Lumpectomy and radiotherapy vs mastectomy

I would consider the following:

1.  If I chose a lumpectomy, would I then be worried about that breast and wish I'd let them take the lot?

2.  What cosmetic outcome can I expect from a lumpectomy?

3.  How much do I care about losing the whole breast?

4.  What are the risks and side effets of radiotherapy (both immediate and long term) ?

5.  How does the answer to question #4 weigh in relative to the answer to question #3? 

People's priorities are not the same. Some of us will do anything we can to preserve as much of the breast as we can. Some of us would prefer to lose the breast in the knowledge that by doing so we are making sure any chance of more cancer in that breast is now gone.

On a personal note, I wanted a lumpetomy at first, but changed my mind quickly when it became clear that this would necessitate radiotherapy as I was extremely reluctant to have that. I knew that even with a mastectomy I night still need it (didn't in the end) but my priorities were such that I was happy to lose the entire breast just for a chance to avoid radiotherapy. 

Thank you for taking the time to reply. There is so much to consider and it is good to hear from the perspectives of others, and how you made your decision. Hope all is going well. Sending my very best wishes and kind regards.

I had a mastectomy a year ago as my breast cancer came back after 23yrs . I had a diep where they made a new boob from my tummy . amazing results and as boob removed alot kiss worry . Good luck whatever you decide x

Thank you for your reply, really appreciated. Wow, after 23 years. So pleased you are now recovering.  Sure I will make the right decision after listening to others experiences. With very best wishes. 

Hi

Really as others have said it is down to what you feel is most important to you (and it needs to be your decision) 20% of lumpectomies need further surgery to obtain clear margins , but as you have had chemo already this may be less of an issue for you , but worth asking the question? I had three lumpectomy/cavity chest shaves to obtain clear margins and these failed so had a mastectomy by which time I couldn’t wait to be rid of it , but although you will be getting rid of the cancer , think how you will feel if you go down this route , will you be happy going flat , do you want reconstruction , will they do a nipple sparing mastectomy or will that need to be removed too. Whatever reconstruction you have it is not the same as your real breast , no matter how good the surgeon is - I had an implant initially , changed to a Diep flap 2 1/2 years later , so ask if this is also possible , that you can elect for further surgery down the line. I am extremely happy with my Diep boob , and have now 5 1/2 years later come to terms with the loss of my breast - I did have a big peony tattoo on it , and think for me that was closure of some kind. 

There will be lots of good advice on here , hopefully that will help you make the best decision for you.

Jo x

Ah thank you so much for your response. Really useful. Has given me lots to think about and some  of the loop holes to consider too. Plus questions to ask my surgeon I hadn’t thought of. Sorry to hear that you had to go through so many procedures but so pleased time has moved on and you finally have closure. Sending every best wishes. 

I had lumpectomy July 2015.  I had 11mm DCIS high grade removed from G cup so cosmetic result is just a dent.  I then had 15 sessions of radiotherapy.  If I have a recurrence in the same breast only option will be surgery as you cannot have a second dose of radiotherapy.  Also ask does a mastectomy mean you will not have annual mammogram on good breast?  With a lumpectomy you have both breasts mammogramed for 5 years.

Im content with my decision.  Minimal invasive surgery and radiotherapy very doable and I have good cosmetic result.  If I had been diagnosed with an invasive cancer my decision might have been different.  

Thank you for your clear reply. Again good information and other things to consider. And other questions I need to ask. Extremely useful. So pleased all is going well for you. Best wishes. 

Hi ,

This is such a hard decision for you, not only are you in a place where you didn't expect to be your mind won't be thinking clear or straight at the moment.  

When I was at the beginning of my journey I was told I would need lumpectomy and radiotherapy, or I could have a therapeutic mammoplasty ('it' removed and other breast reduced) - I was 'take it off - take them both off'.... my head was just take them off and get 'it' out of me!

What I didn't take into consideration is the 'it' was in a 'certain place' - the place they would take if from - so taking more of my boob off wouldn't really help as 'it' wasn't in that part.  On top of this it would be a guessing game of what would happen in the future.

I geared myself up for therapeutic mammoplasty ...... then changed Doctors/Consultant and was told why put myself though this when the lumpectomy won't cause that much difference and with time the body 'fills' in where 'it' is taken from ...... so a lumpectomy it was (I had TARGIT IORT treatment - this is lumpectomy with combined internal radiotherapy at the same time).

I have over run..... so having more breast taken off - is doing just that removing 'good' breast. (unless your surgeon has said you are at more risk of 'it' returning - then if this was the case I would of thought the surgeon would be guiding you towards having a mastectomy - if it is based on choice alone not an increase in risk then lumpectomy maybe the way forward. (this has to be your choice).

Keep in mind 'whatever operation you choose to have - if all goes well with clear margins 'it' will be taken out.

Hoping this helps - just keep asking questions, this way you can build up your own strength on what you feel is right for you....(don't expect help from family and friends - it is at this time you realise 'you have to do what is right for you and only you).....

In the meantime sending you love and hugs xx

Hi

i had to decide whether to have a bi lateral mastectomy, as have cancer in both breasts. I decided on right mastectomy (couldn’t have lumpectomy as had already had radiotherapy.) and lumpectomy in left breast. Consultant said there wasn’t much difference on return of cancer between mastectomy and lumpectomy with radiotherapy.

Had operations 3 weeks ago and I can’t believe how well I am. No pain, and so relieved all the worry has gone.