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!

Interested in more discussions like this? Go to the Breast Cancer Support Group.

@roch

@mjmac

From your other posts, I see your taking Letrozole to shrink your tumor before surgery.

I happen to run across this article, which is the question you were asking back in Aug. It does not give a definite answer because every treatment plan is based on the individual, It does list things to consider, most have already been suggested by other members.
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-how-to-decide-which-breast-cancer-surgery-is-right-for-you/
What surgery did you decide on? Sorry if you already mention it and I missed it.

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Hi Laurie,
I have not decided yet. I go in for 3 month check up to see if tumor has shrunk. Iā€™m hoping it has but if not then I need to decide if I can take another 3 months of waiting.
I know the waiting was hard for you as well. Did you wait the whole 6 months?

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@mjmac

Hi Laurie,
I have not decided yet. I go in for 3 month check up to see if tumor has shrunk. Iā€™m hoping it has but if not then I need to decide if I can take another 3 months of waiting.
I know the waiting was hard for you as well. Did you wait the whole 6 months?

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Hi, I wanted to update my post to you from a while backā€¦ I just had a bilateral mastectomy last Thursday. I had chosen this route because after 3 lumpectomies I still had DCIS in the margin plus they found a little invasive and LCIS as well.
The pain for me has been minimal so far, sort of a gravity pull when I stand up and a bit of general body ache in the late afternoon. I think some of this is due to wearing the compression wrap 24/7 because your body expands and contracts throughout the day. Tylenol has been my friend but I havenā€™t needed anything stronger.
My pathology came back 2 days ago and there was still nearly 3 cm of DCIS in my previously affected breast and atypical lobular hyperplasia (ALH) in my unaffected breast . This tells me I absolutely made the right decision in having the mastectomy. Who knows how long it might have been before I had cancer in that breast as well? I would not want that constant worry. I am 55 years old, ready to live the rest of my life ā€¦ flat and fabulous! 💕

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I'm so sorry that you have had to go through this since June. It is good to have your specialists provide treatment options but it is also good to learn more about the experiences of others. Although we are a diverse group with different staging and options the question relating to lumpectomy and mastectomy remain one many of us grappled with. Its a very personal decision. Carefully consider the feedback from your medical team and then make a decision based on what is best for you at this moment in time. Personally I had a lumpectomy and 15 years later had a bilateral mastectomy but even if I think back at my initial diagnosis. The lumpectomy was a good choice at the time. With my increased understanding and how treatment options have evolved, I think my choice now based on my lived experience would have been a mastectomy. There is no clear cut right or wrong option. Allow yourself to make a decision and to be comfortable with whatever you decide. Be kind to yourself. It will be a journey and not just a moment in time. We look forward to supporting you regardless the treatment option you decide is best for you and your loved ones.

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@mjmac

Hi Laurie,
I have not decided yet. I go in for 3 month check up to see if tumor has shrunk. Iā€™m hoping it has but if not then I need to decide if I can take another 3 months of waiting.
I know the waiting was hard for you as well. Did you wait the whole 6 months?

Jump to this post

@mjmac
I was part of a research study to see if anastrozole would shrink tumor and ki67 level, which it did. I stuck it out 6 months but was SO ready to get the cancer out. I had lumpectomy and two positive lymph nodes removed. I had terrible time while on anastrozole prior to surgery. I would cry constantly. I stopped anastrozole few weeks prior to surgery and almost immediately felt better. I refused to take after surgery, but I did tried other AIs instead.

Everyone reacts to drugs and treatment differently. It would be great if there was a one solution that fit everyone, but we are all individual.

If tumor is shrinking, it is worth the wait. It will give you more options. Most important thing is to advocate for yourself.

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@roch

@mjmac
I was part of a research study to see if anastrozole would shrink tumor and ki67 level, which it did. I stuck it out 6 months but was SO ready to get the cancer out. I had lumpectomy and two positive lymph nodes removed. I had terrible time while on anastrozole prior to surgery. I would cry constantly. I stopped anastrozole few weeks prior to surgery and almost immediately felt better. I refused to take after surgery, but I did tried other AIs instead.

