Two lumpectomies, need another or do I go for mastectomy?

[Hadley207]

@delly 

Thank you lovely 🥰 

[delly]

Good Morning @Hadley207 /Sara.

This is specially for you and your Dad,  Delly ❤️ ❤️ ❤️ 

[Slightly Lopsided]

Hello Sara

I'm so glad you have felt able to make a decision and feel ready for what is to come. Really glad to hear, too, that your BCN is so supportive.I never actually met mine but whenever I phoned her and wasn't sure if she could answer one of my questions, her response was   "Try me... " and she was always able to give me the answer.They're  the best.

I'm so very sorry to hear you are also having to deal with your father's situation at the same time as your own worries.Life can be so cruel and unfair. I'm glad you've been able to spend time with him this weekend .

I'll be thinking of you on the 29th and wish you lots of luck  and a smooth path to whatever is planned next for you.

Take care🤗

[delly]

Oh Sara

Am soo glad the flowers "cheered" you (as hoped). But Crikey, Golly, **** girl, I am SOOO very sorry to hear about your Dad. Jeeez. It is difficult enough coping with your own BC decisions. But the added extra of your Dad upset on top of. Again, I'm soo very sorry.

My Dad was terminal, prior to my 1st BC. I hated it, and to see him slowly wasting away over the predicted year and a half. He actually died in my arms. I felt a weird kind of privilege that he did, as opposed to a hospital bed. I shalln't go on, as you're upset enough.

BUT, I have to say, I feel somewhat "glad" at your now mastectomy decision. Save yourself another op, with the possibilty of yet another negative margin result? I can appreciate how it's all been Soo very tough for you to make. 

Shall be thinking of you and with Loads of love to you, darlin girl.  Dellypoos xX❤️Xx

[Hadley207]

Hi @Slightly Lopsided 

Sorry it's taken so long for me to reply, we've been to Scotland as part of my dad's bucket list, he has a glioblastoma brain tumour, that has given him 14 months at most and obviously we have also been discussing my predicament too. 

Your words and journey have been very helpful, and I thank you for that. I have decided to go for the mastectomy as I feel I need to be rid of the cancer in total and can move forward, rather than wait another four weeks after surgery, to possibly be told again, that I'll need to have a mastectomy anyway.  So, I spoke to one of the lovely nurses at the breast unit and told her what I'd decided, so they could confirm the date of Monday 29th November. Then look towards radiation and/or chemotherapy in the weeks after.

Now, to be honest I feel a little relived to have made the decision and after reading many of the ladies' journeys on here I believe I can talk to any of them as I continue my own journey.

Thanks for being there for me in my decision.

Take care

Sara 🎉💖

[Hadley207]

@delly thanks so much for the flowers, they've made my day

Thanks

Sara xx 🎉💖

[delly]

Hi again girls

Hadley, I so hope all goes well for you, and for everyone one else too.

I'm delivering flowers on the Forum today, to all the threads I subscribe to. Perhaps you could deliver/forward them to yours too, as I can't get around them all. I so love Amaryllis at this time of some, so beautiful, cheerful and spectacular.

Lots of love to you all,  Delly  x❤️x 

[Slightly Lopsided]

Hello @Hadley207 

I really sympathise with your dilemma as I was in your position about 20 months' ago.You always hope these things will happen to someone else!It is quite emotionally draining to be going round in perpetual circles and unable to start the next step of your treatment and reach the end goal of being through everything.  

I realise from reading @Optimisticmz 's reply to you that the post she refers to  was actually mine-so by now you have probably  read what I said then and I won't rewrite it. Your original  history does sound broadly similar to mine;my original tumour was  Grade 2, perhaps marginally smaller, c15mm  but another much smaller tumour was found on the margins after my original lumpectomy and then DCIS. I had 2 wires inserted before the original operation to try to locate the original tumour  and in retrospect, I think it was like looking for a needle in a haystack for my poor surgeon as  everything didn't show up clearly on my original mammogram (and I never felt any lump or indication there was anything wrong and even my original mammogram was "iffy"-it was only when they did an ultrasound that it became clearer ).I have also read somewhere since that having dense breasts raises the likelihood of re-excision. 

As I said in my original post, I had absolute confidence in my team, which I think helped.I could understand it was down to sheer bad luck on my part, not anyone's fault, despite what some "helpful"friends implied  , and that the surgical team were taking the utmost care, given it comes down to millimetres.I do remember asking my surgeon how often it happens and his reply was that in over 15 years, he had had 5 such patients-so every 3 years or so, he is sent a case study like us! The other point I  think I made was  they would not have given me a choice if they really felt a mastectomy was the better option. The decision to have one more attempt maybe also came down  to personal factors on my part.I was resigned to having to have a mastectomy eventually  but felt if they were prepared to give me one last chance , why not?By then I knew I recovered and healed well and it wasn't such a major operation as the original lumpectomy, as there was no new  underarm incision,  and the scar was just opened up so no further wound -and I knew I would be pretty functional straight away-which was maybe a more important factor to me last year during the height of the pandemic, as I live alone and have an elderly father who needs a lot of help-so maybe not completely rational factors but even so, important at the time. 

I did wonder how much they could keep on removing, but the first words  the nurse said to me in recovery were "11 grammes" -so that was obviously the equivalent of a good chunk! In terms of the "end result" I think I was quite lucky that the tumour was in the "12 o'clock position" and it really hasn't made much overall difference to the shape of my breast.I was never particularly well endowed and it is not noticeably smaller to the casual eye .

Whatever you decide to do, I hope you are able to make a decision with which  you feel confident and comfortable and proceed to the next steps of your treatment. If it's any consolation, I found radiotherapy an absolute  doddle after so much surgery!

