Anyone else have lumpectomy followed by breast reduction?

I had lumpectomy on R side and both breasts reduced during the same surgery. Probably because there was no question in my mind that I wanted smaller breasts. I went from DD to a C+, I would have been happy with a B!

I’m 70 yo, 7.7 mm DCIS, stage 0, intermediate grade, ER/PR+, HER untested. 5 days of partial breast radiation 30 gy ttl, tamoxifen recommended for 5 years. I’m 18 months into med.

Tamoxifen was chosen as I have lower risk for uterine cancer, lower risk for thrombosis, and I’ve previously had de Quervain’s tenosynovitis, and plantar fasciitis twice (meaning I’d probably have a lot of problems with connective tissue and tendon problems on an AI). I had terrible vaginal atrophy and dryness before BC diagnosis. With tamoxifen my vaginal area is getting estrogen as tam can act as an agonist (pro estrogen like) in body parts other than breast cells. I had headaches 24/7 and brain fog on 20 mg dose. Now on 5 mg. No headache, minor brain fog.

I wasn’t concerned about the breast tissue being jumbled. There is a systematic method to breast reduction. My doc did the “Wise” method - you can find it on the web, but it’s essentially an upside down W shape of tissue removed. Coopers ligaments help hold it all together and help shape the breast - the plastic surgeon keeps these ligaments in place. So they do know what tissue they are removing, and where it all will fit together. My lesion was in the lower outer right breast and the surgeon said when he removes tissue on one side, then all the breast tissue is shifted and moved over to fill the gap. They don’t cut chunks and move them around.
I have a “lollipop and smile” scar on both breasts that has faded pretty well. The cut line went around each nipple, then straight down to under the breasts and then a smile shape line under each breast.
Depending on breast size they can sometimes do only a lollipop cut, or may work only under the nipple. There is a difference in the general oncology surgeon skills and a plastic surgeon. For me, an oncology surgeon removed the lesion and then the plastic surgeon stepped in and reduced the breasts. It took 3.5 hours.
There is a non-binding law that during breast cancer surgery the insurance must cover adjusting both breasts if needed to make them symmetrical.

Sorry this is so long. Hope the info helps!
Tricia

This is so very helpful to me. Thank you.

I’m 60, had lumpectomy and breast reconstruction at the same time- they called mine an anchor- but sounds like smile/ lollipop as someone else said. ER/PR+ HER- invasive cancer 1.9mm too small for onco test but also took out DCIS 3cm. Breasts look great. Was a 36D went to 36C. I had 15 days of radiation with a boost. Started AI right after radiation ( I had a very mild menopause) anastrazole was a beast for me… literally mentally and physically put me in a tailspin. Took about a month being off it to feel good again. While on this…I ended up with a breast infection that felt like mastitis, Dr order MRI for brain from headaches- came back negative , had a sonogram-which they said I had cyst- Dr oordered breast MRI, which came back clear. Also ended up with lymphedema- mild case… I am currently taking exemestane . Some side effects, but not as many or severe . Insomnia was/is one. I am on my 5th month. After talking to my PCP not my oncologist. I am taking drug every other day- to see if it helps me so I can continue on it. I will be talking to my oncologist soon- I’m at MD Anderson. I do know everyone is different. I know people with no sides effects. I am considering going off it…

I had a lumpectomy in Oct 2021 for Invasive DCIS and was scheduled at a later date for reduction/lift. My surgical oncologist stated that they do not do a lumpectomy and reduction/lift during the same surgery because they want to wait for the pathology report to come back to see if there is clear margins. My margins were not clear and the surgical oncologist went in about a week later to clear the margins, and plastics did the reduction/lift during this second surgery. I am not sure of the procedure he used for the reduction/lift, but the technique did not require drains afterwards based on the type of internal stitches he used. Afterwards, I received 4 weeks of radiation and then targeted radiation of the tumor bed. I was told that the radiation will "freeze my breast in time" and I will not see drooping of the new breast. It is coming up on two years that I have been taking Anastrozole, and other than a bit of joint pain, I have been fine. Good luck to you and I wish you well!

@robbihm, you may also wish to review these related discussions:
- https://connect.mayoclinic.org/group/breast-cancer/?search=reduction#discussion-listview