Wide Local Excision verses Mastectomy

Hi there, Gosh I can remember being faced with this decision, no clear margin but also surgeon was pretty sure there was further tumor that couldnt be detected on scans. The MDT recommend a mastectomy, but I had to decide what to do 

In the end after much deliberation & crying I have to add I opted for mastectomy, to be on the safe side. Sure enough further tumor was found, but also it was an end to further & further rounds of surgery because of margin too.

It is so hard, but unfortunately sounds like you have been through this before, do your MDT have a opinion/ recommendation? 

Hi Kitty1  Thanks for getting back to me, no opinion as such, she thinks she can get a margin but no guarantees and she is not sure that the cancer has not spred further than they 1st thought, so still not sure what to do, but thanks for your help, nice to know I am not the only on this happens to

Hi, yeah, it's so hard, a mastectomy was the last thing I wanted but once they said they thought there was more I was just so worried about leaving it to chance......1.5cm more found that wasn't on scans. 

Best wishes x

Hi Lynyaneli,  This is a big decision and difficult because there is the unknown.  Are there any more tests you can have done like MRI so they could possibly see any hot spots?  So many women need to have reexcision done.  I had DCIS low and intermediate grade right breast and stage 1 invasive left breast.  2 lumpectomies done and then radiation.  The right breast with the DCIS (like to have 2mm margins for DCIS) had an issue after first surgery.  There was a very small area that had just less than 1mm margin but surgeon did not do another reexcision as my breasts are small 34A and he said cosmetically would not work.  So they took the data to the tumor board and after reviewing everything (age, area of concern, etc etc etc ) made the decision to do the 3 weeks radiation on both breasts and then a 5 day boost to the right tumor bed.  I had done lots of research as was concerned and seems like the larger Cancer hospitals like MD Anderson in Texas and Memorial Sloan-Kettering in NY do this for certain patients who qualify.  It is a hard and personal decision and I am sure you will get to the decision that eases your mind.  Take care of yourself.

Barbara

Hi Barbara  Thanks very much for experience, had type 2 in R breast all sorted after surgery and radiation therapy, left one, being a bit of a problem, border line type 3, they thought it was 4 to start with, but with additional tests and no further tumors found they decided it was border line, scans do not show up any more tumors, but no margin from previous surgery and all edges showing cancer cells, I have large breasts but will not have after next surgery if I go for the WLE so not sure if it is just better to bite the bullet and go for the mastectomy, thanks you for your info, people are very kind in sharing their experience and I am sure it will help me to make my decision.  Good luck everyone with your treatments stay positive and fight all the way.

Hi Lynyaneli,  I certainly understand with no margins that means more surgery.  It is difficult to make the decision for sure as both have their pros and cons.  Since you are large breasted would they do the WLE on the one breast and a reduction in your other one?  I don’t know if you had radiation in the other breast.  I am thinking of you as I know the anxiety .  Since I had cancer in both breasts I was seriously thinking of doing a mastectomy and then implants but I was so torn it took me almost 2 months to decide.  Even my surgeon told me it was a good thing I didn’t have an aggressive tumor.  Another problem for me is I want to know all the details and it made me even more anxious.  I didn’t want to make a decision based on my emotions but it was hard not to so I finally looked at everything and what the breast surgeon and radiation oncologist told me.  Finally once I decided it was such a relief as it was not a good state of mind to be in.  You are right about feeling positive I am finally there.  Had my first mammogram last week since surgery and radiation and it was fine.  Also saw my breast surgeon and he said all is great.  I am working on being on the other side of  treatment but I still think about it every day.  Hope you get to feel better soon and so many women are in the same position as you are right now so helpful information will come your way.
Barbara

Thanks so much good luck for the future