Lumpectomy vs Mastectomy?

Diseases & Conditions Breast Cancer
1
Chloe, I saw your post in the other thread and thought a new one on this topic may help you. 
Being as informed as possible is the best way to go in this scenario, as it is not an easy choice for many.
 
You asked how the decision is made and why some wish they had done a mast instead of a lump.  Take caution to not act on emotion, but on facts and what is right for YOU. 
 
Some people are not offered a choice, based on the kind of cancer, location, extent, etc.  Regardless of whether they offer you a choice, I would highly recommend a second opinion...to either offer more options or cement the deal.
 
Factors are many. Some people cannot do radiation tx due to distance from the hospital so they choose a mast. Some people want to be as aggressive as possible. Others just "want it off". Others have high risk of other cancers or are at high risk for recurrance and choose to have a mast and a prophylactic mast on the other side to keep chances for recurrance as low as possible.
 
Keep in mind a mastectomy is permanent. You cannot reverse it, but you can always get a mastectomy at a later date if desired.
 
Many of us find that life after cancer, trying to regroup and get a new normal, is not so easy....and people want to take control as much as possible, and have the mast or bilateral mast later.
 
In my case, I was just barely 31, and could not even imagine getting a mastectomy. Several docs concurred that I had "equal chances for survival" with a lumpectomy, so I opted that route. A mastectomy would probably protect me better from a recurrance later...when I presented this to my doctors a year or so after treatment, they suggested it was "overkill" and cautioned me about making a decision based on fear.
 
Everyone has valid reasons for their choices. The key is that we do have choices in this process. Take time to get the facts and make your best choice....
 
Hugs,
Lori

2

Chloe: Lori is absolutely correct. She has given you some great info. In my case, my cancer was so involved and there were so many lymph nodes involved that I didn't have a choice. I was in such a state of shock that I didn't even think about asking for a bilateral. There is a history of bc in my family. I was 51 when I had my mastectomy. If I had been younger, I might have thought about reconstruction but at my age, I opted not to have it. I am seriously considering having my other breast removed this summer. It is difficult dealing w/ everything that is thrown at you. A 2nd opinion is something that we all strongly suggest getting. In my case, the first surgeon that I saw I totally detested. I already had an appt w/ another surgeon for a 2nd opinion and she was the one that I ended up using. Best choice that I ever made! yeah

Deb

 

3
Lori gives good advice. I will add my 2 cents, although it probably isn't worth that much. I didn't have a choice...too many factors going against me.

But if you are considering a lumpectomy, you should know that you may not have a "normal-looking" breast left, either. Surgeons like to get a sizeable clean margin, which means taking out quite a bit of breast tissue. What you're left with depends on how much you had to begin with, and how much they have to remove. You can often have the remaining breast reduced to more closely match the lumpectomy breast.

Also, I know several young women who opted for mastectomy over lumpectomy, only to find that there was additional cancer in the breast that had not been detected yet. They would have been looking at a mastectomy down the road. A mastectomy is not a "cure" for cancer either. I have a friend who had a mastectomy, reconstruction...and then had a recurrence on the chest wall.

On a brighter note, I've been around a good many years since my surgery...11 and still counting, and I can count a long way! So I wish you well in your decision...and know that we don't survive this fight without battle scars, but we can survive. When I look back on what really worried me then, that is the important thing to know.

Hugs...
BEV
4
Hi Chloe,
So sorry you are having to deal with all this! I did not have a choice, I had to have a mast. because I had more than one area of cancer, but when they took it off they did find another area that had not shown on mamm. or ultrasound. I have NEVER regretted having mast. In fact, I wish I had done both at one. I did end up taking the other breast off and having them both reconstructed about 1 1/2 years after diagnosis. I was 30 at the time and had a 19 month old. I am now 36 and getting ready to celebrate my 6 year anniversary!
 
Just remember first and foremost, your breasts do not define who you are. Make a decision that is best for you and then don't second guess yourself!
 
Hugs,
Julie

Do not go gentle into that goodnight,
Rage, rage against the dying of the light.
~Dylan Thomas

5
Thank you everybody, I will go into todays surgeons appointment that much more informed.  I did pickup Dr. Susan Love's Breast Book and have been busy reading that ovr the last couple of days.  I have a knot in my stomache, a pounding headache and I am week at the knees but I will walk in there today and face whatever I have to face with my best foot forward and a smile on my face..  I will keep you posted.
6
Chloe

Good luck today, we will be thinking of you. Just remember that all of us will be there to hold your hand and comfort you during your procedure.

