Lumpectomy vs. Mastectomy & Reconstructive Surgery

Hi @katrina123

Didn’t you have a low grade adenosquamous carcinoma diagnosis? That is my cancer diagnosed in October 2024.

Susan,
Yes, I had low grade adeno squamous metaplastic carcinoma in 2020. Then in 2024 I had invasive ductal carcinoma in the other breast.

How are you doing? Did you have a lumpectomy and radiation? Did you have chemo?

Katrina123

Hi @katrina123

I was stage 1b with LGASC in my left breast in September 2024 and had a double mastectomy less than a month after being diagnosed. No chemo or radiation. They did find pre cancerous cells in my right breast when they did the pathology during the mastectomy, though my right breast had looked clear during the MRI.

My second surgery to replace tissue expanders is tomorrow.

I’m sorry you’ve had two types. They told me that what they found in my right breast was likely not LGASC but a different cancer type.

Do you have a genetic mutation? I have CHEK 2.

Susan7656
I think that you made a wise decision to have a double mastectomy. My doctors didn't suggest that for me. I think that they were concerned because I have a primary immune disease CVID, and it could have been complicated. Also, I was 75 when I had my first surgery, and I think that also played a part. Unfortunately, now I am worried that I might have breast cancer for the 3rd time. I had cancer invasion into a large nerve with the cancer in 2020, so I always wonder about that. I have never been tested for CHEK2. I did have a genetic result for Gene TSC2 which they said had uncertain clinical significance. It was a genetic change that may or may not be contributing to cancer risk. So, the result just said no clinically significant mutation identified. (There is a lot of cancer in my family, so I still wonder about that.)
I will be thinking about you tomorrow. I bet everything is going to go great for you.
Let us know how you are.

Katrina123

On top of the breast cancer question the radiologist identified several atypical hemangiomas on my spine on an MRI. After the MRI I had a PET scan. I guess it can be difficult to tell the difference between atypical hemangiomas and breast cancer metastasis so I will be having 2 spinal MRI's in a few months and that's in addition to another breast MRI and breast mammogram.

Did you have radiation treatment?

My surgeon recommended lumpectomy and breast reduction. I informed my surgeon to protect my health that I did not want radiation, twice. Surgeon did not relent. I have read a number of medical journals where stage one older women were found not to need radiation and at the five year mark the statical benefit was only 1%. Medical studies were from Harvard and Canada. I understand each case is unique but if you absolutely do not want a course of action the surgeon should listen.

No. I am in the beginning stages of consultations only. No set in stone decision on my course of action as of yet. I need to follow up with medical, radiation oncology, my cardiologist and plastic surgeon (reconstructive). After those visits, I will make my decision. Since I have bilateral carcinoma I am leaning towards bilateral mastectomy.
With lumpectomy, I will probably always be worried it will re-occur but I have learned even with mastectomy, cancer can occur again. Yikes!

Wishing you the best and hopefully in a few months it will all come back clear 🙂 Cheers to your good health!!!

Thank you gigipatula....That's nice.

Hello,
You are absolutely right. It is very overwhelming. However, I can tell you from experience, you WILL get through this. It’s unfortunate that you are not getting more guidance from your doctor or his team, but I think that is also typical. I am a 10+ year survivor of stage 1 invasive ductal carcinoma. I opted for a double mastectomy as my cancer did not show up on my mammogram ( I also have dense breast tissue) and I knew that I would be in constant fear since the burden of finding future cancers would rest primarily on my self examinations. It was the best decision I could have made. I was also gently guided into considering reconstructive surgery by a very empathetic nurse who walked me through the process and options for this procedure. I was able to have saline implants put in place at the same time as my mastectomies which I know is not always the case, but there are other options. This is such a personal decision and you must just ask yourself what you want your future care and treatment to look like after your surgery. I just wanted to get beyond the cancer and on with my life as soon as possible, at the expense of my breasts, but it truly was the best option for me. I hope this is helpful for you and remind yourself that YOU know yourself and what is going to help you to live your best life moving forward. Ask lots of questions but trust yourself. Best of luck.