Hi.
I currently go to a local cancer support group, where most of the ladies there are quite a few years ahead of me, since they were diagnosed with Cancer.
There’s quite a lot of them who’ve opted to have a lumpectomy and cases where the cancer has come back.
Im just curious and wanting to create a mini poll, as it were regarding this.
I myself had a mastectomy and clear lymphodes and bone scan, so in my mind, my cancer is gone. On the other hand, my sister had a Lumpectomy 20+years ago and she still has episodes of recurring cancerous cells forming, more surgery/lymphodes removed which seems never-ending, equally many rounds of radiotherapy and chemotherapy.
So, is it less treatment filled if you have a mastectomy but a dramatic change of no breast, or is it a preference to keep your breasts and endure a longer treatment etc… journey WITH the added risk of it coming back?
OR,
is it not as straightforward as that, obviously taking into account what type of cancer you have and is progression. 
I actually read up on this a little yesterday since a study came out a few years ago showing that a lumpectomy with radiation was superior over a mastectomy in regards to long term prognosis. I asked my doctor about it and she said they believe that data is more as a result of the nature of the surgeries and the complications that can evolve from it. Also perhaps the health of the women who preferred one over the other. At any rate she thinks the true stats are still equal but it’s an interesting subject. So in my admittedly brief research yesterday I found a study talking to women who had both and their thoughts on it. Apparently a lumpectomy plus radiation has more issues with pain long term than a mastectomy. I was surprised at that but apparently radiation can be tough to get over for some people. Women do appear more satisfied with it aesthetically though. As far as their feelings, I think it depends on the woman in question and what they value and need. If their feelings are taken into account and the surgery done as to their choice whatever it is, the vast majority appear to be satisfied. I had a double mastectomy although I only had breast cancer in one. I have never regretted my decision. However, I have high anxiety in regards to scans so never having to get another mammogram was huge for me, hated the look of my natural breasts, and healed quickly and completely from all surgeries. I am well aware that my surgeries did not increase my chance of long term survival though and that I could have had a lumpectomy if I had wanted to. I didn’t want to. When I say I hated my breasts, that is not an exaggeration. I asked my husband to take a picture of my chest the night before my double mastectomy just because I thought I might want to look back and remember what I looked like. He recently sent me that picture just to tease me about something and I shuddered. I am THRILLED they are gone. They weren’t pretty and then had the audacity to make cancer and try to kill me. Good riddance to the bastards.
I find this really worrying as my consultant assured me there was absolutely no advantage to a mastectomy over a lumpectomy. But that the lumpectomy would have better less complications and be psychologically better.
I’d have whatever surgery brought down the recurrence rate.
This would be a good question to ask the Nurses . But basically your last question is correct . It depends on the size grade and type of cancer to a large extent plus other factors . Some will be offered a choice between lumpectomy and mastectomy and for some mastectomy will be what the surgeon and MDT feels to be the safest . They map out the what they feel is the best / safest / most successful treatment plan for each patient . The age and medical history of the patient may also play a part.
For some like myself with early grade 1 or 2 cancer mastectomy is not offered - at least on the NHS . I asked the BCN about survival rates whether there was any difference and said I would be willing to have a mastectomy if they thought it would improve my chance of survival but she said that survival rates are the same whichever . Some are offered a choice between mastectomy only and lumpectomy plus adjuvant therapies and choose to have the mastectomy rather than undergo those. I was so low grade that even if I had said I wouldn’t have radiotherapy (I did have it ) or endocrine therapy ( stopped it after 5 months) I doubt I would have been offered mastectomy.
Like Kay I was also not pleased with the way my breasts looked - they’ve never been the shape I wanted / sat at the right height /one slightly bigger than the other ( even more so now) . Although I’m relatively tall with broad shoulders I’m fairly small chested which makes it slightly awkward finding the right size bra and can make me look out of proportion. However I feel differently about them now - I’m glad to have them and think they look just fine .
This wasn’t the case last year as my operated breast was red and thickened after radio and oedematous with enlarged pores due to radio and having an oil cyst stuck in the axillary tail - but that’s all gone now.
I was never really bothered about how it would look cosmetically .I would have had a mastectomy if needed and probably been happy to be flat . I was concerned about lymphoedema which I don’t have but there is some intermittent discomfort - but not pain .
For some people the clinical results indicate a very obvious choice for others it’s not so clear .I think sometimes the problem is getting the right information at the right time in order to be sure to make the right decision.