Many hugs to you!

Bernadette

 
 

7
Chloe-
(((((((((((((HUGS)))))))))))

For me, the week between diagnosis and finding out next steps was the worst in my life. I cried all the time and read what I could when I was not crying. When I walked out of the surgeon's office that day, I was strong and empowered, I had a plan...I needed to make several appointments, for consults, scans, etc...and having that plan and a next step was tremendously empowering to me. Hopefully it will be for you as well.

Hang in there-
Lori

8

thought I would give you all an update.  I met with my surgeon today and I loved her from the moment I met her.  Her surgery speciality is BC and you could tell.  I went in with week knees and a knot in my stomache.  I came out informed, happy and in control!!!  My Doc had told me I was to have a lumpectomy but turned out the BC was right below my nipple and spreading out so they were going to take alot with a lumpectomy.  Surgeon also said that they were concerned because the original Biopsy, US and Mammo showed BC  was aggressive.  I opted for mast and sent nod

and am happy with my decision.  All is to be done next Wednesday.  Amazing to think my journey

started on Friday January 13 when I called my Doc about my lump and 26 days later I will be in surgery.  Still a long road ahead and many bumps but I am on my way.

9

Chloe: Wow! You have had some day. I am so proud of your attitude and your "take charge" action!!!! I am glad that your surgeon was someone that you have faith in. That is soooooooo important. Yes, you have a long road ahead but just look at what is already behind you. Look how far you have come and you have survived. Your attitude is wonderful. Just keep that and you will do fine. Laughter is a great healer and will really help you during this journey.

I think Friday 13th is lucky also. I found my lump on Good Friday, which was the 13th. My surgery was on the 13th. My chemo began on the 13th and I finished w/ all treatments on the 13th (12 mos later). So keep believing in that magic number.

We will all be w/ you next week. I am sure that we can get the gals aboard our private plane and you will be surrounded by pink feathers.

Keep coming here. Remember, there is always someone around day and night.

Hugs..Deb

 

10
Chloe - I am sooo glad that you feel comfortable with your surgeon. Although its a crummy situation, cudos to you for your wonderful way of handling it!

There was one more thing that I thought of... although getting through the surgery is probably (and rightfully so) the formost thing on your mind, if you have to do chemo, depending on your cocktail, you may want to consider getting a pick line or a portacath. If you decide to go with a portacath, perhaps they could insert it at the same time as your mast??

Some of the chemos can be very hard on your veins. Since my cocktail was AC & T, (with the A - adryamicin being extremely hard on veins) and since they seem to have a hard time getting my veins to begin with, after my lumpectomy, I went back and had a port inserted. it was a very easy surgery, but perhaps you could get two birds with one stone??(that is, if you need a something like a pick or a port to begin with)

Take care of yourself this weekend. Have some fun, get out and try to keep your mind off of evrything (I know - easier said than done). and if you need us, we are here.

Hugs,
Chantry

There are no wrong turnings, only paths we did not know we were meant to take - Guy Gavriel Kay

11
Chloe,
 
I am so glad you like your surgeon.  Mine was very matter-of-fact.  Good, though.  I think you've made the right decision to have a mast.  Mine was actually easier than the lumpectomy. 
 
I love your attitude and that makes ALL the difference in the world.  Sure, you will have bad days, but as long as you keep a positive attitude, you will do great.  My onc said the exact same thing to me. 
 
I will be onboard the PCE for you next week and watch out for all the pink feathers.  We'll try to not get them in the way of the surgeon!   LOL 

L & H,
Kathy

12
Hellow, Chloe. I have not responded to your posts, but have been following them. I am happy that you chose the mast., also. My 2 cm tumor was just behind the nipple, also. Before I knew much at all about my disease, I had already decided on a mast for 2 reasons: first, my family history was such that I had decided a long time ago that given the choice, I would opt for a mast. Also, I with a lumpectomy, one must undergo radiation therapy -- no choice. There was a chance I would have chemo only if the disease was caught early enough. However, I had to undergo radiation anyway -- 5 positive nodes. Regardless, I believe I made the right decision based on the information I had before surgery.

Good Luck with the surgery. We'll be behind you all the way. You seem to have a great surgeon, as I did.

Judy