Mastectomy V Lumpectomy question

Hi Ladies
I have a question and bound to be lots of opinions but here goes. I have had 2 WLE (lumpectomy) and still no clear margins. I have now started chemo and will be operated on again after chemo finishes… My dilemma is do I have another lumpectomy - can I have one after chemo ? Or should I have a mastectomy ? If I have a MX is it more definate the cancer will not come back … What I’m asking are there any people who have had MX and cancer returned … I’m just worried cancer will come back if I have another WLE … Thanks in advance … I want to hear from real people going through this otherwise the surgeon says evidence has shown …

it is a hard one to advise on as it is so personal.   I am aware that the stats say that as long as the cancer is cut away and clear margins then WLE and MX have the same recovery/reoccurance rate so its not simple or straightforward and a lot depends on the stage and type and aggression of cancer too  and the size of your breasts. - so there is no easy answer.   My initial gut feeling was to go for WLE as i wanted to preserve my breast and nipple - that was against my surgeons advice who wanted to go for Mx straightaway.   Anyhow the inevitable happened and no clear margins so the second time round I went for Mx -  He got clear margins but my tumour was 9cm I then went on to have chemo.    You are having chemo first to shrink the tumour so your tumour will be much reduced and another WLE is possible and you will keep a reasonable body shape.  At the time your thoughts are probably on the cancer and get it out of your body but you do also need to think about the future and what your breast will look like and will it be deformed?  The questions you need to ask yourself is will you be content with a WLE or will your be questioning yourself thinking that you should have had a Mx for peace of mind?   The other question is about body image - how important is it to you?   If you go for a Mx you can have a reconstruction but with a WLE this is not the case so again what will your breast look like after 3 WLE’s.  I had a delayed diep and am so happy with my new breast - it was 18 months later but well worth the wait.   Good luck to you and hope you get lots of responses to help you on this xxx

Hi Crocolily. I really feel for you, because I too have been in turmoil over whether I should’ve had a mastectomy. My own personal demons have led me to being placed on an elective waiting list for a double mastectomy with immediate DIEP reconstruction. When I was first diagnosed, I requested a double mastectomy but was told that I would have to wait up to two months for my op. I just wanted the lump gone, so I went with their recommendation of WLE and had to have a second op to achieve clear margins. I went on to have chemo and rads and was fine going through treatment, but at the end of it I fell apart. After discussion with my BCN nurse and surgeon, we decided that its best I have the mastectomy to allow me to move on. I’m not saying that you’ll feel the same, and my team have stressed that the mastectomy has the same chances of secondaries appearing as the treatment I have already undergone. But my surgeon did say that local recurrence is slashed to 2% from the 13% I was quoted when I had my WLE. My team also made the valid point that there’s no point in treating your body if your mind remains in a state where you can’t move on.
You can def have a mastectomy after chemo, so there’s no worries on that front. Whatever your decision, I wish all the best through your treatment. Ann x x

Hi Crocolily, sorry to hear of your dilemma, it’s a difficult one to decide, I was diagnosed with DCIS and told lumpectomy or mx would be necessary but in the end further tests proved that the amount of DCIS and position meant it had to be mx. I have to say that a large part of me was relieved that that decision was made for me because I’m not sure how well I would have coped with WLE from the point of view of fear of recurrence,even though it seems there is probably no evidence for this fear. Because of the nature of my cancer and the fact that they were fairly sure I wouldn’t need further treatment, I opted for immediate reconstruction. The surgeon has made an excellent job and the fake one looks good and in a bra matches well. (Obviously the natural one droops in comparison but I can live with that!) it was reassuring to wake up after op and still have a breast there. I am now 10 wks post op and recovered well but there is still some pain and fullness in the recon boob which I think will continue for some time, judging by the experience of others on here. Good luck with your decision. X

Hi everyone and thank you all for your thoughts and comments. Do you mind me asking if you are NHS or private … Not that it makes a difference with the level of expertise the surgeons use but I do think you have more choice on your treatment when you are private. From the beginning of this journey I wasn’t given a choice of a MX even though I vocally said I wanted one. I still think at the end of my treatment they will give me a WLE even though I would I think rather a MX. In my head I think I feel I have less chance of the cancer coming back even though they keep telling me it’s the same in evidence that it won’t ! Anne I’m glad they listened to you and you had a say in your treatment. Does anyone know if I am allowed to choose a MX as they give me the impression on my meetings it’s not up to me. I don’t want to sound negative about the NHS I really don’t as they have treated me quickly etc but I just want a choice in my treatment plan.

Hi Cocolily,

I’m sorry you are faced with these worries about your treatment.

Why not call the Helpline at BCC to talk your dilemma through? I’m picking up you would prefer a mastectomy? One of the very first things I asked was whether a mastectomy would increase my risk of survival. I was advised that there was clear evidence that a WLE and rads was just as effective as a mastectomy. Not all women are lucky to be in this position.

In the end, I did have to have a mastectomy and live with long term pain as a consequence. I’m just throwing my experience in as something for you to consider. Right now you are inevitably very worried by your recent cancer diagnosis - it’s a scarey time. But you will get through this.

Good luck with your next steps, Rattles x

Hi Kiki
Do call to talk this through, lines are open 9-5 weekdays and 10-2 Saturdays on 0808 800 6000

Take care
Lucy BCC

I was with the NHS. I used the breastcancer care helpline and found them to be fantastic help. Wishing you all the best x x

Hi Cocolily - I have sent you a private message x

Hi … I’m in bed on my phone so can’t access pm. Tomorrow I will look from the computer downstairs x

Thank you everyone for your experiences and comments. I am starting 2nd chemo next week. I am booked to see the surgeon between chemo 5 and 6 to discuss operation.
Next week I see my oncologist just before chemo and will bring it up then again as I know they have weekly meetings with surgeon re all patients. I am going to try to be more assertive in my meetings as I always gets upset. I have never been given the choice of a MX and I have asked for one. Just feel after 2 failed WLE that I should have a choice. Thank you all again and it is really helpful to me to read all your stories xx