Your reply is interesting and a good overview of your experience. Thanks 
We have breast cancer in the family; started with my mother 40+years ago (deceased) then my eldest sister, followed by middle sister, then 5th sister (deceased) then myself the youngest.
For me personally, my cancer was all a rushed process, so I just opted for a mastectomy. I didn’t have time to chew it over or options, as it was an emergency surgery, although caught early.
I also have an autoimmune disease, so I didn’t want the added complications with cancer treatment, overlapping my Lupus treatment. I was very reluctant to have chemo, but fortunately didn’t have radiotherapy, because Lupus effects my heart and lungs, so the treatment could have proved to be unsafe and wasn’t necessary overall.
I too, didn’t like my breasts, but because of the size being too big, with years of steriods to control Lupus etc…
At the moment, I do feel a bit disfigured, as you can increase small breasts, but you can’t hide large ones.
I will be glad to have my corrective and reduction surgery, so that I can get back to being in a much more manageable cup size.
If I didn’t have the added risk of a Lupus flare up, I would have opted to have a double mastectomy at the time and then took some time what to do next, if anything.
I’m due single mastectomy on Monday. When I went for 1st referral at hospital they did mammograms, and ultrasounds. Turns out I have at least 2 tumours grade 3 in different quarters the largest being 37mm, with other suspicious areas. This has appeared in less than 2 years since my last routine screening. They told me then that I am looking at mastectomy. Whilst waiting for confirmation from seeing surgeon a couple of weeks later I decided that mastectomy was my only option. I just want this stuff out of me! I will be sorry to see my breast gone as I am proud of my natural bosom, but my life is more important.
For most of us it’s something of a whirlwind - I can see that for you with your family history it must have been especially traumatic and I can’t imagine what it must have been like for you to be diagnosed as well. It also sounds as though clinically and because of your lupus the path was a fairly obvious one . In your position I wouldn’t have had radiotherapy either and would have felt the same as you about chemo.
I get your point re not being able to make large breasts look smaller .I have a friend who had bilateral breast reduction to prevent back problems but also because the reactions of other people ( mainly men ) made her feel very self- conscious - and she’s never looked back. It was to do with my build - having broad shoulders / big build/ tendency to be overweight . Even when I was slimmer I had a tummy bulge which I inherited from my otherwise slim petite Mum which meant that my tummy always stuck out more than my breasts . Altogether it made me feel unfeminine and I always thought if my breasts were bigger that that would make up for it. Most pretty bras in my back size started at a double DD cup when I’m more of a B/C depending. I would never have had breast enlargement though. If there’s an upside to having cancer it’s that I don’t care about any of that now .
Wishing you well with your forthcoming surgeries
Joanne. X
I had a mastectomy 10 years ago and chemo and radiotherapy and 9 years of tamoxifen. Everyone expected that to be it and I’d be fine, 9 years on Tamoxifen didn’t stop it coming back in my lungs so I don’t think they fully understand how and why some cells seem to “sleep” for so long and then are triggered to start growing again. I think there is some research going on at Nottingham University to try to understand this but it will take a long time to get meaningful results.
Spikey
I’ve come to the conclusion that every persons unique. I was 31 when I ended up having to have a double mastectomy with immediate recon. Fast forward 6 years later I then ended up with recurrence and ended up having to have chemo and radiotherapy and complete lymph node clearance.
Lumpectomy would definitely have less complications. It is not always psychologically better though and it bothers me quite a bit that so many doctors don’t seem to grasp that. Scanxiety is a real thing. If I had a lumpectomy I would be so much worse psychologically. A lot of women would be. Thank goodness I was offered that choice and no one tried to talk me out of it.
Good luck with your surgery. I’m 11days post single mastectomy and very happy with my new look and relieved to be free of the cancer (DCIS).
The pain is bearable and I used paracetamol the first 4days and now, just when it niggles.
I had my drain out at 8days and feels so much more comfortable as I’m a side sleeper and happy to be able to get to sleep on my side again, albeit with a little pillow.
I’m happy to send photos if you’d like to see as my op was a Monday too and I’ll be just 2wks ahead of you come Monday x
Same …one big surgery and done…never looked back…love the flat look/thing….no reconstruction either for me.
I had a bi lateral mastectomy 23 yrs ago .
Friends that had lumpectomy are no longer with us x4 .
I have pain in my chest from trapped nerves and radiotherapy.
But have gone on to get 23 yrs and wanting more .
