3rd lumpectomy or mastectomy?

3rd lumpectomy or mastectomy?

3rd lumpectomy or mastectomy? I have started this topic on behalf of new user MoiraM

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Has anyone else been faced with this dilema? One breast surgeon has advised that I should have a mastectomy, another a lumpectomy followed by radiotherapy. I’ve also had a sentinel node biopsy, which has come back clear. I have small breasts (34AA), two small tumours (6mm and 2mm) and was going to opt for an immediate DIEP flap reconstruction before I heard the second opinion.

I’m trying to weigh up the pros and cons sensibly, but feel anxious and panicky.

Would love to hear from anyone else who is or has been in a similar situation.


Hi Moira

I sympathise completely as I toed and froed between both options, too. I ended up going for a lumpectomy and have been ‘reasonably’ happy with the result.

My situation was different from yours. I had a single 3cm tumour on a 34B breast. My surgeon felt removing it would cause a noticeable distortion in my breast so I had chemo first and the lump shrunk to 1.9cm. My surgeon felt he would be able to remove it with cosmetic results I would be happy with.

Initially I was - you could hardly tell anything had been done. But as scar tissue began to develop the tissue began to pull in, causing my breast to shrink slightly. Radiotherapy has made this worse and now there is a noticable difference in size between the two breasts. I look ok with a bra on, but not without.

The main thing that would concern me in your situation is that you have two tumours. Although they are small, bear in mind that they need to remove a ‘donut’ of healthy tissue from around EACH tumour and your surgeon will not know how much he will need to remove until he’s in there. Mine had to end up removing quite a lot to get clear margins. As you don’t have a lot of breast tissue to start with I would say there is a chance you may not be happy with the result. But that may depend where the tumours are. (Mine was on the underside of the breast.)

It’s a very personal decision and I think it helps to go with your gut and be at peace with your decision, whatever that happens to be.

Despite not being enitirely happy with my lumpectomy results I’m still glad I went down that road. I didn’t have enough body fat for DIEP or any other tissue donation reconstruction and felt that having an implant only with loss of sensation, loss of nipple, etc would have been a permanent reminder to me that I’d had breast cancer. Plus, if I’m lucky enough to get through the next 10 or 15 years, the implant would have to have been replaced. Lumpectomy just felt ‘right’ to me.

I helps, I think, that I’m in an established relationship. My fiance thinks my breast look fine and he is the only person who sees me naked. I can see why younger,single women may feel more pressure to get a more perfect result.

I hope that helps. Good luck with your decision. Let us know what you decide.

Lola x

Thanks, Lola It was kind of you to take the time to write back and it was good to hear a personal story rather than a statement of facts.

Like you, I’m lucky enough to have a partner who just wants what’s safest for me. But I want to achieve the best result for both our sakes and which procedure will give me that is not clear cut.

By the sounds of it, I’m sure you still look great.

I will let you know what I decide to do.

Hope all goes well for you and you stay healthy.