Mastectomy versus lumpectomy

Hello all,

I am new to this forum but i have read all the supportive messages that everyone is posting and decided to ask for some advice and hear your experiences. I was diagnosed with triple positive grade 2 breast cancer on 1st June 2018. I am 51 years old. I have had five cycles of neo-ajjuvant chemotherapy including Herceptin to shrink the tumour ( the invasive tumour had shrunk from 5cm to 1.5cm at the half way scan). Behind the invasive tumour there is a large area of DCIS. I am unsure if the chemo will shrink this or not. I am seeing the surgeon after my last chemo, so I have an appointment on 18th October. If I am offered both options, does anyone have any advice or would share their experience?

They think there is no lymph node involvement. If I have lumpectomy and radiation I know that it is meant to be as successful in terms of prognosis as mastectomy but I think a lumpectomy would leave the DCIS in the breast. Ideally I think I would like a total mastectomy with immediate reconstruction but the breast cancer nurses have said that’s unlikely in case I still need radiotherapy after the mastectomy. Also can anyone advise how long it takes to recover from either procedure? I really want to get back to work in January 2019 if I can!  It is such a dilemma, and it may well be that I won’t be offered the choice in the end, but it would be good to hear of other women’s experiences.

Thank you.

Hi Janie 123,

 

I understand your dilemma as I was in a similar place in May this year. A re imaging suggested that the tumour had disappeared but showed that tiny fragments had dispersed further. I was offered lymph node biopsy, tissue biopsy followed by radiotherapy or lymph node clearance and mastectomy. I am also on herceptin.

 

I decided on the mastectomy and the pathological report confirmed that I had made the right decision (for me) as within the tissue they identified a 8mm tumour which had not shown up on the follow up CT scan and 2 lymph nodes affected. In my case I had dense tissue which I think can make cancer harder to detect.

 

I was accessing counselling at the time and with the conversations I had this helped me make a decision. When offered the choice I made the decision there and then. 

 

I am now in the middle of radiotherapy which was offered due to the size of the initial tumour. 

 

I would say have those conversations, difficult conversations too, and you may become more decisive if you are offered a choice. 

 

In in terms of recovery we are all different and I would not like to comment. 

 

Wishing you you all the best during this difficult time. :slight_smile:

 

 

 

Hi Janie123

Sorry you find yourself on here, but a big welcome, you will find it a great source of information and support.

 

I wasn’t offered an option, but I’ll tell you about my story particularly regarding reconstruction in case it helps you.

I had an invasive lump plus DCIS and node involvement. I have small breasts so was told I had to have a mastectomy and node clearance. I had chemo first and radiotherapy after my mastectomy, and I had immediate recon at the time of my mastectomy. I have an implant that is in some sort of mesh sling (Braxon) and sits on top of the muscle. I was warned that the radiotherapy might cause hardening (capsular contracture) but it was a lower risk with this type of implant so I went ahead with the blessing of my surgeon and plastic surgeon.

Anxious Soul makes a good point about everyone being different in terms of recovery times, but the recovery time for my type of implant is about the same as for a regular mastectomy with no recon, I think I was driving again in about 3 weeks from my op.

 

Your team will give you the best possible advice for you, so go armed with a list of questions so you don’t forget anything. I’m very happy to answer any more questions either on here or in a private message if that helps at all.

 

Hugs and wishing you all the very best.

Evie xx

Hi Ladies,

Thank you for your replies so far. I am really overwhelmed about how supportive this forum is. I already feel so much happier, having had your replies, as though family and friends are supportive, it is not the same as communicating with ladies who can really empathise.

I have just returned from an appointment with the oncologist. He seems to feel that lumpectomy and radiation would be an option. The CT scan is booked for the day before the appointment with the surgeon so I expect that will inform their advice. 

 It has been, at times, a very difficult journey, but I have realised that it is important to plan ahead but also not to jump ahead too much as I might make a decision and find the treatment I have chosen isn’t even an option!

Many thanks again