Lumpectomy??

I had IDC stage 1a in 2022 and because the cancer was very small, I opted for lumpectomy. I had 19 sessions of radiation after and endocrine therapy (Zoladex, Letrozole, 2 years) then switched to Tamoxifen. I have been NED since. I say, whatever helps you sleep at night for your decision and do what you want, not what others are doing/ have done. I feel confident in my decision but does the fear ever really completely go away, no. However, I exercise, eat very healthy, stopped drinking alcohol and practice stress management and live my life in confidence of health while also continuing 6 month Oncology check ups.

I had a lumpectomy three years ago for the removal of a rare neuroendocrine tumor in my left breast. The scar is barely visible, due to location, and healed easily. However, I still have some pain and stiffness towards the armpit, but stretch every day. I had 15 radiation sessions and am on letrozole. All of this has been fine--some minor fatigue with radiation. Even with a mastectomy you might be offered estrogen inhibitors if appropriate. The outcomes, I was told, are close to identical for lumpectomy/radiation and mastectomy. What are your concerns? Have you tried journaling the pros and cons--for you--of each option? Since outcomes are similar (unless you've been told otherwise), basically you can make this decision based on what you think will be best for you emotionally. I'm very happy with the lumpectomy as I have large breasts and a huge amount of scarring on my torso due to an earlier emergency pulmonary surgery. However, I know several women who are satisfied with the mastectomy. Keep in touch if you want to as your decision making evolves.

I had a lumpectomy 2 months ago and am so happy having done that! Several docs called for a mastectomy (their opinion: better safe than sorry in cash more tumors decide to show their face; my opinion: I don't suspect that more tumors will come within the next 5-10 years, and I am happy with that). Other docs said partial mastectomy. I chose a new oncologist who had given me second opinions before, and I hoped she would break the tie. But she actually changed everything: Said my taking anastrozole shrunk my tumors (in one breast, 1 DCIS, 2 IDC, 1 atypical thing) to nothing, can't be found on any imaging, so she recommended lumpectomy. Done. Titanium clips removed, no cancer found anywhere in that breast, can't even tell by looking at my breast that I had the surgery, except for that breast is a teeny bit smaller than the non-cancer breast. I was thrilled with the outcome, still can't see any cancer at all in either breast. Had radiation 5 x . I'm doing great. Remember: doctors have opinions, and they don't always agree with one another, and somebody is wrong, therefore. Work with someone you trust, do what you think is best, and it will work out fine. There is a reason you trust that doctor, and there is a reason they have high ratings - it's because they are good at what they do and don't take the easy way out. Much luck to you.

2023- I was 60, had IDC 7mm and DCIS 4cm on left breast. I had lumpectomy, reconstruction( ant the same time) and 15 rounds radiation. My breasts look very good- left breast is a tad darker. I’m pleased.

I have had two lumpectomies in my right breast, one in 1990 for a palpable mass and that turned out to be a fibroadenoma, and the other more recently after micro-calcifications were noted on my mammo and these were attributed to atypical ductal hyperlasia (ADH) after a steriotactic biopsy. At that time I wanted a single mastectomy but I was advised that the path was focal and it was best not to remove health tissue - so breast conserving surgery (lumpectomy) was recommended. Like yourself I was comfortable with that surgery but I laid awake worrying about the what ifs? What if I had the lumpectomy and in a year or two time they find more? How many lumpectomies should/can one endure in the same side? What if they find a cancer? ...and I don't want to feel mutilated from several lumpectomies? Wouldn't a mastectomy be a better option? I went through with the lumpectomy and lost the lateral lower quadrant. The surgeon did a great job reshaping the breast mound but it was notably smaller then my left. Not the biggest deal because the shape was still similar.

Well, the lumpectomy path report resulted in a second diagnosis Lobular Carcinoma In-Situ, LCIS. Because this path is "in-situ" (focal and not moving through the tissue) it is not considered a true cancer but a pre-cancer. It may or may not move to the next stage of Invasive Lobular Carcinoma (ILC) but having this form increases the chance of this same disease in the healthy breast. My surgeon remembered I had asked for a mastectomy in the first instance and said she could offer me a bilateral mastectomy (DMX) if my life time risk score was 20 or above. Having these two diseases (personal history) and a family history of BC lead to me agreeing to genetic testing. I have two mutations, not BRACA, with one of two associated to the BRCA complex - both are suspect for BC. My life time risk score was 35 so I asked my surgeon to perform a prophylactic DMX. You should know that for some diseases, there is no difference in longevity whether we chose lumpectomy or mastectomy - and there are arguments that a mastectomy is over-treatment. But I don't think these same studies address the psycho-social element of either procedure.

Upshot being - I did wish I would have had pushed for the single mastectomy when diagnosed recently with ADH. I think I laid awake at night because I knew something was wrong... at that time, I didn't consider that I still would have had two surgeries in a short amount of time (lumpectomy to double happened, single right mastectomy and single left mastectomy could have happened). So maybe having the lumpectomy to double was the better option? If nothing was found in the lumpectomy pathology I would have had one breast larger than the other, bra cup puckers, asymmetry, etc. - and for sure I would have preferred the single mastectomy. BTW there are partial breast prosthesis for lumpectomies just as they have full falsies for mastectomy. I have tried several prosthesis since the double - I don't really care for them so much, but I have not yet had a special occasion (such as wedding) where I would wear a dress and want a more shapely figure.

I have adjusted pretty quickly to not having breasts - largely because I enjoy symmetry/balance; in artwork to how I set up my home furnishing! So of course I would feel unbalanced with a breast on one side and none on the other. Since the mastectomy I don't feel awkward/ashamed, or mutilated, since the right and left sides are identical. I will say my chest wall is COLD since having the BMX - nothing I would have ever imagined pre-surgery. But other than that I am very happy with my choice.

At the end of the day, lumpectomy or mastectomy is a personal decision - there is no one size fits all... Good luck with your decisions and prognosis. BTW I am happy to answer any other questions that you have about lumpectomies.

I’m almost 3 years from mine (June 2023). Had rapidly growing idc - initially measured at 1.2 and final was 1.7 in 5 weeks. While she went over the options, surgeon pretty much left the decision to me. Thinking back, I hope she would have countered that decision if she felt another was better (did say that if anything else showed up on the presurgical MRI, it would change things). I did choose the lumpectomy/radiation/ai therapy because it seemed like mastectomy was “overkill” for 1 small tumor. Ended up Oncotype positive so did end up with 4 rounds of chemo as well. Currently, I don’t regret this decision because margins and lymph nodes were clear. The only thing that would have changed with mastectomy is the radiation and I didn’t have many problems with that. So would I do the same again? Yes I would. However if another tumor shows up, will probably go for double mastectomy to try to eliminate future reoccurrence.

I would suggest getting a 2nd opinion from a different oncologist for your peace of mind. Knowledge is power & a 2nd set of eyes can be very helpful.

Thank you to everyone who has responded. It has been very helpful!!! I really appreciate you sharing your stories with me.

@mistymar How many zaps of radiation ?

I was diagnosed 2 years ago with Invasive Ductal Carcinoma Grade 1. All of my doctors recommended a lumpectomy but they said that the decision was mine to decide if I wanted that or mastectomy. I had the lumpectomy and 5 days of radiation. I am on Anastrozole, as of now, for 5 years. I did not have any lymph nodes affected. It is all so overwhelming at the time. I guess I had faith in my doctors and am praying for the best. I just had my 2 year checkup and, so far, all is good.

I am sorry for your diagnosis and know what you are going through and feeling. I will pray for your complete recovery.