So I have the choice of lumpectomy or mastectomy, which ever I pick I have to have chemo and radiotherapy afterwards. I just don’t know which to choose. Lumpectomy seems easier and less recovery but I worry about clear margins and having to go back for a shave. Mastectomy is drastic but no problem over margin. I have stage 1 grade 3 2.5cm invasive bc triple negative, need gene testing. Any thoughts??
Hi Raitchr
It is such a difficult decision for you to make so I hope you have a little time to weigh up the pro and cons. I was diagnosed with Invasive Ductal Cancer - at the time of biopsy a 9mm lump. With no preamble the consultant surgeon, after giving me the diagnosis, said “We can treat this one of two ways, either a mastectomy or a lumpectomy”. I’m afraid I never even asked him which he recommended, as the lump was so small a mastectomy seemed a bit OTT, so without a thought or any research I said. “Maybe in a few years if necessary I’ll need a mastectomy but at this stage I’ll go for the lumpectomy”. He seemed sort of _pleased _and said that the outcome would be “promising” or some such word. I have since had the lumpectomy and Sentinel lymph node removed and margins were clear and the lymph node not affected, so was glad i went with my intial thought, though the lump turned out to be 1.4 cm after surgery.
I think the size, grade and stage of our tumours might be a factor in making the decision. I am ER+, though I didn’t know that until after the surgery when they biopsied the removed lump. I asked my oncologist at an appointment between surgery and rads and I said that I had been really surprised at being offered the choice of a mastectomy and he said they do offer that, because some ladies want the whole thing over and done with and feel more secure having a mastectomy.
So I wonder if it would be worth asking the consultant for some truthful pros and cons about which to choose? The fact that you have been given a choice does sound as though it may not be _essential _to have a mastectomy…but only you can decide on the basis of evidence (unlike me who just went with my first thought, which I do not regret however) These appointments don’t give us much thinking time do they? Sorry for the long post but this is SO important isn’t it? Good luck with whichever way you decide to go. X
PS: RE your concern about possibly having to go back in for a “shave”. Not everyone has to have this though some do of course. For me, on the day of my surgery I said to the surgeon: “Look, I’m too old to be concerned about a dent in my boob, and i don’t want to be back here in a couple of weeks for you to take more out, so can you make sure you get a good portion out and if in doubt take a bit more than you think you need!” He smiled (as in humouring me), but he DID get clear margins and a bonus is I don’t have a dent - I think the other tissue sort of budges up to fill the gap.I’ve got small boobs anyway.
Thanks for your reply.Yes I am afraid of the margin with lumpectomy and would hope they get a clear one first time. I just don’t want to waste time before chemo going for another op. I never thought I would say it but I am desperate for chemo to start so it can sort out any rogue stray cells on the loose. Mri and ultrasound showed clear nodes but I have triple neg invasive so I need it to be gone first time. An mx would not need clear margin so I was told today. I did ask consultant if it was his wife, mother or daughter what would he recommend and he said lumpectomy.
PS . I too have small boobs!!
Hello, my situation is a little different, if I have a lumpectomy one breast will look significantly different to the other, my surgeon is not confident that there will be enough breast tissue to correct it. Plus not enough fat on my stomach/back to help reconstruct (I seem to have the build of a child!) So I have opted for a mastectomy with immediate reconstruction, there is only a small chance afterwards of needing radiotherapy. They are doing gene testing on me too (I’m 37 with no family history of it, but I had previously had an inconclusive mass removed in the same area 2 years ago) Its such a hard decision really if you have options x
Hi, I have gone back to my original decision of mastectomy, op is booked for 29March. Worried too much over clear margins with lumpx. If I had lumpx then right boob would be A cup and left boob would be C cup. I don’t want to have regrets as need chemo and rads. Boob goes then less tissue. Good luck with your op.
Hi just come home today. Surgery was fine but had anaphylactic reaction to blue dye for sentinel node biopsy so had to stay overnight. No drain or dressing on wound, supposed to heal quicker this way. Taking paracetamol every 4 hours and have been given a bottle of morphine in case I need extra but so far so good on paracetamol.