Lumpectomy Vs Single Mastectomy

Can only give you my experience. I was diagnosed with lobular - very hard to spot and size accurately. But was recommended a lumpectomy - took 2 ops to get a cLear margin on a 23mm tumour. 4 nodes out, 1 positive 

I’d say - even though in the end I had 3 operations - lumpectomy, then back in for clear margin , then back in to fix a hematoma …… it really wasn’t too bad and boob now looks normal in a bra (admittedly it’s not qUte normal when you look at it unclothed!) . The recovery was straight forward (extra ops aside!!) and I haven’t got to think about reconstruction o guess.

Im now having radiotherapy. 15 sessions. So can’t tell you what that’s like but I can tell you that having had 6 so far - it’s totally fine so far.

i asked my oncologist about lumpectomy with radiotherapy vs mastectomy and he said that oddly he gets better outcomes with the former. Go figure? 
so personally if I had the choice I’d go for least invasive operation. Having said that I have many moments of thinking - if I’d just got rid of my boob I wouldn’t have to worry about it coming back

its totally  personal Obviously  

Good luck 

Hi Fruitbat

I totally understand how you are feeling. It's difficult to make a decision like this.

If you have a lumpectomy there could be a risk of further surgery if the margins aren't clear. There is also a risk of a deformed or dented boob. However it does mean you keep your breast to some extent. You will need radiotherapy too and if the cancer does come back in the future (God forbid) you will have to have a mastectomy, as they can only radiate the area once (I think that is correct).

A mastectomy means the whole breast is amputated. The surgeon is likely to get clear margins. However, you will be flatchested on the one side and this could be mentally very challenging. Radiotherapy could also be avoided, but you may also have radio with a mastectomy, depending on your individual situation. There is the opportunity for reconstruction immediately or later down the line, but different reconstructions also have their own pros and cons.

I've opted for a mastectomy which I am having on Friday. I am freaking out about it somewhat as I don't know if I will cope mentally (physically the recovery is quite easy so I am told) but the main thing at the moment is ridding my body of cancer.

Good luck with your decision. I think you need to take into consideration your person as a whole, what you will worry about now but also in the future? It's so hard. Perhaps make a list? Seeing it in black and white might help.

Good luck lovely and big hugs

Jo

Hello,  just read your post and I think it is difficult when the surgeon gives you a choice without explaining everything.  A lumpectomy is also called a partial mastectomy in medical terms and I think that some women can be shocked if they need more breast tissue removed than they thought.  I can only let you know my personal experience.  I had bilateral lumpectomies as had DCIS in one breast and invasive ductal cancer with dcis in the other.  Tumor was small 3 mm and DCIS was 6 mm.  DCIS was not measured in the other breast as there were some scattered areas.  I am small breasted 34A so very glad I was able to have the lumpectomies and the outcome is really nice.  My right breast is a little smaller but not really noticeable.  I was scared because I knew I needed radiation to both breasts but did well and all in all am doing great.  Hate the Anastrazole hormone blockers though.  
I did not find the lumpectomies a difficult surgery.  I only took a pain pill the night of the operation and then nothing.  Now everyone is different and glad I did well.  No matter what you choose it will be the right decision.  

Doctors can do oncoplastic techniques too to help make your breast look good and if you have dents or issues post op with cosmetics lipofilling is an option too. 

I also think that radiation was the most difficult decision for me and if I had been in my 40’s or early 50’s I am not sure what my decision would have been. Take care and sorry if this is so long.

Hi C22

Thanks for the information. My tumor is 15mm, they say it's grade one and the MRI and ultrasound scan did not show anything in the lymph nodes but obviously that won't be confirmed until they remove them. Can I ask was your tumour able to be felt my hands or was it picked up on a mammogram check up? Trying to understand how many cases are there that have to have second surgery to get clear edges? My surgery is booked for October so got a few weeks to consider the options. Glad you are doing ok on the radiotherapy x

Hi Jo

I have everything crossed for you for Friday, I hope it all goes well  

As I have family history of BC, my initial thoughts are a mastectomy as in my mind this would be the best way to go, however now that I have been diagnosed, and have been given options I am so confused, and frightened of making the wrong choice and not getting rid of the cancer in one go and then getting back to my normal life. Can I ask how you came to your decision? Xx

Hi Barbara 

Thanks for the info, I am currently on letrozole and seem to be doing ok, am a bit more tired with achy joints. The lumpectomy seems to be less invasive surgery and seems to be quicker to recover from than a mastectomy however I am a bit frightened about the radiation afterwards. Was your lumpectomy successful at getting clear edges on the first surgery, was your tumour able to be felt by hand or was it picked up on a mammogram? I am glad you are doing great x

1. Hi,  the first surgery for the invasive ductal carcinoma was successful on the first try with clearance of 3mm margins.  I didn’t have a sentinel lymph node biopsy as my tumor was small and I was over 70 and not recommended so was glad.  I was 71 almost 72.  No tumors were felt in either breast.  Calcifications were seen on screening mammogram and an MRI picked up the small cancer in the other breast.  

The breast with DCIS was a little more complicated because one of the margins was about 1mm and they like 2mm or more.  They took my case to the tumor board and with the research etc the decision was no more surgery and instead get a boost of 5 extra radiation treatments to tumor bed.  Results have shown no difference in recurrence etc.  so that is what I did.  I was a bit apprehensive but after seeing research I was Ok because the studies show if there is a recurrence it is usually in tumor bed or close to it.  I was not a fan of radiation either but with the lumpectomy it is a partner. 
Mastectomy is definitely a bigger surgery with a longer recovery.  
I really do understand what you are feeling as there is no turning back so you want to feel right about your decision.  

Hiya

So I was diagnosed with lobular in August. Two areas found on mammogram but after the MRI a third area was found. So total area from one mass to the furthest mass is about 7cm and surgeon said he would need to take about 10cm to get clear margins.

I decided on a simple mastectomy with possible reconstruction at a later date as I want to be sure that the cancer is gone. If I had opted for a mammoplasty, I would be constantly worried it could come back in the same boob. Would I like looking at my breast again or would I resent my it being there, possibly growing a cancer again? For me, getting rid of it all means a break in worrying (although I'll still have my other one to worry about). I also don't like the thought of another surgery to get clear margins, which is fairly common, and have my treatment delayed.

It's a very personal decision and I agonised for weeks over it. When I told my surgeon I would have the mastectomy he looked relieved and said I've made a wise choice. Whilst I obvs don't want ANY surgery, a mastectomy was best for me.

Hope that helps. Good luck!

Jo xx