picture
Apaugh
Posts: 856
Joined: Aug 2016

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
Posts: 36
Joined: Jun 2019

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. 

ts72
Posts: 5
Joined: Jun 2020

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.

guitarplayer
Posts: 3
Joined: Feb 2020

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! 

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