Conservative breast surgery or mastectomy

Hi,

I was diagnosed with grade 3 triple negative breast cancer in June, have 4 more chemo sessions left and then I need an MRI to determine whether I have surgery or another 6 rounds of chemo.

 

When I was diagnosed they were talking about breast conservative surgery, and I have been told that it’s as effective  as having a mastectomy, however I’d like to hear from ladies who’ve been in a similar situation and which surgery they chose and the reasoning behind it.

 

I assumed rightly or wrongly that if I had a mastectomy, I’d reduce the risk of it returning more so than having the conservative surgery?

No research shows outcome pretty much the same. Key thing is the radiotherapy  and it is many years since mastectomy was automatic 

I had breast conserving and now am having a mastectomy … I guess one thing I would say is it could depend how “neat” the area is … I think mine was a bit sprawling which made it hard to get margins on it but I think it’s less than 20 % that happens for … every case is totally unique … I known surgeons don’t link to commit but I must admit I have tried to hook information out to help with decisions … one negative of a mastectomy is losing sensation … with breast conservation that can be kept … so certainly worth considering x

I had a similar surgery choice (albeit no chemo for me), and wasn’t sure: I have now, happily, opted for reduced surgery and radio.

I posted this to another query - it may help?: 

To cut to the chase, I have hauled in a few contacts (I’m a Dr), and it seems the ‘view’ now is that radioRx is felt to have minimal side effects, that, really, there is no point risking the major surgery of mastectomy.  this has immensely reassured me, and I think I am now much happier proceeding down this route: but, obviously, it is so personal (I keep staring at my boobs in the mirror wondering if I could stomach a mastectomy…).

You might find these articles helpful: cancernetwork.com/oncology-journal/decision-making-surgical-management-invasive-breast-c… (this is quite medical and detailed, so perhaps consider if you want to read this??). This link is a decision making tool (tbh it didn’t tell me anything new, but it is useful as a starting point at least): researchgate.net/figure/Option-Grid-decision-aid-Breast-cancer-surgery_fig1_310666496 

Hi meeting breast care team at 9am today. Can’t sleep, and it’s my first contact since my Triple Neg diagnosis in September 2019 to discuss surgery and options. Since then I have been undergoing 6 chemo rounds ~ first three FEC now started first of last three rounds of Ducetaxel and I’m not coping well with last round of chemo as it hit hard. Not been able to get out bed this week and side effects kicking in hard. Not sure if I can manage next round let alone future years of chemo. Also breast painful and swollen and I can feel another lump. Bigger then when I started? But will get to appointment soon. Just wondering how you faired. My initial advise a way back in Sept was lumpectomy with radiation but I’m so worried it will increase my risk of it coming back. My head screaming mastectomy get them both off one minute then the next I’m a bit calmer. I’d like to hear also from ladies who faced same demons and how it worked out. Hope all well with you x

I was initially diagnosed in Sept 18 with grade 2 ER+ HER2 -ve breast cancer and had a lumpectomy and 20 sessions of rads and tamoxifen. Annual check up in Oct 19 showed a large 70 mm area of high grade DCIS. Mammogram initially reported as normal but found on the MRI. Nipple sparing mastectomy and immediate implant reconstruction recommended which I had on 16th Dec and I’m very pleased with results. Biopsies taken in surgery from behind nipple and sentinel node and both negative so no more surgery needed. I initially asked the surgeon if he would do the double mastectomy and reconstruction instead of just the single and he said the problem was because I’d previously had rads on my other side it could cause complications with the reconstruction and healing so he wouldn’t do it while doing my left side for treatment. He said if I needed further treatment after and they run into problems with my side that has previously had rads it would delay things. I wish now I had known in Sept 18 that rads can have an affect on mastectomy and reconstruction surgery in future. I was never offered a mastectomy then. I think with hindsight I wish I’d gone for the mastectomy when I was first diagnosed. I am much happier with the scarring at the side of my breast with reconstruction than the scarring being right in the middle and a dipped area of my lumpectomy. 

Hi, I’m facing similar decision. My instinct tells me mastectomy is the better choice for me.  I have been advised that radiotherapy after lumpectomy has same outcome as mastectomy for me.  Let me know your thoughts as you work through this one.

All the best 

Michelle