Mastectomy or Conservative Breast Surgery

Hi, if you want to chat through the pros and cons, the lovely people here at Macmillan can help. You can call them on 0800 808 0000.  Best wishes, it's tough when we are given these decisions, I know I’d prefer just to be told. 

Hello Vicky,  I know it is difficult to decide when you are given options.  If you are a stage 1 the description is below:

Stage 1 invasive ductal carcinoma

When a breast tumor is smaller than 2 centimeters in diameter and the cancer has not spread beyond the breast, it will be classified as stage 1.

I guess my first question would be why the mastectomy.  I guess if you had very small breasts and the cosmetic outcome would not be good it makes sense.  
Sometimes women cannot or don’t want radiation treatments so they can opt for mastectomy and sometimes avoid radiation.  

My personal experience involved having bilateral lumpectomies followed by radiation treatments.  One had DCIS and the other stage 1 invasive.  I am small breasted only 34A so was glad I could have my breast conservation surgery.  
It is important to ask questions and I agree about talking to the Macmillan nurses.  I live in US so don’t have that option but my surgeon was wonderful and explained it all to me.  

Not an easy decision and I understand how when faced with these decisions everyone has an opinion but my take is to go with the science.  
Take care

Barbara

Hi Vickyx 

You may have already looked at this but this link to Cancer Research UK is useful.

Choosing between lumpectomy or mastectomy | Breast surgery | Cancer Research UK

The area they had to remove was large but  I had breast conserving surgery and reconstruction and I am pleased with the results.  It is a very personal decision and I wish you good luck with your choice.

My question would be what is the type of cancer?  I am triple negative and a BRACA 2 carrier. A grade 3 cancer. What ever route I went I would have to have chemo..  This despite it was stage 1. I had a double mastectomy with breast reconstruction. 

More questions to be asked might be the way forward.

Hi Vicky, that is a similar diagnosis to mine. The DCIS was large (6cm). The way it was explained to me by my surgeon was that they had moved away from mastectomy as the only option as psychologically it could be hard and the physical recovery from a mastectomy was not always plain sailing. So I think that is why they give women the option if they think it is feasible. Research shows the results are the same (over 20 years I think) if you have breast conserving surgery + radiotherapy v mastectomy. What i would say with BCS there is a risk that they may have to do a re-excision to get the margins but it is a low risk. Talk to your breast care nurse that is what they are there for, these decisions are never easy and it is a personal choice. Good luck! 

Hi Ricki, I also have stage one triple negative and carry the PALB2 gene meaning I have 30% chance of recurrence in my life time. I am now 59. I think in terms of risk limitation I think I will also have a double mastectomy  but was veering against a reconstruction as I am a small 5ft 3, 8.7 stone woman - had a lot of unrelated surgery this decade and can’t face too much more invasive surgery. How did you find the surgery/recovery if you don’t mind me asking.

Jan 

Hi Jan  A very good question. The surgery and recovery with hindsight was more straightforward than my treatments,  EC and Paclitaxel. That said I knew I wanted to keep my breasts and the option if possible for me was not going flat.

I am 71 years old, 5ft 4inches and weigh 8ibs 12ozs. I had every confidence in my breast surgeon.  There were 2 teams doing the operation and my breasts are symmetrical. Coming home with 4 drains was a challenge but doable. My breast surgeon said that is the hardest part. I had to have breast implants because I didn't have enough body flesh. I massaged my breasts with E45.

I had an amazing oncology physio and we are still in touch a year on.  The goal was to get ne back playing tennis. I am now playing and it feels good.  Pilates and yoga has helped. I am please I can wear a normal bras and have a proper cleavage,  I also wear a normal swimming costume.

I hope this helps.  There is not a right or wrong choice.  It is what is right for you. All the best

Hi Vickyx

Grades and stages are very different things. I was stage 1 and grade 3 cancer.  Worth checking

Hi Vickyx,

I had the same question asked to me 5 years ago now and like you I wasn't sure. I chose to have breast conserving treatment instead of mastectomy. I also had radiotherapy. Looking back I don't think I was given the time to look into the options or really understand what the different outcomes would entail. I was told I had lobular breast cancer, I had the 2 options and would probably need chemo and radiotherapy, luckily after tests I was just on the fence for chemo and the surgeon decided that I should ust have radiotherapy. I felt I was made to make a decision there and then. My lump was big and right near the chest wall. 

So I had a breast conserving operation but my margins were not clear so had a 2nd operation, after this treatment my breast was alot smaller than my right breast and shrunk further after 23 sessions of radiotherapy. Now I am having reconstruction surgery, my first operation was as you described, they used the chest wall and tissue/fat from under my arm to fill my breast, however, they had to remove alot of scar tissue first which left a bigger space than anticipated so now have to have lipo filling operations, maybe 4 or more to build it up completely. 

As you can imagine it's been a long 5 years but I'm so grateful I'm still here and have always remained positive. In hindsight if I'd know then what I know now I would have had a mastectomy but saying that, I'm still on a positive path and I'm sure the end result will be great. 

I have had blips along the way and who knows what's in front of me but I choose what I thought was the right path for me at the time with the information we had and even though it's not quite gone to plan, I am still well and enjoying life. So no matter what option you decide just remain positive and know you will reach the end of the tunnel and will be able to get on with your life, it might not quite be the path you wanted but it's a path none the less and you will get through it. 

Sorry I've rambled on but I know I wish I had spoken to someone who had taken the same path so I knew what could be ahead of me but ofcourse your path could be very different from mine. 

I wish you luck in whatever you choose. Please don't hesitate to ask me anymore questions. 

Big hugs x Sue x