What should I do ?

Hi there
I was diagnosed with with breast cancer 2 days ago (May 13th) im 39 it’s about 1cm, there was also a cyst that has been tested and the results will be back on Monday. In the meeting with the surgeon he gave me a choice of wide local incision or a full mastectomy. I wasn’t expecting this as I thought the choice would be made for me. I am booked in for the op on June 4th (surgeon on hols until then) and need to make a decision before then. I was only taking the essentials in when he was explaining to me, but he did explain that this risk of it coming back was less with the mastectomy. I know that they plan on removing some nodes, am I better to have the incision and see the outcome before deciding on a mastectomy. Any advice would be great.

Hi Anndi

Firstly can I welcome you the the forums, Breast Cancer Care have published a Resource Pack, it has been designed for anyone newly diagnosed with information to help you better understand your diagnosis, test results and various treatments, it is available via the following link or by contacting the helpline: breastcancercare.org.uk//content.php?page_id=7514 You may find our helpline useful to call to talk through the concerns you have about surgery and treatment options, they can talk to you about our other support services too and also offer support, information and a ‘listening ear’. The number to call is 0808 800 6000 Monday - Friday, 9am - 5pm, Saturday, 9am - 2pm. I hope you find this helpful.

Best wishes
Katie

Hello…
Sorry you’ve had to join us :frowning:
I’m Lauren, 25yrs 2 kiddies 3 & 11 months and was dx 3 weeks ago. Since then i’ve had a mastectomy, am home and very well now and start chemo on tuesday…My lump was 7cms in total as i had some abnormal cells around the actual cancer and 9 of 14 lymph nodes removed were infected.
There’s so much to take in at this stage, i wasn’t given an option which to me was best…
When i heard ‘mastectomy’ i just cried and cried…Now, i look back and realise it isn’t anywhere near as bad as i expected… In fact i’ve even asked if i can have the other breast off too if it lessons the chance of returning…The reconstruction that they do is AMAZING, and to me the present i deserve once treatment finished…Wearing a great bra & prothesis and no-one would ever know i only have one boobie!
No-one but you can make this decision, i personally would want the whole thing off in the circumstances as a) i’d feel safer knowing that it’s all gone… and b) i wouldn’t want to risk the chances of having to go back again and have more removed if needed…
Have they given you the option of a reconstruction?
Lots of Love to you at this very very difficult time… Try and stay positive as it really does help (hard i know)…The cancer has been found, it’ll be treated in the best way for you and you’ll recover in time.
Lauren.x.

The risks after mastectomy and breast conservation surgery are about the same for any lumps under 2 cm which yours is.

Surgeons sometimes influence people to have whatever operation is their favourite. The best bet is to go to a breast cancer centre of excellence where there are likely to be more options.

Personally I would never have opted for mastectomy unless absolutely clear that there was clear evidence from research (randomised controlled trials) that it was better for me., I think mastectomy is mutilating surgery

Mole

Hi Anndi
I was diagnosed on the 23rd of april with invasive ductal cancer , 1cm grade 2 er positive.and was offerd the choise of a lumpectomy or mastectomy. after agonising over which dicision to make i finaly decided on the lumpectomy being the lesser of the two opps especially as the incidence of reacurrence is not a great deal higher with the lumpectomy. but untill you get your final results after the opp nothing is certain anyway.I am having my opp on monday and am still not sure i have made the right decision (which doesnt help you much) but you are the only one which can make the decision. on this site you will find lots of women with experience of both procedures, read the posts and ask as many questions as you can think off, you will find so much support on here. I learnt much more on here that at the hospital or the breast care nurse.I will be thinking of you.
Tina

dear Anndi

I am with Mole on this one, the research I have come across is pretty clear that for small lumps it makes no difference. To put it bluntly, if it has already spread to other parts of the body, removing the breast makes no difference - sorting the stray cells out is the job of the chemo. The masectomy is to deal with local spread in the breast. If they do a wide local incision and find evidence there may be local spread (they test the ‘margins’ of the piece they remove) they can always do a masectomy after. SO the worst case scenario is that you end up with two operations.

I had a 19mm lump so was borderline, but opted for the WLE, and luckily had clear margins. It had in fact spread down the lymphatic system as it was found in 2 lymph nodes but I am still here 4 years on. I don’t think a masectomy would have made any difference at all.

