You are welcome, pleased to help outline the considerations. It's such a personal decision and you are so early on, so I can imagine how it threw you if you weren't expecting yet another thing to think about!
Just to clarify, I ended up having 3 op's in all. Given they were reducing only one (the non bc side so long after initial lumpectomy), they were concerned about removing too much just in case many cells died due to the surgery (over the 6 months or so after surgery) and it ended up too small! So as a result, they were cautious, and as it turned out I didn't get shrinkage due to post op cells not surviving, so ended up reduced but still too big! Hence the second reduction op on the same breast! So 3 op's in all.
Yes - I wasn't sure whether your surgeon was proposing lumpectomy on bc side, with breast reduction other side to match, or, lumpectomy and reduction on bc side, with more significant reduction other side!
Don't feel pressurised if you aren't sure enough to do it now. But getting it all out the way sounds positive rather than eeking it out! It was the miss balanced weight that really bugged me, more so than the visual aspect. I think it also helped me feel more confident again. My surgeon was very neat too.
All the best making your decision and talking it all through with your consultant.
Do contact me if you think I can help any further.
Thank you Seabreeze for your swift and comprehensive reply!
the surgeon I think was suggesting breast reduction as part of lumpectomy so radiotherapy would not need to penetrate so much Breast tissue in the side with bc. However to be honest I was so unprepared for this discussion that it’s all a bit vague and I could be wrong. I have googled him since and his expertise is oncoplastic Breast surgery so that’s reassuring.
You have given me plenty to think about and discuss when I see him and it does make sense to wait with the reduction on the unaffected side until later, although that is then 2 operations instead on one?
always good to know about other options, so again: thank you.
And brilliant to hear you are doing so well!! 💕
I had lumpectomy on one side, tried this with a prosthesis (in case you are not aware they do make prosthesis to sit over a breast and make it appear larger, they are not all for women who have had a mastectomy). However my skin had a strange reaction to the prosthesis (the fitter at the hospital who has worked there for years said she'd never come across it before so the vast majority of women must be fine)!
In the end due to feeling lopsided and not being able to wear a prosthesis I decided to have a reduction of the larger side. Because I was having just one side reduced, the surgeon didn't want to risk removing too much (since apparently some women lose a bit more during the healing period). I left it 12 months to give things a good time to settle and was getting shoulder problems since I was still lopsided. So had round 2 reduction, which worked well re balance angle. I wasn't actually offered a reduction at the time of my lumpectomy, so a slightly different situation to you.
Considerations/things to ask the surgeon about to help you decide:
1 - Clearly the degree of lopsideness will depend on how big and where your lump is.
2 - By having surgery you do lose some sensation in your breast (to varying degrees), particularly for surgery near the nipple. Most reductions take the form of incisions around the nipple and down from the nipple or that with a curved line under your breast (my surgeon referred to this as lollipop or smiley face if it helps you get the picture). Any breast surgery, particularly near the nipple can lead to some degree of loss of nipple sensitivity. So in that respect it's a balance of what is most important to you.
3 - My understanding is that radiotherapy can cause some breast shrinkage. You might want to ask if this is the case and if you are likely to end up with a better result if the reduction is carried out at a later date, or if given the individual level of tissue die back which can happen, whether having both reduced at the same time, with the lumpectomy is most likely to give the best balance angle.
4 - Personal preference and depending upon level of lopsidedness - would you prefer to keep one breast intact and wear a prosthesis? The only thing is if for example the lump is just above the nipple, the lumpectomy may mean that breast is tightened up and the nipple may become a bit higher....which clearly increases the feeling of lopsidedness.
5 - If you ask if you could see how you go, and consider a reduction in the future, check if the surgeon thinks there is any chance the NHS may change it's policy to doing this as part of the breast cancer package. Hopefully the policy will not change...I'm just aware of what future NHS budget pressures may be.....
6 - I'm a bit mystified re your surgeons comment about less breast tissue during radiotherapy means less risk of damage to tissue. Yes re the bc side (but that side will be smaller after the lumpectomy), so is the surgeon referring to the non bc side? If so that side shouldn't get much zap anyway since all the radio will be directed at the bc side?
Or have I misunderstood, and is your surgeon talking about lumpectomy AND further reducing the size of the bc breast, which would make sense re less tissue damage to the zapped side.
