Hi I am Shital 45 years old, I was diagnosed last September with Her2+ ER+ breast cancer stage 3.
I started chemotherapy to reduce the 3cm tumour and now I am scheduled to do lampectomy as advised by the surgeon on the 22nd march.
But my oncologist in the same hospital, IPO Porto, thinks a mastectomy would be more appropriate since I have dense breasts difficult to surveil. Can anyone help me? Also, I would like to know what follows the mastectomy, is there any chemotherapy to do?
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Mastectomy versus lumpectomy is a conundrum for a lot of breast cancer patients. First of all, there is no benefit to long term survival regardless of what you go with. But in saying that there are some other benefits to consider. With a lumpectomy there will be less recovery time and of course you get to keep a body part. For a lot of women this is the most important thing and the radiation that comes with it is a small price to pay. With a mastectomy, you’re taking off a body part, the recovery will be more difficult, but if the nodes are clear you can avoid radiation. You also avoid the future scans to monitor your breasts because you don’t have them anymore. And for a lot of women this is the path that causes them the least stress. Either way though, I doubt more chemotherapy is in your future since you’ve already gone through it. Now as far as which person you should listen to the most? I would say your oncologist. Your surgeon’s job is to do a great surgery and give you clean margins. Your oncologist’s job is to make sure you stand the best shot of never hearing breast cancer in relation to yourself ever again. So if your oncologist thinks a mastectomy is the way to go for this, then I’d be inclined to listen.
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Thanks a lot for your advice. Today I went to another second opinion with an oncologist and he said baring in mind your stage 3, with a proliferation index above 70% and the Her2+ type cancer there is no doubt a mastectomy is the procedure to follow. If course, it’s a body part you I will leave without but there is always a reconstruction afterwards. Thank you once again 
Of course. And I’m so sorry. If it’s any consolation though I had a double mastectomy and later reconstruction and am perfectly satisfied. And I LOVE not having mammograms.
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