I had the same choice as you when I was diagnosed and went for the WLE with reconstruction with skin from my back in a second op. The surgery went really well and I had a really good result. I had a mental block over the whole mastectomy thing and wanted to keep my nipple (odd what you get hung up on)
The only regret I have about the whole thing now is that I have a BRCA1 mutation, so in hindsight for me a mastectomy might have been better.
My surgeon said the same as Anthi said, that a lumpectomy with radiotherapy has the same recurrence risk as mastectomy.
It is not an easy decision, but your surgeon wouldn't recommend something he thought wasn't right for you. However it is your decision at the end of the day.
Clinical trials have shown that lumpectomy followed by radiotherapy and mastectomy have the same outcome - with regard to recurrence and survival - i.e. neither of them gives you a better chance than the other.
As others here have said, if your surgeon has recommended a lumpectomy then he must believe it will be enough. The tissue he removes will be sent to the lab and the margins measured very carefully to make sure that he has taken enough.
I had a WLE 5 years ago and thankfully the surgeon got clear margins the first time. I've never had any regrets about not having a mastectomy.
Good luck with your decision. Anthi x
I started with a lumpectomy but didnt get clear margins, this I believe from others on here is not unusual. Therefore I was told I would need another lumpectomy or I could go for mastectomy, I took the second option. It turned out that there were no cancer cells in the breast tissue when examined so therefore a second lumpectomy would have been enough. But as I wait for my 1 year check (march 22nd) just knowing that I have no breast tissue at all on the affected side makes my waiting just a little bit easier...
Basically I would say that you have to consider how important your breasts are to you, mine were small to start with and I dont miss it that much! Consider your age and circumstances, your desires and support. Phone the helpline or your BCN they will help you think it through.
Good luck x
Just to reiterate what the others have said, your specialist will do what he/she feels is right for the disease, not purely for cosmetic reasons.
I was told originally that I would need a mastectomy, no doubt because my lump was big (4.5cm) and right in the middle. I had chemo to shrink it and by the time I had finished it had completely disappeared and was only scar tissue. I ended up have a WLE and then radiotherapy to completely zap the whole area.
Like angelfalls says, the main thing is to get clear margins and if they can do that with a lumpectomy there is no benefit to a full mastectomy.
It makes no difference re recurrence - sadly that is the luck of the draw so to speak.
Good luck with it.
I would say you have to trust your specialist, who clearly feels that this can be successfully treated with a lumpectomy. The lump will be removed along with additional tissue, so that they get clean margins, then the area will be treated with radiotherapy to ensure any stray cancer cells are zapped.
In answer to your question "will it come back?", the sad truth is that there are no absolute guarantees, either with a lumpectomy or a mastectomy. But if the specialist thought there was a high risk of this, s/he would be advising a mastectomy. For example, when I was first diagnosed by ultrasound and biopsy, I was told I would have a lumpectomy, but when the results of the mammo came back, I was told that I had no choice but to go for the mastectomy. The specialist wants the best result and best outcome and deals with this on a daily basis, so we just have to trust them.
Hope this helps, Angelfalls xx