Mastectomy planned, should I ask for a re-think

Hi, I’m new here, just found out today that I have BC, three lumps, one 3 cm. I have small breasts (so feel that this is even more of a raw deal!!) and the surgeon didn’t say that was the reason, but more because they don’t know how far the biggest lump goes back. I didn’t know about shrinking through chemo or other treatment. I have surgery booked for 24 April, should I contact the hospital to see if they can re-think. The surgeon won’t do reconstruction until they know what other treatment (if any) is needed. I’ve had mammogram, scan, biopsies on the lumps and fine needle in the lymph glands(?), and they can’t tell whether it has spread or how bad it is. Have a 3 1/2 year old daughter and I’m 44, so at moment feel like world turned upside down. Any help would be great, having looked at mastectomies on google images now very worried I might be butchered, and they might be a bit too keen to go for a more straightforward option rather than give something else a go.

Hi Aliceblue,

Although the surgeon didn’t say your breast size was in issue, it does make a difference. I am only a AA cup, and my surgeon was very straight forward about it, and said that mastectomy was the only option for me. I think this may well be the case for an A cup too? Also as you have three lumps, by the time the surgeon has removed all three, plus margins (they like to get a clear 1cm margin around each lump)there would probably be very little breast tissue left.

I am sorry, I know this is all such a huge shock. I was dx two years ago, also 44 at the time. I was not allowed an immediate reconstruction either so now my decision is whether to go for a reconstruction or not. This is something that I wish I had known more about at the time, as I am not convinced that it was impossible. My understanding now is that an autologous LD flap reconstruction (one using the muscle from the back, and your own fat rather than an implant)tolerates radiotherapy well and so is OK for an immediate recon. So I don’t understand why this option was not presented to me. I see my surgeon next month, and will ask him then.

Hello Aliceblue

I was diagnosed last June and had to have a mastectomy as I had two lumps, one the size of a pea and the other the size of a broad bean. I did not have reconstruction at the time of surgery as I decided it was more important to crack on with my treatment, I have chemo and radiotherapy. I only have/had small breasts, and guess what??? I am now fully on the road to recovery, I have my reconstruction in Aug and he is going to give me a new bigger pair of boobs!!! bonus. I look at it as my reward after a very crap year. Oh by the way I am 42 with three sons. I am an air hostess and start my flying again in may. If you want to talk to me anytime about anything then I would love to help you

Julie

Could you ask for a second opinion? There are lots of different types of mastectomies these days. I had a newish type that was skin-saving and nipple-sparing. I had an implant put in straight away but it didn’t use any back muscle. Before the operation I also had an MRI scan to see the size of the tumour because it’s more accurate than a mammogram or ultrasound. It was 3cm and I had a question area over another bit, but that turned out to be a fibroid.

The surgeon who was going to do the operation fell ill, and in his absence another surgeon took over my case. His approach was very different - he wanted me to have a radical mastectomy with reconstruction later (and with the certain loss of my nipple).

Luckily, my original surgeon recovered soon after and did my operation. It was rather eye-opening to realise how much surgeons differ in their approach. I was a DD beforehand and the same now.

I know that for smaller-breasted women, the Royal Free in Hampstead has started doing a mastectomy-plus-implant that leaves no visible scar. The surgeon’s name is Mr Keshgar and women I know who have been treated by him really like and trust him.

I hope things go well. At the time my operation was the worst thing that had ever happened to me but a year on and I’m fine.

I am a DD cup and had two very tiny tumours and a small area of DCIS in one breast. The surgeon told me that my only option was a Mx because lumpectomies in 3 separate areas would leave my breast looking very deformed.

I was told I could have a recon once my treatment was over. But two years down the line, I really don’t think I can face a long operation.

xxx

the Japanese are experts in doing ops for small breasted women as japanese women tend to be small breasted. At least that was what the last surgeon I spoke to said when I went to see if I could improve the look of my segmental mastectomy (a quarter or so removed).

It’s a shame that they can’t do more. If you end up misshapen it is probably better to go down the reconstruction route in my view but there are other issues such as having no feeling in the reconstructed side.

I am afraid we are in the hands of surgeons so it’s best to find a specialist in the kind of surgery you think is best for you, and maybe someone who has done more ops on small breasted women would be best.

Hi, thanks for the posts. I had mastectomy and clearance on 24 April, and it was probably the only option in the end. They found more lumps and other stuff going on in between. Also as it has spread to all the lymphs I’m not sure whether there would have been much of an option to do anything else. My surgeon has done a good job considering, it is a really neat scar, not half as bad as the google images. There is a bit of swelling that goes up and down depending on what I end up doing during the day, but when it is all healed up I’m sure it will be fine. My surgeon was also right not to do reconstruction immediately as in addition to chemo I’ll need radiotherapy too. Still I think it is always right to question what they are proposing, as it is your body after all!! Love Alice xxx