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

Posted by mjmac @mjmac, Aug 8 5:52pm

Hello,
I have been reading posts since shortly after I was diagnosed in early June with ILC. It has been quite informative, has made me hopeful, and I am greatful that this sight and you all exist to help with the feelings of helplessness an uncertainy when diagnosed with BC.
It has taken this long to get all of my tests and I am now to the point of making a decision about treatment. My bone & PT scans were clear, 3 lymph nodes tested positive and my onco score is 11. The tumor is border line for lumpectomy and my surgeon has given me a choice of staying on Letrozole and shrinking tumor size for lumpectomy or having a L breast mastectomy. Everything in me just wants the cancer out of my body but is that the best solution? Any input on both procedures would be most helpful. Thank you!

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@tullynut

It has always been attributed to radiation and showed up on my fist scan after chemo/radiation ended. At first they said it would go away. It didn’t, however I have good lung function, no cough. So I don’t need to see pulmonologist unless I develop symptoms For a time they were suspecting radiation induced lung injury but no longer. I found one study of breast cancer patients who had a lung scan sometime after radiation. They found a group like me who looked like they had RILI but were otherwise asymptomatic.

If you have pulmonary symptoms the pulmonologist should have an idea if radiation induced lung ng injury is at hand If you had pulmonologist nary symptoms before, radiation may not be a factor?

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I chose mastectomy for both. Even though the dr said I just need the one breast removed. Why? Because I wouldn’t trust my breast tissues again. Good luck with your decision. Do what you really feel.

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@tullynut

It has always been attributed to radiation and showed up on my fist scan after chemo/radiation ended. At first they said it would go away. It didn’t, however I have good lung function, no cough. So I don’t need to see pulmonologist unless I develop symptoms For a time they were suspecting radiation induced lung injury but no longer. I found one study of breast cancer patients who had a lung scan sometime after radiation. They found a group like me who looked like they had RILI but were otherwise asymptomatic.

If you have pulmonary symptoms the pulmonologist should have an idea if radiation induced lung ng injury is at hand If you had pulmonologist nary symptoms before, radiation may not be a factor?

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My first diagnosis was radiation induced pneumonia especially as it was on the side of radiation only. When it would come back, it’s in the form of organizing pneumonia in both lungs. I’m hoping this is it and am done.

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@zeerj

My first diagnosis was radiation induced pneumonia especially as it was on the side of radiation only. When it would come back, it’s in the form of organizing pneumonia in both lungs. I’m hoping this is it and am done.

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I hope so too!

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@hopeful2024

Wishing a positive journey !
I also have had both removed and am flat and happy !
I pray for you to have the same result of cancer free!!
Hopeful 2024

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Thank you! I was hoping to avoid mastectomy but my gut is telling me it’s the right thing to do. I’m worried about what else might be floating around in there! I hope you had a good recovery? I’m a bit anxious about that.

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@meg55

Thank you! I was hoping to avoid mastectomy but my gut is telling me it’s the right thing to do. I’m worried about what else might be floating around in there! I hope you had a good recovery? I’m a bit anxious about that.

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Yes my recovery was quick. I was off from my desk job a week. Take it easy though. Don’t do like I did. I was about and doing about everything like usual. I think this might have attributed to the cording. I had lymph nodes removed as well. I don’t regret my decision. I’ve met a gal from support group. She had lumpectomy about 4 years back and when it came back, she opted for mastectomy. Good luck with your decision. Deep breath and life will come back to close to normal.

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I'm sorry you're on this journey - but here's my experience and my decisions. I was dx with BC Nov. 21, it was later determined I was TNBC then BRCA2+. My age, family history of longevity, my goals all helped play a role in the decision I made. I was 68 at the time, there was no family of BC in my family; but in my early 30's was dx with "border-line" ovarian cancer (might now be considered stage 0 or 1); father and grandparents all passed from natural causes in their 90's (so I can live a long life). I chose (after researching and talking with my doctors) to complete chemo then bilateral. I believe TNBC BRCA+ has a higher recurrence rate even on the other side, I believe the recurrence rate is also higher within the first 5 years after dx. So off went the breasts - no longer needed them and its taken a while to come to terms with the decision I made - but I believe it was the right decision in order to minimize recurrence and live to see my new grandchildren graduate at least high school. I have both the medically prescribed prothesis and the "knitted knockers" I made which provide shape without the added weight and are great for the summer heat.