Wishing you lots of luck and please don't hesitate to ask if you have any more questions.🤗

[Hadley207]

Hi @Optimisticmz 

Thanks for your reply, I have had my nipple and areola completely removed and so have a 5 inch incision straight across my right breast, so I call it my winking face 😜 my surgeons have done a super job of keeping the shape I was a 38E but it doesn’t look too bad.

I’m pretty sure he said he’ll take another 2mm but if that still shows pre-cancerous cells I’ll need to have a mastectomy as they only try three times for preservation of the breast.

I’ll have a look at your suggested heading, as you said it’s always good to be informed before making a decision.

Thanks again, sending you good vibes

Sara x

[delly]

Hi again @Hadley207/ Sara

Aren't these decisions blummin difficult. On the one hand, there can be "Pro's" to be given an "option". On the other hand, sometimes it would save a whole load of personal deliberation (and no doubt headaches about what to do), if a surgeon just said: Actually Sara, speaking from my experiences of similar others in your case, I would recommend foregoing yet another attempt at margin clearance, and just have a mastectomy. Save yourself having to have yet another op, if margins are still not clear." 

Golly, Sara. How much boob DO you have left, from the ops you've already been through??

Hope you're happy with what you finally decide, dear girl, and GOOD LUCK with it all.  xXXx

[Hadley207]

Hi @delly 

thank you for your reply, it has been a very tough few months, but I’m determined to beat this, reading through the forum has been hard but I now know that so many other ladies/gents have been through these tough decisions over many years and have come out the other side and continue to help others. My heart is full of admiration for you all. 
It’s been my choice of what happens after listening to each Dr/nurse I have encountered and it’s always been an informed decision and I chose to go for the rad for the lymph nodes, rather than excision.

I’m definitely erring towards full mastectomy after reading lots of information on lots of other platforms, but I’m still taking my time and thinking everything through and chatting to my husband and family too.

Thanks again, your comments have been extremely helpful.

lots of love back

Sara x

[Optimisticmz]

Hello @Hadley207

You have been through a lot and don't have much time to make a decision  I was diagnosed in 2017 and had a lumpectomy with clear margins so haven't gone through what you have been through. I remember reading a post from a lady who went through four surgeries and thought this would be useful for you. I am not computer savvy but this is the subject heading if you put it in the search bar.

Re: Close margins following second surgery

I  also think your decision may depend on your breast size? How will three surgeries impact on the size/look of your breast  I was lucky that my incision scar is under my breast and I just have a bit of irregularity to the side. From "face on" you probably wouldn't know I have had surgery. 

Also, is there plenty of "margin" to take? How close, for example, is the incision from the skin or chest wall?

i would encourage you to speak to your Breast Cancer Nurse who maybe able to answer any questions you may have. Or try the nurses on here (number at top)

i am the type of person who likes to do a lot of research before I can make an informed decision. I wish you well for your decision and surgery. Michele 

[delly]

Crikeybobs @Hadley207 

What a horrible time you've had of it, in just the last 6 months!!

I have to admire your persistence and keep being knocked back, due to failure in achieving "clear" margins. Your latest Offer being yet another lump/mass removal, and if STILL not clear margins, then a mast. Afraid, I'd give in to a mast, get blummin rid, rather than yet another attempt. Plus, If your afraid to lose the whole lot, the recon options are fantastic these days.

Are they talking about having to "remove" any of the lymph nodes, with whatever next surgery you choose (either another further lumpectomy or mast)? Or to just treat them with rads, which is more a precaution against any possible spread, as opposed to it reducing the risk of lymphoedema? If the former, i.e. removal, then yes, you may have an increased risk of developing "lymphoedema" at some further stage. But NOT if you're careful afterwards.  

I was offered lumpectomies with rads or masts with full node clearance. Opted for mast and full node clearance with 1st, 2006 and 07 was a no brainer decision - just to get rid, to avoid/reduce any further possibility of recurrence.

Have never had any prob with lymphoedema developing. But AM always very careful with both arms. Avoiding jabs, blood taken from, BP cuffs, cannulas, bites, stings, scratches (wearing sleeves when gardening) and sunburn. 

Hope this all makes sense, and is of some help to you, flower. But I soo wish you well whatever you decide, and speedy healing.

Lots of love,  Delly  xXx 

[Hadley207]

Hi everyone, I'm looking for some advice before Monday 8th November. I was diagnosed with right breast invasive ductal cancer on 20th July 2021 (my 56th birthday), decided to go for a lumpectomy. On 16th August I had my first operation of right ultrasound wire wide local excision including nipple areola complex and sentinel node biopsy, the histology came back has having removed 24mm, grade 2 invasive ductal cancer with associated intermediate grade DCIS which extended to less than 1mm from the inferior margin and one out of one positive sentinel node. Before the operation I had developed a severe Bronchospasm, which they are still unsure why, as I couldn't be tested on due to lack of phials to test my bloods.  

My surgeon said I needed another 2mm taking from the area, this was done under general anaesthesia (without complications) on 8th October 2021. The histology for this was that there are still no clear margins and therefore I will either need another margin clearance or mastectomy, if I go for the margin and it's still not clear, they advise a mastectomy anyway. 

So, catch 22 do I go for margin clearance or mastectomy now, I had spoken to my husband about this and had sort of decided to go for a mastectomy if it still wasn't clear, but now I'm really not sure has anyone had to make this choice!! I have already decided to have radiotherapy on my lymph nodes as I feel it's probably less likely I'll get Lymphoedema. 

Any advice would be gratefully received.

Thanks 

Sara