Lumpectomy + radiation VS Mastectomy -- pros cons?

I don't have the same type of cancer, I have medication resistant TNBC, was diagnosed in Aug 2023. Just to give a bit of background, after 6 months of chemo, and immunotherapy I decided for a bi-lateral mastectomy in June 2024, along with reconstruction. After those 2 surgeries, they started my back on the Immunotherapy (no radiation) and was taking it through February this year. After the immunotherapy was completed, a CT was completed which found another tumor and I had to go for a partial-mastectomy and am in the middle of 30 radiation treatments then my oncologist wants to have me take capecitabine next.

With that being said, it is such a personal choice which to go with, for me it made more sense due to the higher odds of TNBC coming back and just hoping that it would alleviate some of the fear of it coming back. I am tolerating the radiation pretty well so far, today is the half way mark, it is just causing tiredness which that is a normal side-effect and also it can cause the tissue to harden (think scar tissue).

I wish anyone reading this good health for the future, keep positive and listen to what your body is telling you 🙂

I was also given the choice of a mastectomy or a lumpectomy. I had previously had radiation and chemo. Between the two of us, we went with the lumpectomy, The previous treatment had all but obliterated the bad lymph nodes and and she removed 20 more. I decided to leave it up to my Dr. as I felt she knew more about it than I did. Everything went well and I am doing great!!!

My cancer has been in my left breast all 3 times. The first was a tumor. Had a lumpectomy, radiation, chemo. 2nd time was a calcification that was cancer- DCIS. Mastectomy only.
The 3rd time was in pretty much the same place as #2.
I'm sure that radiology will recommend radiation, but TBD.

@geet69 It is interesting, the partial mastectomy in April was for a tumor that was in the exact same space as the first one they found, so much so that my oncologist was suspicious that the original surgery didn't get it the first time. I get it is difficult to go in there and figure out what should be removed and what should not. The 2nd one they put a wire that the surgeon could follow to it, and I asked the oncologist to do a CT scan to make sure it was truly gone (didn't do that after the first surgery)

If I can add one comment to sschafer, I too had TNBC. Check out the MD Anderson study on lipophilic statins and TNBC reoccurrence. I now take Lovastatin,
On the mastectomy decision, I decided to have a total mastectomy with no reconstruction. I am now 76, 4 years past diagnosis. I found that one of things that was never discussed with me was the possibility of lymphovascular invasion and microscopic DCIS. Neither of which is known before surgery. I wanted one and done and to get on with my life.

I love my new body as well! I am hearing women going through multiple lumpectomies and radiation, along with taking medication. Again, your body, your choice but, the double mastectomy was what was best for me. I would recommend this route personally, as it removes the mass/masses and reduces the likelihood of recurrence. Best to you in your living your best life cancer free!

To me, it seems that all choices are SHIT. LOL We have to choose the better of the crappy. I've also learned that there is A LOT of nuance in every case. It is most definitely not a one size shoe fits all. ALSO, you can start down a path and be re-routed quickly.

I chose a nipple sparing double mastectomy after chemo at the advise of my plastic surgeon and my sister (She is a nurse in a wound clinic and sees lots of radiated skin). I'd read about the nipple preservation option and requested the surgeon TRY. (The surgeon counseled that he may not be able to save the nipples because of the tumor location but he would attempt it). I am 2.5 months post surgery. The surgery was successful, NOT perfect but good. In a shirt you would never be able to tell I had a mastectomy. You can tell in a bathing suit. (I am 41 years old)

I would not change my decision if I had it to do over.

I hope you have peace no matter your decision!!

Thank you for your advice. It sounds like radiation is brutal. I hate the thought of doing either. Appointment on Tuesday with the surgeon

You are right. It all seams crappy. I think if mastectomy is my decision then I have another hard choice on reconstruction or not. I think making a decision and going forward and feeling good about my choice is so hard. Change my mind every day

When do you have to make the decision?