Making a decision on treatment options

I am struggling with how to decide between radiotherapy and a mastectomy at the moment with time pressure following lumpectomy. I have generic issues that make my risk of BC really high and am being offered a preventative mastectomy as a alternative to radiotherapy. I have conversations coming with plasic surgery and also radiologist to discuss potential outcomes but I was wondering if others had the same issue- choosing between 2 full on treatments which are both “preventative” but with different effects on the future. There’s always the ‘chance’ that this was my one time and nothing else will happen so i’m concerned a mastectomy is a huge step which I could take later if I need to. Love to hear any thoughts or experiences. Thankyou.

Hi Katz,
Firstly sorry you’ve found yourself here.
In my case I wasn’t given a choice, I was told I needed a mastectomy.
In a way I’m glad I wasn’t given a choice must be a horrible position for you to be in x

Knowing what I know now (Having gone through chemo) if I had your genetic risk, without hesitation I’d opt for the mastectomy every time.

I had a skin sparing mx with an implant, in a bikini you wouldn’t know I’d had surgery let alone a mastectomy.
If the cancer had progressed they might not have been able to save the skin so I’d have to have a full reconstruction with the additional scaring.
Basically what I’m saying is you’d probably get a better looking result doing it now when you have a choice.

Also when my path results came back they found 10cm dcis which they didn’t know was there beforehand!
The surgeon said we call it ‘the silent killer, so having the mx was the right thing to do’.

An mx is major surgery, so you do have that to think about but I guess they wouldn’t offer it if they didn’t think you could cope with it or benefit from it.

Best of luck with whatever you choose xx

I was offered a wide local excision with radiotherapy or a mastectomy. I went straight for the mastectomy without reconstruction. My aunt has had breast cancer 4 times, and although they haven’t found a genetic cause, it does seem likely as there’s also a great aunt who had ovarian. It’s actually a good job I went for the mastectomy, because it was bigger than they had expected.

I couldn’t face the thought of further operations if excision was incomplete. Also just having the rest of the breast there waiting…

I went for no reconstruction because I’m not particularly attached to my boobs, they are quite small, and I didn’t want a looong operation. Also didn’t want anything foreign in there which might make it harder to detect a recurrence.

A mastectomy is not that big an op without reconstruction - mine was a daycase! The op takes around 2 hours.

Tuns out I need chemo and radio anyway due to lymph node involvement.

Good luck whatever you decide!

Oh, and if you go for mastectomy without reconstruction, look into a group called flat friends, very helpful.

I have just decided to go for another reexcision as one margin from my original surgery was not clear enough.  I was told that the guidelines state I should go for a mx but I am not ready for that.  I have to have surgery anyway for an axillary clearance so I want to give it one more try.  Maybe not the choice other people would make but it is the right choice for me at the moment.  If I have to eventually have a mx then I know I did everything possible to avoid it.  Its a difficult decision and not one that I wanted to make but my third surgery is booked for 10th Jan and I am hoping and praying that I have made the right choice.  Good luck with whatever you decide.

I’m struggling also. I’m 34 was diagnosed last sept and have had 3 rounds of chemo made the decision today to not continue with the other three they wiped me out and have given me further problems I have to deal with however I’m still going ahead with the herceptin as I tested positive for her2. I have to have breast surgery which is now being pushed forward because of my decision to stop chemo however I’m not sure if they will offer me a lumpectomy or a mastectomy I’m ok with either of I’m honest just want to bloody thing gone!! If I’m honest I’d prefer to have mastectomy as the chance of recurrence is low xx

Hi I have just been diagnosed and have been told I need a masectomy and hopefully no radio or chemo therapy. I guess it depends where you are in life. I’m 48 and in a fantastic relationship with a wonderful man I was initially devastated when they told me but I took some time to look at the actual procedure and I’ve decided it is more preferable. I’ve talked to the surgeon and discussed several options, turns out he can do both boobs at same time do a reduction (my boobs have always been a bit big)and give me neat smaller sized ones. I’m actually looking at it as a bit of a medicinal boob job. I know it’s a bit extreme but have to put a positive slant on things. So my old droopy 48 year old boobs will have the cancer removed and have a make over at same time. I know it’s scary but talk your options over. Good luck.

Hello can someone tell me what BC stands for.

 

I have just been diagnosed and am in a simillar situation. Choosing between maesectomy only or wide local excision with radiotherapy. I have osteoporosis and am concerned about radio therapy but terrified by the thought of looking at myself after a maesectomy. I go back to the hospital next Monday to agree a way forward and am not naturally a good decision maker I am very scared. I do not want reconstruction but am self conscious and appearance conscious. I do not have a large bust 34 b . The osteoporosis scares me too. I have been told if I opt for maesectomy I shouldnt need any other treatment. I know many drugs have a detrimenatal l impact  on bone density.

Liz 

Hi Ladies,
Thanks so much for replying, I didn’t expect so much of a response. It shows that when you become affected there are so many people out there with stories to tell.
I’m writing this in the bath in a hotel in Istanbul on the quickest work trip ever with another planned to Hong Kong in a couple of weeks. It’s been a busy few weeks and I’m thankful that there are so many people who have invested time and effort in learning how to fix people up and put them back together again and into sharing their stories.
The appointments were hard but as nice everyone was they finally talked figures in a really pragmatic way and I came to the conclusion I can’t argue with a risk rating of 85% and an increase of 1-2% every year as I get older. That means I’m almost certain that something else will rear it’s ugly head and I might not be so lucky if it happened again. Even the psych appointment against all my previous thoughts helped to sort things out for me. It seems I’m a control freak and the thing that was freaking me out is the short term- the op, the recovery, the after effects and not being in control of my own body. But I’m not in control now really, the genes are and if I don’t fix it now then there won’t be anything left for me to control later.
So, the strange sick feeling that was residing in my stomach has given way to the start of a plan and me telling myself it really is my choice albeit between 3 really **bleep**ty things. On my terms it’s looking like it will be the preventative double mastectomy with immediate reconstruction. I’m working on taking every bit of positivity out of this situation including shopping for new bras that might actually fit, a size reduction (believe it or not) and being able to wear some more revealing clothes!! Also I’m training again, I figure if I’ve gotta do this I need to go into it strong.
I’m surprised how I feel now in comparison, I might lose it again nearer the time who knows but either way I have to keep going and get to the other side. I’m aiming to be in a bikini on a beach somewhere ASAP !

Hi Katz

Good for you girl.Your positivity from your first to last post is quite atounding.

I opted for a mast over lumpectomy and rads, because the night before the op, I pinched in a 7cm sphere of flesh and it wouldn’t have left me with much. I had to have mast on the other side a year later (non genetic), but am since part way through recon. 

Have you decided what type of recon to have? Yet another decision!! I opted for “implant” as it doesn’t involve extra scars and the extra infection risks of self tissue recon, and the results with the tear drop silicones are a lot more natural than the old silicones. Has it’s downsides, not warm natural flesh and may need replacing within 15-20 yrs.

Good luck with it all, hope it goes well.

Keep us in touch with where you’re up to.

Lotsa love, Delly xxxx