Like you, I was fully prepared to have a mastectomy if that was the best thing for my type of cancer (triple positive) . My surgeon said there was absolutely no benefit to having a mastectomy. I had lumpectomy and my sentinel node removed. Sentinel node clear and tumour had gone as a complete response to chemo. I think years ago I’d have had a mastectomy. Things develop and change. Completely not sure but thought mastectomy more often carried out for triple negative
Depends on your age and pathology. Some people get confused and lump all stage one cancers together. I was stage one-E+P+ HER- and 60 years old. My friend was stage one-triple negative and the same age. We were diagnosed within a month or two apart. Her cancer had a high probability of returning, my probability was very low risk. Both had Onco DX evaluation. I went for as advised by my oncologists and surgeon of treatment by lymph node/sentinel node being negative to lumpectomy, Radiation, and five years Arimidex. My friend had bilateral mastectomies and chemo. She couldn’t tolerate the AI treatment. We both were told the younger you are at diagnosis, the higher chance of return. I have another friend who had her diagnosis at 35, and thirty years later, never had cancer again. I was told data shows no difference in survival between mastectomy vs lumpectomy w/radiation. I chose to trust my doctors considering my age. I have noticed the women who are 40s and early 50s, their Doctors seem to choose mastectomy, but I’m not sure what their pathology was either. All you can do is read, ask questions and if you don’t trust your Oncologist, find another Doctor. Best Wishes to all.
I was first diagnosed at 36, had lumpectomy, no node involvement, came off Tamoxifen after 6 months as my survival rate was half % more than without. 31 years later I have a new Primary same breast and double the size of the last one. Thankfully it hasn’t spread, in for mastecomy and node biopsy Monday. I am very small breasted and been living with one boob high up on my chest which is a shrunken hard lump due to radio therapy. The other half way down my chest, been wonky for years lol! Having a mastectomy will not make any difference to how I look! The surgeon asked if I wanted reconstruction, I said are you serious lol! He did see the funny side.
I was diagnosed in 2003 with left breast cancer. Nineteen years later, in 2022 the same breast had another tumour in it so goodbye to left breast but I have had reconstruction. I am now taking letrozole and having six zoledronic acid infusions over the next three years, as the cancer was very close to the chest wall and the mastectomy lowest part was less than 0.5 mm from my chestwall.
I had always thought I was small breasted but after I visited Rigby and Peller, (corstetiere to her Majesty) in 2004 I discovered I was the most common size 34B.
In 2004 I only lasted two weeks on tamoxifen as I did the calculation for .9cm tumour grade 1 with no lymph node involvement and like you the recurrence rate came out very low. I decided this might be wrong, so I joined the generations breast cancer study that started in about 2005, which aimed to recruit 200,000 women to look at factors causing breast cancer.
I told the generations scientists when I was rediagnosed after 19 years and sent in details of my new diagnosis. This time I had NOS = No special type ductal so the grade went up to grade 2 and this time instead of no nodes with cancer, I had one intramammary node with metastasised cancer in it.
So now I am taking letrozole but this has some nasty side effects so as I am now 68 I don’t know how much longer I shall persist taking it. Constipation, wind, pains in the knees, wrists, fingers, backs of my legs, pain in my new reconstructed breast even though it has no nerves in it now (apparently). Depression caused by letrozole or maybe having cancer again, so now on sertraline for this. Taking calcium tablets for osteoporosis as letrozole stops oestrogen that makes bones strong. Worried about heart disease as letrozole raises cholesterol levels.
Yes I am a walking medicine chest full of drugs and was given a questionnaire at my GP practice when I had my flu jab yesterday asking questions about all the drugs I take. This assumed the drugs would be to deal with symptoms / pain I have. None of them has helped with any pains, I didn’t have any before I started cancer treatment. I just had two painless lumps, although I did feel my breast was a bit more sensitive than it had been, the shape was better as the tumours were filling up the space where the other lump had been removed in 2003.
I wonder whether they will stop prescribing all the medicines I am now on, or junk them all?
Seagulls
Seagulls
It’s a very interesting question, and as others have said it seems to be a very personal decision as there are so many factors. I had a double lumpectomy (one in each breast) and radiotherapy earlier this year as the consultant said that that was as effective as mastectomy. I ummed and ahhed about it but went with that in the end. I don’t know if that was the right choice or not, time will tell. But as others have said, a mastectomy is no 100% guarantee of it not returning. Feel sorry for people who have a recurrence when you think you’re well past it! I’ve a follow up MRI in a couple of weeks for a suspicious area which seemed to have disappeared on another scan - so who knows.
Im taking Letrozole for a year now. I just hope it doesn’t turn on me, further down the line…