Why just remove lump not whole breast?

DearAsblueasanaprilsky,

I was like this when first diagnosed, I wanted 'it' all out, I wanted 'them both off".  Then I started looking into my treatment, I found this site and spoke with various ladies and slowly started to see part of the bigger picture - I was thinking 'have it all off' that will get rid of 'it' - but 'it' was only in a 'certain' place - taking the rest off might prevent and reoccurrence - but there might not be reoccurrence.

I am a larger lady - not sure about the lady haha - I am large busted so was on the 'get rid of them'.  My lump was on my left side and I was reading all different stories to do with radiotherapy given on the left side - and with everything the more you look the more you will find.  My focus then became about the radiotherapy as oppose to 'it'.  Radiotherapy given after operation, externally, is given daily over the course of 4 to 5 weeks (some now have stronger radiotherapy given over short period of time), it is very 'focused', I think they put a tattoo marking on the skin so that get the right place/area each time - I believe the area is where 'it' was removed from. 

Speaking from my own personal treatment, I found a treatment which gives a combined lumpectomy operation and all the radiotherapy 'internally' at one time.  So if margins are clear and no chemo is required 'all treatment is done in the one operation'.

This treatment is called TAGIT IORT - well when I found out about this, this is what I went for (at the time it wasn't approved for use on the NHS - it is now, only many Consultants don't offer this to qualifying patients (over 45 years and 'one' lump is the main criteria) - it is mainly political why this treatment is mentioned (Radiologists say this the lesser treatment would end up costing them their jobs - not looking at this treatment would free up machines for more patients to have treatment sooner - this a different story).

Due to the upset, the feel of rushing and panic - I went from wanting a double mastectomy to a therapeutic mammoplasty (reduction on good breast to match the operated side)..... to finding this treatment 'combined operation/lumpectomy and radiotherapy' and being told that 'after' treatment and healing give or take a 4-6 months my body will absorb and fill in where the operation was and the area would naturally 'fill in', leaving me with a 'slightly' smaller breast (and was told that nearly every woman has one good larger than the other). 

I actually had approx 75mm x 75mm (just under 3inches in old money) taken out from the upper right quadrant if looking at my boob or between 12 and 2:00 in the clock - I am larger boobed.  At first I couldn't look at my wound (I think many of us are like this) and then when I could see the dent and this upset me - then over the coming weeks and months I got used to it and took to ignoring it and then noticed 'it was filling in'. 

So my rainy day had arrived and I was going for the TAGIT IORT treatment - the crazy thing is it was the 'radiotherapy' side that pushed me.  My operation is on my left breast, I was worried about my heart and the radiotherapy - and here's my biggy 'I could hopefully get away with having treatment and not having to let my elderly mum even know about this - (other than I found a little lump and family doctor said best to have it removed (family doctor didn't say this, this was my way of at least letting mum know I was having an operation).

That was it all done, no daily travelling for radiotherapy etc. and I can say the area as 'filled in', the scar line is virtually none existent, looks more like a mark where bra or clothes sit.

Back to 'why' - I could in a way have either treatment the lumpectomy or the therapeutic mammoplasty.  I found this site and came on asking which should I do (thinking one way is this benefit and the other way is another benefit and me thinking both having down sides).
This wonderful lady said it out right to me....
                        If I was offered lumpectomy - I would want mammoplasty. If I was offered mammoplasty, I would want lumpectomy.

So, now I am at the other side of it and I can say when I was at the start of the journey I wanted my boob, both boobs off - to get rid of 'it'.

I was told having it done un-necessary could in its own rights cause my more problems. So, I went for lumpectomy and internal radiotherapy, done in one combined treatment and I can honestly say this was the best choice 'for me'.

Listen to what others say, it is your body and mind - you have to do what is right for you. 

here is a link to the treatment I had, dependant on where you live this treatment (if suitable) is available on the NHS at a handful of hospitals around England, most are London area.  There was a system call (?) 'Choose and book' of something similar.  If you fit the criteria for this treatment then they should be able to refer you for this (saying this you may meet with a lot of negativity at the start - I did at first, but once they knew I wanted this and nothing else the hospital staff were great and forwarded records etc on with no problem. 

Think it all through and go with what feels right with you - once you feel comfortable with the treatment plan the rest seems to go a lot easier.  I hadn't had an operation before, not stayed away from home type of person and I can honestly say, once I had this clear in my head it was all done without the worry you would associated with having an operation - I think because mentally every day we are preparing in our mind without knowing 'we are going to get this out'.  

Link to the treatment I had, they are amazing - you could even phone and ask if suitable how go about getting referred to NHS hospital for this treatment.

https://www.targit.org.uk

Wishing you all the best in whatever you decide - remember we are all here for you should you need us xxx

You explained everything so well. What I was also unaware of was that a mastectomy doesn't prevent recurrence, as the underlying tissue left behind is still prone to the cancer. This is not talked about enough, and many women are having unnecessary major procedures done 

I think that surgeons only do mastectomies if there is a reason like the cancer is multi focal,  is large in a smaller breast,  there's an area of DCIS as well or a generic reason.  My surgeon wanted a lumpectomy but I wanted a mastectomy as my sister had breast cancer which returned and I was worried some would be missed.  They found an area of DCIS  not seen on the mammograms (four of them!) or the ultrasound and told me that I'd made the right choice. The lumo was at the back of my breast and I was also worried about radiotherapy and damage to my heart as I have asthma and should have found breath holding difficult. 

It's a personal choice, and not always easy being lop- sized, wondering about  having a delayed DIEP in the future though. 

Hi, I just wanted to say that often the masectomy itself isn’t a choice, however you do have some choices around reconstruction or not. In my case I had masectomy and chose the diep reconstruction and radiotherapy was not part of my original treatment plan. Post op, I have just been told radiotherapy is now required in addition to 10 years hormone therapy. It’s a shock and I’m concerned that it will ruin my diep reconstructed breast. I guess I’m saying that there is no guarantee you would avoid radiotherapy with a masectomy, there are still certain situations that deem it to be necessary to reduce the risk of local reoccurrence. 
Mickey xx️