lumpectomy or mastectomy

Hello ladies,

I am half way through chemo and saw the surgeon last weeek. He said that my tumor is shrinking nicely and that I will have a lumpectomy and full node clearance (the lymph node tumor is bigger than the breast one) in April. I’ve read alot on here about this being the second time round for a lot of people and they all appear to have had lumpectomys, my thinking is to make sure it doesn’t come back can I not just ask for a mastectomy or am I just being mad!.

I have dealt with this absolutely fine from day one but its the thought of it coming back (not the fact that I have it now) that is filling me with dread!

Any thoughts greatly appreciated.

Sara

Hi Sara

I am one of those ladies who had a lumpectomy (1997) and then a recurrence so had a mastectomy last November and am about to start a course of chemo. That is a good question though that you ask. Most of the doctors and bc nurses I have spoken to have said that it is real bad luck it came back - I don’t think its the norm but I can see your point.

I’m sure someone with more info will reply to you.

I’ll look forward to seeing what other people think.

Take care.

X

Hi there,
Hard isn’t it??? What a choice! I had DCIS which is quite a bit different, as t was in two patches, albeit tiny themselves, I was advised to have a mx and told that would reduce recurrence chances.

For other BCs, I believe recurrence is in part to do with the type of tumour…have they discussed actual statistics with you based on your type of BC? I found mine very reluctant to deal in stats but some centres are better thab others for this.

For a small number of people, recurrence is linked to their genetics.

In terms of the finished product, somepeople need more than one lumpectomy and this can have an impact on the cosmetic results. I think getting clear margins is partly about the location of the tumours. If you got more info about yours you could research a bit more, and ladies are entitled to a second opinion too.

Surgeons often offer a choice, perhaps you could ask more about this? There’s so much difference depending on surgeon, hospital and area…as well as the personal nature of BC!

Good luck and good wishes

Lynette

I was diagnosed in November 2010 and was told right from the start that I would need a mx due to the size of tumour (45mm) and location (right in the middle behind nipple). It was also a grade 3 aggressive tumour and Her2+.

I had chemo first to shrink and saw my surgeon half way through by which time he said that it was shrinking rapidly and would only need a WLE. I questioned whether this would be enough as by this point had totally got my head around a mx and said that I didn’t want him to feel obliged to only take out the lump etc and that I wanted the best chance of no recurrence etc etc.

He said that it was all about clear margins and that if he could get clear margins first time with a WLE there was no extra benefit in a full mx. It did mean that I had to have 20 sessions of rads though to “sterilise” the whole area to stop recurrence.

That’s what he did and from a recovery point of view it was only a matter of days, so I feel really lucky at that particular outcome.

I was also lucky in that I had no nodes involved so only had a sentinal node biopsy.

I am sure you will see your surgeon again before the end of your chemo so question him further if you are still a bit unsure.

Sam

Hi there, I too had large lump grade 3 lump ‘just behinnd the nipple’. I had sentinal node biopsy and 1/4 was involved. I was told from the start i would need MX and to be honest i worry too much so probably best option for me. I also chemo and had 25 rads and am now on Tamoxifen. i have had an LD flap reconstruction and last week had further fat transfer. I only need a bit of tweeking to be finished. I am very happy with my boobs and cleavage. My hubby brought me 2 swimming costumes today for our holiday and you would never tell i had had reconstruction… just wanted to give you another viewpoint

I was told by my surgeon that as there was a high risk of a tumour coming back that if I had a lumpectomy it would be easier to deal with, following a mx a reoccurance would be more likely in my chest wall…

we’re all different so it’s hard to advise. I asked my surgeon what he would recommend for his wife if she were in my situation! He did also say the survival and reoccurance statistics were about the same when comparing mx with lumpectomy and radiotherapy.

I’m 2 1/2 years down the line and no reoccurance…

good luck with what ever you deccide x

I had a lumpectomy in 2004 in my left breast, no further treatment. Diagnosed 2008 triple negative 6.5 x 4.5cm tumour in right breast. TAC chemo first, tumour disappeared! But lympth nodes affected. Decided to have a bi-lateral along with the axillary clearance (5 out of 19 nodes affected with spread into surrounding tissue all still active!) So as not to possibly have to go down the same road for a third time! Living breast free is great, I can decide whether or not to wear my boobs. Also it is great for peace of mind. But only you can decide how you will feel. My lady surgeon said a lot of ladies decide to have both off at the same time and she was quite happy to go along with my decision.
Good luck and love to everyone
Nonny

I don’t think there is a clear cut right or wrong decision in a lot of cases, I think the most important thing is that it has to be something that you are comfortable with.

If you think that you will have more peace of mind in the long term with a full mx then that is the right decision for you. And vice versa in terms of lumpectomy.

Your surgeon can give you facts and figures and all the statistics in the world but ultimately it is your future going forward and from what I can tell everyone has a slightly different story to tell.

Sam

I really struggled with this decision. It was by far the hardest part of the proccess for me because there wasn’t really a right or wrong. tHey said to me there was a 1% lifelong risk of recurrence with mastectomy and a 1% year on year risk with lumpectomy (so after 10 years risk would be 10%) but the survival rate is the same for both. I didnt want to overreact by having mastectomy if not neccessary as the recovery is so much longer but I was also petrified at the thought of recurrence.
I also had an amazing result with chemo. After 5th one I had a mammogram and MRI scan that couldn’t even find the tumour! I was then left with the fact that it was so tiny that it made it more difficult to have lumpectomy as the surgeon was going to struggle to find it and when they tested it after the surgery if it was clear I wouldn’t know if it had just gone or he’d missed it. At this stage they advised that mastectomy was probably the safer option. So thats what I had, along with axillary clearance and when they tested it postsurgery there was no cancer cells left at all so I’d had a complete response to chemo. But I haven’t once thought I wish I hadnt had the mastectomy. I think if I’d had the lumpectomy I might have always been wondering did they get it all but now I’m just confident they did.
Good luck with your decision and the rest of your treatment