Lumpectomy vs Mastectomy

Hello Bettie,  oh these decisions are always so difficult as have to weigh pros and cons for both.  Since you were stage 1 that is good news.  It is important to remember that breast cancer can also return after mastectomy too as they can never remove all the breast tissue.  I live in Florida so lumpectomies are more common in the US.  However we always have a choice here to have either.  I think you are doing the right thing by taking everything into account.  By the way are you older as that can make a difference in your choice too.  Hugs to you and you will do the right thing.

 I had 2 lumpectomies age 72 one for DCIS and the other for stage 1 grade 2 IDC.  Had radiation after that.  16 treatments to both and 5 boosts to one breast.  I am doing well and feeling good even though I take hormone blockers. Since you were TNBC no hormone blockers needed.  

Hi Bettie,

I'm in England and I was told that the type of surgery was completely my choice. I ended up going with their recommendation which was a lumpectomy as well as surgery to the other breast to maintain symmetry.

You might want to ask them whether the risks are different for a mastectomy vs a lumpectomy and whether there is a difference in recovery times (I was advised not to do any heavy lifting/anything stenuous like vacuuming for 6 weeks after the lumpectomy and my chest ached for about 3 weeks which made it difficult to find a comfortable sleeping position).

I would also ask whether the mastectomy will change the adjuvant treatment plan and if so, what the side-effects would be. You could also ask what the chances of cancer recurrance are for the different surgeries, this might put your mind at ease if you decide on a lumpectomy.

I wonder whether they assume that you'll be concerned about body image after surgery so, unless there's medical reason to consider, I guess they prefer the less drastic option. But, if you'd feel more comfortable with a mastectomy then I guess they would take your preference into account too. I think operating on both breasts was recommended for me as I'm relatively young (40) and I might have hated being lopsided (half to a full cup size different - I'm approximately a 32D) so may have asked for a corrective surgery afterwards. I did consider simply adding extra padding to one bra cup though so you might also want to ask about mastectomy bras and prosthetics if this is important to you.

Thank you for the reply Barbara
i understand that it can still return after a mastectomy. I'm even more unsure now.It's the thought of having to go through this treatment again that is edging me more toward the mastectomy should the team agree to it of course.

I'm glad you are feeling good and i wish you well for the future x

Thank you for the reply ScienceGeek
You have raised some good points for me to bring to the meeting with my surgeon, thank you.
I am about to turn 60, and body image isn't too important to me. Beating this cancer is my main concern as the thought of it returning scares me to death. 
I will be entitled to 2 prosthetic bras free of charge per year after surgery, so i'm ok there.

Again, many thanks for the reply and i wish you well for the future x

Bettie

Hi Bettie , it’s a difficult question and I imagine there are pros and cons either way. It’s great though that you are asking the questions now. Another question I’d suggest is (unless you already know the answer) - will having a lumpectomy rather than a mastectomy mean that you will be recommended to have radiotherapy? The reason I raise this question is from my particular experience - I had a lumpectomy and sentinel node sampling. After my surgery results which luckily showed good margins and negative nodes, I had my oncology appointment where I signed up for radiotherapy and hormone treatment. The oncologist told me that for my stage and size of lump, a lumpectomy plus rads gave the same result/ prognosis as a mastectomy. My immediate question to him was, if I’d had a mastectomy then presumably I wouldn’t need the radiotherapy? He agreed but said that in my case a mastectomy would have been regarded as over treatment.  And I wasn’t given the option anyway, and obviously by this stage it was too late. So I had 3 weeks rads and am still taking Anastrozole. My point is (sorry such a ramble) that it’s good you’re asking now. I didn’t think of even asking about a mastectomy but if I am unfortunate and have another cancer in the other breast, I would definitely be asking about whether mastectomy was an option. It seems to be assumed that everyone would rather have a lumpectomy if it’s possible. 
Good luck with it all, love and hugs, HFxx