Everyone reacts to drugs and treatment differently. It would be great if there was a one solution that fit everyone, but we are all individual.

If tumor is shrinking, it is worth the wait. It will give you more options. Most important thing is to advocate for yourself.

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I had chemo and radiation before my surgery. The biopsy only showed one lymph node infected so they gave me the option of a mastectomy or a lumpectomy. I opted for the lumpectomy and the surgeon said everything had pretty much turned to dust after all the other treatments. She ended up removing about 20 more to be on the safe side. So far, so good! Best of luck to you!!

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@meg55

Hi, I wanted to update my post to you from a while backā€¦ I just had a bilateral mastectomy last Thursday. I had chosen this route because after 3 lumpectomies I still had DCIS in the margin plus they found a little invasive and LCIS as well.
The pain for me has been minimal so far, sort of a gravity pull when I stand up and a bit of general body ache in the late afternoon. I think some of this is due to wearing the compression wrap 24/7 because your body expands and contracts throughout the day. Tylenol has been my friend but I havenā€™t needed anything stronger.
My pathology came back 2 days ago and there was still nearly 3 cm of DCIS in my previously affected breast and atypical lobular hyperplasia (ALH) in my unaffected breast . This tells me I absolutely made the right decision in having the mastectomy. Who knows how long it might have been before I had cancer in that breast as well? I would not want that constant worry. I am 55 years old, ready to live the rest of my life ā€¦ flat and fabulous! 💕

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Yes it sounds like you absolutely made the right choice!
Best wishes on your recovery. 💕

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I am in the same place you are, need to make that decision...

I completed 6 rounds of chemo and after my post chemo MRI it was determined that the tumor had only shrank .6cm! A little depressing and on top of that, the MRI detected a NEW spot that is .4cm in a different area! How can that be I asked when we are throwing all of these drugs into my system. Unknown is the answer....

The ultrasound and Mammogram were inconclusive to what the new spot is. So I am having an MRI guided biopsy next week and will get the results before my surgery which is scheduled for 11/5. If the new spot turns out to be cancerous or something that is concerning, then I will opt for a mastectomy. Because I feel it will be safer for me as a whole and I have small boobs and if I elected for a lumpectomy on both spots, I would not have much boob left anyway!!! šŸ™ If on the other hand, it is a benign "something", I will proceed with a lumpectomy. For a historical reference, my Left boob will have had 4 biopsies after this one next week. Only 1 of 3 was cancer. My cancer has not spread to my lymph nodes and is Triple positive.

For me, I felt the lumpectomy was the best choice. Even though it has not shrunk much, I would like to keep my girls as long as possible. This is a CHOICE that we get to make, no one can make it for us. We are our own best advocate and know our bodies LONGER and BETTER than anyone else does.

Weigh your pros/cons and go with the decision that makes sense to YOU.

Good luck! We have this...

Tits UP! 🩷🩷

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@mjmac

Yes it sounds like you absolutely made the right choice!
Best wishes on your recovery. 💕

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Thank you!

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I just finished 18 weeks of chemo and am opting for skin sparing bi lateral mastectomy. Iā€™m 57 years old so having reconstruction at time of surgery. No cancer found in my other breast but my invasive ductal carcinoma showed up out of nowhere (my dna test was negative). So I canā€™t risk it. I want this chapter over and Iā€™m so relieved to have finally made the decision. Meeting with plastic surgeon today. Will be 4 weeks recovery. Good luck, I know itā€™s a hard decision.

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My surgeon gave me the option of a lumpectomy or mastectomy. I opted for the lumpectomy and was glad I did as the tumor had turned to just about dust. I had chemo and radiation before my surgery. Now I am on an AI (Exemestane) and so far so good!!

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