Newly diagnosed invasive ductal and lobular in right breast

You might be surprised that the oncologist may not recommend a mastectomy over a partial mastectomy - although I’m not sure with lobular cancer if the “disease free survival” DFS is much better with either, with ductal cancer I believe the outcomes are similar.

If a partial mastectomy is considered, you probably have enough breast for it to be reshaped into a smaller size. They should give you the option of having a mastoplexy, breast reduction, on the other breast to match. It’s the law that they must match the breasts.

You might even consider asking them to reduce the left breast even if you have a mastectomy on the right so the difference is not so much. Hopefully you’ll hear from other women who had similar issues.

I was a DD before, I had a lumpectomy with oconoplastic surgery on the right, and a mastoplexy on the left. Because my lesion was not large the right side it is now a large C- small D. (I would have been happier with a smaller breast, but their goal was to remove cancer not re-size it) so my left is still pretty large, too. But both are better shaped than they had been prior to surgery, I was 68 at diagnosis.

Thank you so much for your reply!! I didn’t know they did partial mastectomies. I had a breast reduction in 2001 and went down from a triple D to a C. I was really happy at that size but then I had 3 kids and went back up so I’m definitely familiar with a reduction. I’m hoping maybe that’s an option for me. I really appreciate the time you took to answer me and I hope you are doing well since your surgery!!

Technically a partial mastectomy is a lumpectomy - they just don’t seem to use that term much. I didn’t know that until the after-surgery report said I had one!
I had been reading that loss of e-cadherin is common in lobular breast cancer and its loss is a sign that cancer cells may move into nearby tissue (I think instead of the typical movement into the lymph node or through blood). That may be a deciding factor on radiation or not, or mastectomy or not.

If you like knowing information about your cancer, you might ask for details of the histology report, that includes e-cadherin, p53, and Ki-67. I felt it helped me feel comfortable with my decisions. In my case, I had DCIS and needed to decide about radiation. Knowing that the pattern of cancer cells included solid along with cribriform, and was an intermediate level made me think that radiation (5 days, 3000 gy) was the right thing to do. I just think I would have worried too much knowing that there had been solid formation and somewhat faster growing than grade 1. Talking about the histology and other descriptive features with the doctors gave me extra time to consider, and I felt I learned more during these discussions about stuff I didn’t even know enough to ask about.

One other thing I think is important is DFS vs OS vs DFI, that is disease free survival, overall survival, and disease free interval. Many of us will survive with breast cancer. But I’ve realized what I REALLY want is disease free survival! My type of cancer may be more likely to return or form a new site over time. When they tell me - Yea! You’ll survive this! I think but wait, tell me the risk of it coming back. I want to treat it so it doesn’t come back. And, if it’s likely that I’ll get it back, what is the expected disease free interval? If I do radiation will the disease free interval be more like 12 years instead of 5?
So when you talk “risk” with the doctor it’s important to know - are they talking overall survival (most often used) or disease free survival risks?
Sorry, I do tend to write long answers 😕

Thank you!! I’ve been trying to learn as much as I can about this disease but there is obviously a lot more to learn!! I definitely believe that knowledge is power and I want to make the most informed decision I can.

I was 60 yrs. I had DCIS 4cm and IDC. .7mm in left breast my cancer was at 5 o’clock- so under breast. I was a DD mainly due to breastfeeding and chubby. I had lumpectomy on left and reconstruction on both… plastic surgeon was excellent-the only silver lining of my experience was perky boobs again. I ended up being about a C cup.

Ask away … if any more questions. Each cancer is different.

And so many terms that you have never heard before and so many acronyms.

Keep a journal of questions and answers. Have someone go with you if possible

Thank you!! I’m glad you had such a good experience!!

Definitely!! I’ve never googled more medical terms in my life. The acronyms really get me but I’m sure a year from now it will all be familiar. I’m waiting on an oncotype score too. I’m very curious how that will turn out. I’m hoping my surgeon has the results Tuesday so I can have the full picture. All this waiting and if this then that is the hardest part for me. I feel like once I know I can work on accepting it and moving forward.

The waiting is tough

Yes!! It’s been since April 23rd went in for my mammogram and could tell by how the nurse practitioner reacted after my exam it wasn’t good. It’s definitely teaching me patience!! I’m sure many others on here have experienced the same.