What to ask surgeon ?

Hi Gusmum 

The first thing to say is that studies have established that a wide excision plus radiotherapy achieves similar outcomes in cancer terms to a mastectomy, and it’s a much simpler operation to recover from, with fewer complications. They only recommend a wide excision if the volume of breast left behind is sufficient to get a good aesthetic outcome. So they wouldn’t be recommending it if it wasn’t the optimum answer for you. It’s unlikely to result in any significant symmetry difference. I had one, and other than a bit of dimpling on the side, plus the faint scar line, you can’t tell. 

The NHS doesn’t like to remove healthy tissue so they are reluctant to, say, do a double mastectomy when there is only cancer in one breast. The exception is people with BRCA1 and 2 defects who carry a higher risk of getting cancer in the unaffected breast. I have heard of people successfully using symmetry arguments to get a double mastectomy, based on the issues of being left with 1 very heavy breast. 

I would ask where they intend to make the incision, is it one or two (assuming they are also testing nodes), what impact will it have on breast volume and shape, and will it need drains. I would also get them to explain why this is the best surgery for you. 

Thanks 

When you speak to the surgeon ask them specifically what they are planning to do and what the anticipated cosmetic outcome will be. My surgeon actually physically showed me what she expected by moving my breast so I knew what to expect. She said if necessary we could consider “fat filling” later but, to be honest, there is actually very little difference between my boobs and I’m more than happy with the outcome. I guess it depends how much tissue is removed and where in your breast the tumour is. Mine was at the bottom so I have a neat little scar in the curve under my boob and then a very small one in my armpit, both are hardly noticeable. x