Lumpectomy or mastectomy that is the dilema. Any insight would help.

Perhaps your body image is the major factor at this stage. A lumpectomy will leave you with your breast. But Sometimes the surgery leads to the need for the mastectomy when the surgeon actually sees the cancerous tissues. Personally I had no strong need to keep the breast and my surgeon was clearly in favor of a mastectomy. Turned out she was correct—more tumor than expected, more lymph nodes involved than expected. But yes, getting the cancer out is number one! Your surgeon will take care of that when the time comes. Good luck in your journey.

It all comes down to personal choice, but my original dx is Grade 3 HR+ DCIS.
A recent MRI and US showed another area in opposite breast and also a suspicious area on DCIS side. I go back next week for biopsy of each.
I do not carry the BRCA genes, I have no family history of BC. However, for better peace of mind, I am choosing DMX aesthetic flat. My boobs aren’t that important to me. I am in 2 great groups with women who chose the same and they are living life to the fullest. It has been very encouraging to read their stories.

I was diagnosed in May with bilateral DCIS, HR+, grade 3 in the left, grade 2 in the right. I've opted for bilateral mastectomy but it took me awhile to get to that decision. My oncologist advised that the lumpectomy could leave my left breast very deformed. I started thinking about mastectomy as a result and then read here that some women regretted not having mastectomy because they had a recurrence. That sealed the deal for me. My mastectomy is scheduled in a couple of weeks and will follow up with a DIEP flap procedure.
I would add that I do not carry the BRCA gene but do have a family history with a maternal aunt, paternal aunt and a first cousin.
Best of luck with your decision!

I was diagnosed 5 years ago at Stage 3 of right breast only with some lymph involvement. My surgeon gave me both options 'though he was leaning towards the mastectomy. I started on 7 months of Letrozole to shrink the tumor hoping to avoid chemo. No such luck. I chose the lympectomy because a) my left breast was "pristine" (my surgeon's words) and b) it was out patient surgery with shorter and easier recovery. I did have 7 of 13 lymph nodes involved which made chemo and radiation necessary. I'm not vain about my breasts, but even with the tissue removed I'm not obviously "lopsided" which is what I was going for. I'd make the same choice today. The one drawback was the first surgery did not produce clear margins (cancer cells were found in the area beyond the tumor) so I had a second lumpectomy which was successful. The second procedure was a piece of cake, and as it included implanting a port for chemo it it was going to happen anyway to a certain extent.

@mjmac

Welcome to Mayo Connect and glad you have found helpful.

I was in similar situation five years ago, tumor in one breast and one positive lymph node. I took part in study of taking AI for 6 months to shrink tumor, and it did shrink. I used that time to get as healthy as could prior to surgery. But was definitely ready to get cancer out when came time for surgery. I went for lumpectomy, and even the day before surgery I was questioning my decision.

I did genetic testing to make sure I did not have a genetic reason for cancer. I did not. My sister had similar diagnosis years before mine and had same surgery I did.

Surgery went well, removed tumor and two lymph nodes that were positive. Easy recovery. I then had chemo, radiation and AIs for awhile. Could not tolerate AIs, so no longer take. Was monitor by an oncologists for 5 year now just have mammograms and MRIs 6 months apart ordered by my primary. I have dense breast so that is why I do MRI in addition to mammograms.

You can never predict the future or if cancer will comeback. My oncologist told me surviral rate is same for both procedure. If I did a lumpectomy and cancer returned, he would just treat again.

Susan G Komen foundation has a page that talks about making this decision:
https://www.komen.org/breast-cancer/treatment/type/surgery/mastectomy-vs-lumpectomy/
Another article from Susan Komen foundation on genetic testing:
https://www.komen.org/breast-cancer/treatment/issues/genetic-testing-after-a-breast-cancer-diagnosis/
Each individual has to evaluate the options based on their situation.

Did you have genetic testing? It might have an impact on your decision.

Thank you for your input. I have a meeting with plastics next week, then with surgeon & oncologist to come up with a plan.
Talking with my surgeon I asked about one choice being better than the other and she believes the outcome would be the same.
Good luck to you as we travel this bumpy road.

I also had a questionable area in my right breast and had it biopsied, it came back negative. These groups are wonderful, good luck with your biopsy.

This is good article from Breas Cancer.org on different type of breast plastic surgery if want to familiarize with terms prior to appt.
https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types

Thank you for responding and the best of luck with your surgery. To be comfortable with your choice is what I’m aiming for.

I also am hoping to avoid chemo and as it stands right now I can but I know this could change and I will do whatever it takes to beat this!
Thank you for your positive outlook and your obvious strength. Best of luck!