Sarah

Hiya
I had a masectomy after agonising over my options - I was told masectomy cos 3cms but then offered me the option of the lump, in the end opted for the masectomy as the thought of them not getting the margins and having to go back in was the deal breaker for me as terrified of Ops. Your lump is much smaller so sorry but its a total personal choice.

Thinking of you
xx

p.s. after all my fears the Op wanst as bad as the build up to it!!

I’m with Mole on this one. A mastectomy is mutilating. I wasn’t given the choice as I’m only a AA cup and my lump was 2.7cm so there would have been nothing left anyway after allowing for the margins they take. But I hate it and would have had a lumpectomy if possible. I wasn’t allowed an immediate reconstruction so now have to decide if I want to put myself through further surgery for this.

If I had been able to have an immediate reconstruction, then mastectomy would have been OK. For me it is a problem as I swim regularly, the session I go to there are always other people in the cubicles when I arrive so I have to change in the communal area, which is manageable but I’d rather some privacy. Also I’m tall & get my clothes from Long Tall Sally who of course don’t do mastectomy swimsuits. So I’ve had to sew in a pocket, and it’s not really very satisfactory.

I really don’t understand this culture of us choosing our preferred treatment. To me the choice would be not to have to make a choice, how are we supposed to know if its the right one. If you go for the lumpectomy you may be left worrying about spread, if you go for the mastectomy you could be left regretting such a drastic course. The docs are supposed to be the experts, I’d never read a word about breast or any other type of cancer until the day of my DX. For me it was always a lumpectomy, mastectomy was never mentioned and I have to say I never asked, maybe cos I was in too much shock and wouldn’t have known what to ask.

Chemo on the other hand was apparantly going to be my choice, I had no idea what to do. I promised my family right from the start that I would do whatever was necessary to cure myself of this disease, I would listen to the docs and do as I was told all the way but you cant help thinking is this overkill, what if other people need more treatment than me to save their lives and I’m taking up beds, drugs and time. It was a right rollercoaster ride but in the end, after what I felt was a ridiculousy long 6 weeks from surgery with very little information at all my onc said that as the tumour was grade 3 I was having the chemo “to cure me once and for all of this thing”. I was so relieved that he did this and took the burden off me. He then booked it to start the following week giving me a whole 6 days to come to terms with it all.

Maybe some people like to be in control of their treatment more than others which is fair enough but for those of us who really don’t have a clue what to do for the best I think those with the knowledge should take the lead maybe abit more than they do, after all we are all different and should be treated as individuals.

AJxxx

I opted for mastectomy … and I dont regret it one bit this was last october had recon Jan and getting a nipple in July my surgeons were amazing and honestly you think about it spreading whatever you choose at the end of the day the choice is yours
Hope you decide soon xxxxxxxxxxxxxxxxx

I was initially only offered a WLE as my lump was so small (12mm) and no lymph involvement and nothing else showed up on the MRI scan beforehand. However, once the histology was back, it showed extensive LCIS (lobular carcinoma in situ) and my consultant said we’d be mad to leave it in. Therefore, I had a mastectomy with immediate DIEP reconstruction - no further treatment aside from tamoxifen due to no lymph involvement.

I think what I’m trying to say is nothing is certain until they get the pathology back. Of course, nothing is certain full stop with BC.

Hope you make the right decision for you - basically, I wasn’t asked to decide and just did as I was told, except for chemo which I refused as it would only add 3% to my 10 year survival rate and as I didn’t have lymph node involvement, didn’t feel it was for me. I’m keeping it in reserve.

Sorry if I’ve gone on a bit!

Sally xx

Anndi,

I had WLE/SNB in April.My lump was 26mm.There was another girl in the ward who had a smaller lump and had a mastectomy.She says that she had no choice as she had very small boobs and a lumpectomy would effectively have been just the same as a mastectomy. Perhaps it would help if you discussed your own individual circumstances with your Breast Cancer Nurse so that you feel a little more informed.

Good Luck whatever you decide!
Tricia
xxx

I wrote my comment this morning before I went to work and really wasn’t expecting that much response. Thank you all so much. It’s such a lonely and frightening time, and knowing that there are lots of you out there who know how I feel really helps. I think i’m going to go for the lumpectomy and hope that it hasn’t spread any further. I feel really positive today I think it’s the sunshine!.

