Stage 4 cancer should go for mastectomy?

Posted by agneslim @agneslim, May 13, 2023

Hi, Agnes here. In 2019 I diagnosed stage 4 cancer spread to lungs. Undergone chemo, perjeta n herceptin. I m taking tamoxifen too.
Control well. Cancer stable n lungs cleared.
On May 2023, my right breast tumour enlarged 0.4cm, oncologist ops for mactectomy.
Will it help if I go for mactectomy or only radiology+ herceptin.
Currently: every 3 weeks will inject herceptin.

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Hi @agneslim -- hopefully your oncologist explained the reasoning behind recommending a mastectomy to help you with your decision. Don't hesitate to get a second opinion if you need more input. I opted for the recommended double mastectomy 10 years ago due to BRCA2+ status. No reconstruction. No regrets. Prayers for you.


I had unilateral mastectomy 2 months ago. After over 2 years since my first diagnosis and they wouldn't do surgery because of in my lymph nodes, liver and bones as well as breast. The tumor stayed stable for 1-1/2 years but went from 1.4 cm to 2.9 this past January. Cancer was out of lymphs and liver so we decided on surgery. Once taken out, the tumor was actually 5.1 cm and it was now hormone negative and not hormone positive as we thought which the oncologist and surgeon were shocked it changed. Negative means it grows faster so I'm glad they decided on surgery. Good luck on your journey and remember . . Look up, something good is going to happen!


Following treatment with aromatase inhibitors or chemotherapy, BC frequently goes from ER+ to ER-. Another good reason to have local treatment before systemic therapies.


Please understand that my breast cancer experience happened 31 years ago. I had invasive DC, hormone receptor negative. Due to the size the overall recommendation was mastectomy and chemo.
In your case your tumor grew.
I would chose mastectomy as first treatment because then the tumor in the breast is gone and you can focus on controlling the other areas.
My best wishes for a good outcome.


@agneslim, I agree with @californiazebra about questioning your cancer team about the pros and cons of having a mastectomy specifically as it relates to you. Keep asking questions until you feel comfortable making an informed decision.

Have you decided to go ahead with the surgery? Any update?

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