My best to you as you make your decision. It's not an easy decision but you will know what is right for you based on your dx and where you are in your life when you make the decision.

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@eaglewings22

You have lots of good info from many here. I'll add my experience and hope that you will come to a decision that seems right to you. I remember being in your situation and going back and forth many times! My initial strong response to my diagnosis was to have a total mastectomy, which my medical team did not think was necessary or advisable. It took the surgeon talking to me a long time to help me understand that the mastectomy was not more protective of future recurrences, and that a smaller surgery was more likely to minimize infection/additional side effects. I'm grateful they were so straightforward with me and cited so much research to back their recommendations to help me settle down about it!

I was dx with ILC (4.2 cm), Stage 1, Grade 1, sentinel node plus 3 nodes all negative. I decided to have a lumpectomy using oncoplasty (breast surgeon plus plastic surgeon). My surgical breast tissue was "fluffed up" to fill in the lumpectomy site via a small incision around half of my nipple, and then a breast lift using the same incision was done. The plastic surgeon did a breast lift for symmetry on the opposite breast, using the same type of incision. I am very happy with the outcome and after a year and a half, the scars are barely visible. I received 15 radiation treatments, plus 7 boosts of the tumor bed, which over time did make the radiated breast slightly smaller...

I was treated at MD Anderson in Houston and very happy with my medical team. Sending love and wishes for increased clarity to my ILC sister! Good luck!

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Oh my gosh, very grateful for your post! I was wondering about the other breast and what would be done for symmetry. Were you on Letrozole to shrink the tumor, if so for how long? My surgeon says 6 months then the surgery. Since I have lymph nodes affected I will need radiation regardless of my choice and I’m good with that. It’s the waiting to see if the Letrozole is working that concerns me. I have a plastics appointment this Wednesday, after that more consults with surgeon & oncologist. Hopefully at that point I will come to a decision. Thank you ILC sister ☺️!

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@gooch34

Hi, in April 2024 I had a right breast mastectomy for stage 0 DCIS. I have issues with AFib & diabetes, so decided to just remove it & I wouldn't need chemo or radiation treatments. They actually found a stage 1 inside the breast tissue that was removed & said good thing I opted for the mastectomy, which was my choice& went flat. Im 70 yrs. & rather be safe. Now I'm having to take Anastrozole for 5yrs. I started a few weeks ago & am having lower back pain, sciatic with my leg actually giving out pain & am thinking of stopping the medication. I'm reading to many side effects!! I also had a full right knee replacement surgery 2 months ago, just after the mastectomy. What should I do about this Anastrozole for cancer? I'm tired & scared of all the side effects that's a possibility of getting.

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I’m so sorry you’re having such trouble. Maybe your Dr can find a medication that will work for you. Best wishes and thank you for your input!

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@claudiaovando1

I was diagnosed with DCIS 1A in left breast, the surgeon advised me that due to being localized lumpectomy was the best road because of shorter recovery period and same outcome with mastectomy. I did radiation after lympectomy and my margines were clear, my lymphnodes were clear. I did not do chemo, but I am doing Lupron with Letrozole. I started feeling something weird on my right breast and long story short it was just fibroadenoma. But, at that time I questioned myself for nor just have both breast taken out for a peace of mind. But, I had also read women who have had mastectomy and had the cancer come back. So I think that if I were you I would listen to my body, what is your body telling you? Also if it is not localize and you have more than one spot then maybe is best to go with everything. In my case if this cancer returns I will go with everything mastectomy and chemo. I pray you make the right decision for you and remember always listen to your body it will tell you what is the right thing to do.

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Thank you, I have read that same thing as well as my surgeon saying the outcomes are pretty much the same. I am leaning toward a lumpectomy but will wait until I see plastics dr and get my info from surgeon & oncologist.
Good luck to you!

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@zeerj

Yes my recovery was quick. I was off from my desk job a week. Take it easy though. Don’t do like I did. I was about and doing about everything like usual. I think this might have attributed to the cording. I had lymph nodes removed as well. I don’t regret my decision. I’ve met a gal from support group. She had lumpectomy about 4 years back and when it came back, she opted for mastectomy. Good luck with your decision. Deep breath and life will come back to close to normal.

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Thank you so much 💕

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