Keep smiling ladies

Ann

xxx

Hi Ann

I had a WLE and 2 Lymphs nodes removed in Jan 2007 my lump was just under 2cm and grade 1, i was really lucky i found it in time. I also have small boobs 34B and told i was lucky cause if they were bigger i would have had been offered a mastectomy. You make the decision that is right for you!!! I am here happy and healthy and im so thankful. Good luck in your decision. Take Care.

Allison x

You need to factor in radiotherapy if you have lumpectomy - I didn’t like it but it definitely ups your chances of survival and also reduces the chance of recurrence. I had 15 sessions but some consultants opt for more. It depends on your hospital policy and to some extent the size and shape of your breast.

Mole.

I’m a 34B so quite small. I’m sure the surgeon mentioned radiotherapy but didn’t go into it too as he wanted to do the surgery first and see what the outcome was. What is radiotherapy like? how often do you have it and what are the side effects? After a lumpectomy and removing a few nodes to test how long will I be off work? When will I be able to drive? I need to plan how to tackle the next couple of months.

My husband told one friend for me yesterday ( lots of crying ) and we are going to tell my inlaws on Sat when they get back off holiday. I will tell my boys age 9 and 11 on Sunday and will try not to frighten them. I am more worried about other peoples reactions when I tell them, my friend was so upset and there are quite a few others to let know. I want them to know that it’s not that bad. I must admit that before I started reading the posts on this site I didn’t understand how individual each case was and how different each outcome could be. Hopefully they won’t all think it’s the end of the world, and i’m going to pop my clogs!

Love

Ann

Glad to see you are feeling more positive … we all fall down the big black hole at the begining but we all manage to claw our way out again good luck
Maz xxxx

Hi Ann

I have just finished radiotherapy for a lumpectomy. I only had 13 and to be honest, it isn’t that bad, however it would depend on how many you would need which can vary. But others on here who have had more radiotherapy than me still say it isn’t too bad. Main short term effects are reddened, tender skin and tiredness - again this seems to vary from individual to individual. Like Mole said, if you are not 100% happy with your surgeons recommendations, ask for a second opinion. None of the doctors mind and I am sure they would rather you went into surgery happy with your decision than undecided.

I also agree with AJ that we are left to make a choice when we know sod all about cancer treatment. OK, we can ask on here and look up information which can again vary in quality, but how do we know what is best? It is because the culture is now to ensure that patients have all the information to make an informed choice and therefore have informed consent. This boils down to a lot of the litigation that has arisen recently where patients say “you didn’t tell me that” and sue. It has backfired on most of us who are left in the dark and have the added stress of trying to decide. I am in healthcare and I too have to give my patients options. I tend to stick my neck out and say “if you were my sister, I would recommend this etc” totally unethical and one day my maverick approach will come back to bite me hard on the bum, but I feel so sorry for people having to make up their minds with so little to go on. And like Tricia said, your doctor may prefer mastectomy because of some reason individual to you. Start off asking your breast care nurse to explain your situation thoroughly and then take it from there. She will help you arrange a second opinion too.

Hi Andi

The following links will take you to our factsheet about radiotherapy and another called ‘Your operation and recovery’ which may answer some of your queries about these treatments:

breastcancercare.org.uk/docs/radiotherapy_mar_06_0.pdf
breastcancercare.org.uk/docs/your_op_and_recovery_07_web_0.pdf

Best wishes
Lucy

Hi Anndi,

I’m also 39, have kids aged 4 and 2. Was diagnosed on 30th April and had lump and nodes removed on 7th May, get results on 20th May. My surgeon didn’t mention mastectomy at all, but I told him to take it all off if it looked bad once they’d opened me up (but it’s probably not easy to tell just by looking at it!!). It must also depend on where your lump is.

There are lots of decisions to make, and we have to decide quickly it seems. There’s a whole new vocabulary to learn as well.

It is hard telling people. In a lot of ways you have to handle it for them as well as for yourself. Many people I’ve told cried, but I haven’t when telling people, just recounted my story in a matter of fact way. Some people do look at you dfferently and don’t know what to say. I have been overwhelmed by the number of bouquets of flowers that I have received.

I live a long way from my parents and didn’t want them to come here as their worried faces would have added to my distress.

After I was diagnosed, I had 3 working days to sort a lot out, get in help for my team etc, and it really isn’t easy as you have no idea how long you’ll be off for/when you can drive etc.

I’m sure that we all find comfort in coming on here, I know I do even if it’s just reading other people’s posts.

Best of luck with whatever you decide, and at least we’re off work in the sunshine!

Kinden
x