Why do ladies have to have mastectomies then chemo? I am having chemo for 6 months then surgery later,I have asked the surgeon to take out the tumour now but he can’t because it’s to aggressive. Why do these ladies have to have mastectomies first, i don’t understand how it works, surley every 1 would want the option to have chemo to shrink the tumour and have a lumpectomy rather than a mastectomy?


I wasnt offered chemo first, where I live seems to be the norm to have the lump removed first. I was offfered lumpectomy by one doc ont he condition might still need masectomy and the other told me if I were his family hed tell them to opt for masectomy right away reducing the chance of recurrence and due to my fear of surgery and mine was aggressive. but it does seem that more people on here are having chemo first, its all confusing and to be honest, i was deadly against masectony but in the end I wanted to do everything possible they told me to get rid of it! Mine was 3cms and grade 3 aggressive. Look forward to seeing what other comments come back and good luck.

I didn’t have a lump. I had lobular cancer which occurs in the lobules where the milk is produced. It was described to me as a collection of peas. Once all these “peas” and healthy surrounding tissue was removed then there woudn’t be much breast tissue left. I was told the only option would be to have a mastectomy followed by chemo. Not every breast cancer is alike and the surgeons have to decide how to deal with each case on an individual basis.

Like valentine i had invasive lobular cancer - just next to the nipple. Mine was grade 2 - about 24 mm for amin tumour and one lymph node. After an MRI the surgeon told me that the radiologist had said i was a candidate for WLE and i looked at him and went - hmmm the blown volcano look… not good. he said… but i have to say i would feel happier if you agreed to mastectomy… we would still need to check lymph nodes…

I opted for MX because i thought it woudl be easier to manage prosthesis wise. it’s been fine… my chemo and rads was described as mopping up stray cells.

My understanding is that they like to try to shrink larger tumours first and that younger women are more likely to be offered lumpectomy to conserve the breast… plus it depends on your type of cancer…

different treatmeents for different people… but i still don’t understand the criteria for sentinel node stuff!!


Some of us (like me) are young and have aggressive tumours. In my (and a few others) case the risk of another tumour developing later in life is so high that it’s better not to have any breast tissue left… so mastectomy. In some cases where the tumour is large and the breast is small it’s better to remove the whole breast and have reconstruction.

I wasn’t that bothered by having mastectomies actually. I don’t feel it’s done a huge amount of damage to my image and having already had 2 different breast cancers at the same time I am personally extremely relieved to have the risk of future recurrence drastically reduced.

I am 47 and was diagnosed with IDC (invasive ductal carcinoma) in February. The biopsy on one of the nodes showed positive. Surgeon said that because the cancer was aggressive they would treat with drugs (chemo) first and then do surgery. This would shrink the cancer and, as chemo is a whole body treatment, would help prevent any further spread.

Had chemo (3 x FEC and 3 x Taxotere) between March and July. Then had mastectomy and node dissection on 8 Aug. Histology showed that cancer had responded to the chemo but was still 8cm grade 3 with 5/19 nodes infected.

Although I had been hoping that a mastectomy wouldn’t be necessary (don’t we all?), I think that in my case this was the right decision.

Good luck with your treatment.

Spongebob x

I think that if the tumour is above a certain size you have to have chemo 1st to try and shrink it, then the surgery after. Mine was so tiny 7mm, that I just had WLE and because sentinal node was checked during surgery and no spread to lymph nodes, then didn’t need chemo and just had 5 weeks radiotherapy. Not all hospitals are able to do the Sentinal Node Biopsy & radioactive injection, so some people have to have lots of nodes removed sometimes for no reason if they turn out to be all clear.
I think the younger you are the more aggressive the treatment is - I’m 64 so they are more relaxed about it than if you are 34 or even 24 for example.

I am 58 and had a lump in my armpit rather than a lump in the breast. A biopsy on the lump showed it to be a lymph node containing bc cells. An MRI eventually showed 3 tiny tumours in the breast, two of which were invasive ductals, the third DCIS. The total size of the three tumours was just over 1cm. However they were spaced widely apart which was why I had a mastectomy rather than a WLE. All my nodes were removed but only the one was affected.

My surgery was followed with 4 x FEC and 4 X Taxotere, 15 rads and as my tumours were ER and PR and HER-2 Positive, I am now having Herceptin for one year and five years of Arimidex.

So, Shell, there are all different reasons for having mastectomy first!

Best wishes with your treatment.


Thank you all for your experiences and knowledge.
My tumour is 7cm & i now understand why the surgeon just didn’t whip it out.I hope the chemo works well for me so a lumpectomy could be preformed.

Good luck to you all,

Love shell


My mum had lobular, and her tumour was 4cm. If she had had surgery straight away it would have been a full mastectomy, but they put her on Letrozole instead and they managed to shrink it considerably and do only a partial mastectomy.