7 - When they do a lumpectomy, they remove the lump and a margin of tissue around the edge of it. They then test that tissue, to ensure the margin is clear of any bc. You usually get the results 2 weeks after the lumpectomy. If there are any signs of bc cells in the margin, they will want to remove more tissue. Hence you might want to ask if this would be likely to mean you'd need more surgery just on the bc side or also on the non bc side to balance. I guess the answer probably depends on how big the lump is?
8 - Clearly more to recover from but then it gets it out of the way with one op, only 1 lot of anesthetic.
Me - I'm pleased I had a reduction. It was definitely the right decision for me. The scars fade a lot and to me the physical discomfort of being so lopsided was unpleasant and caused shoulder problems. I got fed up of bras twisting round me and due to the extremely unusual prosthesis issue, I had no option but to try to disguise my shape under baggy tops. But this isn't the case for most women re prosthesis so the factors influencing your decision are slightly different to mine.
Timing is a whole different question!
I hope that helps. Do post again if you need clarity on anything above, or message me if you want to discuss more details.
All the best
Seabreeze (5 years on and doing ok - reduction 2.5 years after diagnosis/lumpectomy, further reduction op 3.5 years, now at 5 years no evidence of disease)
Hi just picked up this thread as trying to find out a bit more about this.
I was diagnosed two weeks ago and had an appointment with the breast surgeon last Tuesday. My son is getting married next week so I have started hormone therapy and I have a second appointment on 30th.
He has given me a choice: lumpectomy only or breast reduction with lumpectomy as I have bra size 38F. He said this would help with the radiotherapy afterwards as less Breast tissue means less potential damage.
i did not expect this option ( I did ask whether it would be both breasts! 😂 yes, I won’t be left lopsided!)
what to do??
Does anyone else have experience with this?
Hi Gigii sorry to hear about your diagnosis.I remember being very shocked and frightened to find out I had cancer. I cant really comment on what your surgeon is going to do however most of the surgeons are very experienced and will always think ahead as to how they can help you look the best possible after your surgery. Maybe you could phone your breast cancer nurse to have a chat about your concerns as Im sure she will be able to talk you through things and put your mind at rest a bit and answer any questions you have.. As for myself I was given a wide local incision to remove the lump. At the time I remember the Surgeon saying she could do a breast reduction on both breasts at that time if I wanted smaller breasts, however I did not want that done at the time as she said after the surgery it may not look too different, but she did say that they could do some correction surgery afterwards if needed. I had surgery at the end of Jan 2016 followed by radiotherapy . The surgery and the treatment left me with one boob bigger than the other and also my nipples were not in line which I wasnt happy with as it looked very odd. They agreed I could have a breast reduction on my larger boob to make it more symetrical with my other one .also to move the position of the nipple so they would be more in line. Im still presently recovering from this surgery so not sure of the final outcome. I had been nervous about going ahead with the reduction as they point out all the things that can go wrong so I can understand why some people choose not to go through with it. Please let me know how you get on and def give the breast cancer nurse a call as she will know about the details of your cancer so best to a tobe advise you. Take care Corrina xx
Hi Corrina, a dissolving stitch poked out last night, half an inch long, I think that was the culprit!
So I was at a dressings appointment and there was a doctor there so I enquired about the results, she checked the computer and said it came back clear and I asked for a paper copy of the report - which you are entitled to - otherwise I suppose I would have asked the plastic surgeon when I see him in a few weeks. I think in this case I would have only heard back if something had been found in the removed tissue.
You sound like you are doing really well so hope you will continue like that. I am pretty much back to normal now but given that 2 weeks is recommended recovery for this kind of op, that would have been too soon for me.
best wishes, girly x
Hi Corrina, I had a reduction 6 weeks ago and still not quite healed as the dissolving stitches and some of the dressings have irritated my skin - so I have two tiny holes on the vertical of the anchor scar.
Other than that I had very little pain, hardly any swelling, more sore than anything and was a bit difficult to find a comfy position to sleep but that eased off week by week.
The pathology report was all clear - that was a relief.
Would say that my reduced boob shape looked great immediately after surgery and I'm really pleased with it although its a bit high up but I know it will drop over the next few months.
Hope you continue well,