Lumpectomy vs Mastectomy
Lumpectomy vs Mastectomy I have been recently diagnosed with breast cancer and have been told that I can choose between having a wide local excision followed by radiotherapy, or a Mastectomy. I go in for the op on Tuesday but I am having problems deciding which is the best choice for me. The advice from websites, leaflets, doctors and breast care nurses all says that either op will give the same chance of a ‘cure’ for my situation. My only personal experience of breast cancer ‘survivors’ are those who have had mastectomys. I would love to hear of a positive experience following a lumpectomy operation. Is there is anyone willing to share their experience with me?
Hi Diane,
I had a WLE last July which would then by followed by rads. As clearance wasn’t achieved I had anothe WLE in September. The path report from the first WLE showed 2 out of 14 lymphs, so I the knew I would have to go down the chemo route. The path report from the 2nd WLE showed another unrelated tumour which did not show on any mammogram or scan. It was then decfded to go down the mammogram route as I would have to have a 3rd op anyway. The path report from this revealed another 4 small tumours, also not visibale on any scan or mammogram, so obviously the breast was prone to tumour.
While it was not special having 3 ops I understood why it happened as they were trying to save my breast and the info they had at the time indicated they could do that. It is only when the path lab reports come in that they really know what is going on.
I am afraid while you are on this journey you have to take one day at a time. I am 55 years old so as I don’t do topless, I drcided not to have a reconstruction, as I felt my body had been through enough ops.
Everyone is different and you must decide on what you will be happy with. Talk to your bcn if you want more info.
Whatever you decide, you will be given exercises to do, and please do them they really help. Also listen to your body and rest when it tells you to.
Take care & best wishes
Jan
WLE Hi -
I had a WLE my tumour was just over 2cm and I am an ‘E’ cup so as my surgeon said they had a bit to play with!
It went really well - a smashing radiologist marked me up using ultrasound the day before (my tumour did not show on a mammogram). The whole lot came out with good margins. My lymph nodes had 50% chance of being affected so I elected to have them removed as well (the right decision as it turned out).
I was keen to have a masectomy as I didn’t want more surgery and really just wanted to get shot of the tumour. My surgeon talked it through with me apparently she has an 80% success rate of clearing the tumour in one go. I decided to trust her judgement and take a chance. She did a brilliant job fortunately the tumour was in my bigger breast so I look pretty even. She also squidged things around a bit so there is not too big a dent.
I really think you have to follow your heart and do what feels right for you.
Good luck what ever your choice hope this helps
Swanie
Hi Diane
I’m a WLE ‘survivor’, although I only had mine at the end of January.
Like you, I was unsure which route to take and found the following questions helped me reach a decision.
Would you plan to have reconstruction following mastectomy? If so you may want to meet up with a plastic surgeon to discuss your options. I am slim so would have needed an implant which needs replacing every 10 to 15 years.
What size and shape are your breasts? It you are large, or your breasts have some sag, you will normally have to have some surgery on the other side to even things out.
Where is the lump and does your surgeon think he can remove it with good cosmetic results? Mine was on the underside of my breast, so any dimpling is easily hidden.
How do your feel about your breast? Would it bother you to lose sensation? Even with a ‘natural’ reconstruction using your own tissue there may be some loss of sensation and you will lose your nipple.
I opted for the WLE and was delighted with the results. However, over time, I developed a lot of scar tissue which has cause the breast to shrink. Radiotherapy has made this more pronounced and now one breast is noticeably smaller than the other. It may settle given time.
Long-term survival is the same with either procedure but local recurrence rates are slightly higher with WLE as you still have breast tissue. The cancer can still come back following mastectomy and tends to happen in the chest wall.
Hope that hekps. Good luck with your decision.
Lola x
Hi Diane,
I had a WLE at the beginning of January and blue dye node sampling. I had a further op as a day patient 3 weeks later to scrape away a little more tissue. Luckily there was no spread to my nodes. Now I have just a small scar under my armpit and the surgeon did a really good job of my breast as the scar is barely noticeable just under the nipple. And that breast doesn’t sag as much as the other one! The only way you can tell is that nipple tends to point down a little. The consultant (and all he specialises in is breast surgery) said chances would be the same whatever. I am only small but actually wore a bikini again the other day. My follow up treatment was 5 weeks radiotherapy and 5 years tamoxifen. Underwired bras are still a little uncomfy round the side going under my armpit but I can still wear all my tops and dresses from last year even if quite low. Hope this helps and that you feel you have made the right decision.
Shorty2
Hello Diane
I had my surgery fairly recently also - the week before Christmas. I had a 12mm tumour in the underside of my right breast. The surgeon did a very good wide local excision - he took the tumour plus some clear tissue and got clear margins the first time. I also had full axillary node clearance at the same time.
I’ve had chemo and am having radiotherapy at the moment. My breast looks very good. At the moment it is slightly swollen - partly because I have slight lymphoedema of the breast and also as a result of the radiotherapy so it is a bit bigger than my other breast, but I understand that it may shrink later. However I still look good in a bikini and have bought some new ones for my holidays later this summer.
Best of luck with your decision and your surgery.
Anthi
Thanks to everyone who has replied and sent their good wishes. I think I will choose to have the lumpectomy on Tuesday and feel much happier about making this decision now.
Thanks again.
Diane
Good move! I’m glad you made your decision, Diane.
I think it’s important to get as much info as you can, chose the option that feels most comfortable and then be at peace with it. Although my results haven’t been perfect I still feel I made the right decision.
Good luck with your surgery.
Love
Lola x
Encouragement for you Diane Good Luck Diane and just to give you some encouragement I had a WLE (6 mm tumour) and 9 nodes removed (all negative) 17 years ago. My shoulder was rather painful for a few weeks but I recovered full range and was back in the gym and doing yoga pretty soon. I had rads which I tolerated very well and then took Tamoxifen for 3.5 years. I was unlucky in that I had really bad side effects - hot flushes - and stopped but I was at menopausal age which I am sure exacerbated the reaction. My scar was quite acceptable and I was not worried about sunbathing topless. There is good quality of life after breast cancer and I know that I, personally, changed my attitude and priorities.
Let us know how it goes and don’t hesitate to ask any questions however trivial you may think they are.
I was given same advice as you. I went for the mastectomy and have no regrets other than the scar seems very high up, but I hadn’t asked where it would be before, didn’t think to. I am hoping to have a reconstrution next year and know this scar will show if I wear lower cut tops.
Just wanted to remind you to ask where your scar would be if you go for a mastectomy. Good luck.
Irene