Hello

Hi, It is scary having cancer, and natural to want to be sure all the cancer has been chopped out. But there are a couple of things that I learnt about when I was presurgery that I found helpful and although it is also scary, I would like to share it with you so you can make your decisions on the basis of knowledge not the assumptions many people make.

Susan Komen Cancer website has a very good section on deciding between a lumpectomy and a mastectomy ot this URL:

http://ww5.komen.org/BreastCancer/DecidingBetweenMastectomyandLumpectomy.html

which you might find helpful to discuss with your surgeon.

in deciding whether to offer you a lumpectomy with radiotherapy (you always have both if you have a lumpectomy) or a mastectomy, they consider how big the tumor is, whether there is only one or more, if you have any lymph node involvement etc.

If the cancer is singular, small (which I think means under about 1.5 cm), not adhering to the chest wall, and without any obvious lymph node involvement, they can often have a very good chance of removing the whole thing with clear margins leaving you a breast that is still the shape you are used to and comfortable with.And depending on what they find in surgery and in the pathology report on the tumor and sentinel lymph node etc, there is a good chance then that you will not need any further surgery and will not have a local recurrence, or a metastases elsewhere in your body.

My daughter had a possibly cancerous lump under 1cm, and was glad to only have a lumpectomy. My cancer was 2.2 IDC in a 6cm high-nuclear field of DCIS, and I was told a mastectomy was my only choice.

But the Susan Komen page does say that there is a slightly higher risk of recurrence with lumpectomy. People who have lumpectomy and radiotherapy are therefore monitored very closely and any recurrence is likely to be picked up quickly  and treated very quickly so this process can be shone not to  affect  survival rate at all. So  if you have a lumpectomy, esp for a medium to large cancer, you have to understand that it is not a sign that you have any increased risk of a bad outcome. You cannot let this frighten you. All it means is you took the second treatment path that a few of the people who  have lumpectomies end up taking.

One point that all of us here have to deal with is that there are no guarantees that any particular treatment will stop our cancer from recurring. Even if you had a double mastectomy with all your lymph nodes removed and radiotherapy all around the area, it could still come back because recurrence is not often caused by cancer cells left behind.  We all have to live with that possibility of recurrence and to learn how to live well and full of hope and happiness despite this fact. And we do, and you will too.

A big problem researchers are discovering that there are stem-cell-like cancer cells inside breast cancers that can  that can change between forms so they seem quite innocent, and back into a cancer seeding-form. They can move out into the lymph fluid or the blood, can stay in their innocent form in the blood or lymph and not be found. At some time later, they can find a suitable spot in liver or lungs etc and start to form a new tumor.

Researchers are learning how to find these cells, and how they work, and how to stop them. They are developing vaccines and other approaches, and in time to come, there will be many new and very effective ways to deal with them. I read that  Herceptin and its related treatments often seems to have some effect on these cells so even some current treatments can work on them.

So surgery is only half the story. This is why lumpectomies have radiotherapy with them. And why so many of us have chemotherapy to help clear out any rogue cancer cells possible. But it is also why despite that, an unlucky few still get recurrences, and why at present they cannot stop this happening.

I hope you get a chance to discuss things with the surgeon and to be sure you are happy with the choices you make together, and that it all goes well from here on.

best wishes

 

Hi, It is scary having cancer, and natural to want to be sure all the cancer has been chopped out. But there are a couple of things that I learnt about when I was presurgery that I found helpful and although it is also scary, I would like to share it with you so you can make your decisions on the basis of knowledge not the assumptions many people make.

Susan Komen Cancer website has a very good section on deciding between a lumpectomy and a mastectomy ot this URL:

http://ww5.komen.org/BreastCancer/DecidingBetweenMastectomyandLumpectomy.html

which you might find helpful to discuss with your surgeon.

in deciding whether to offer you a lumpectomy with radiotherapy (you always have both if you have a lumpectomy) or a mastectomy, they consider how big the tumor is, whether there is only one or more, if you have any lymph node involvement etc.

If the cancer is singular, small (which I think means under about 1.5 cm), not adhering to the chest wall, and without any obvious lymph node involvement, they can often have a very good chance of removing the whole thing with clear margins leaving you a breast that is still the shape you are used to and comfortable with.And depending on what they find in surgery and in the pathology report on the tumor and sentinel lymph node etc, there is a good chance then that you will not need any further surgery and will not have a local recurrence, or a metastases elsewhere in your body.

My daughter had a possibly cancerous lump under 1cm, and was glad to only have a lumpectomy. My cancer was 2.2 IDC in a 6cm high-nuclear field of DCIS, and I was told a mastectomy was my only choice.

But the Susan Komen page does say that there is a slightly higher risk of recurrence with lumpectomy. People who have lumpectomy and radiotherapy are therefore monitored very closely and any recurrence is likely to be picked up quickly  and treated very quickly so this process can be shone not to  affect  survival rate at all. So  if you have a lumpectomy, esp for a medium to large cancer, you have to understand that it is not a sign that you have any increased risk of a bad outcome. You cannot let this frighten you. All it means is you took the second treatment path that a few of the people who  have lumpectomies end up taking.

One point that all of us here have to deal with is that there are no guarantees that any particular treatment will stop our cancer from recurring. Even if you had a double mastectomy with all your lymph nodes removed and radiotherapy all around the area, it could still come back because recurrence is not often caused by cancer cells left behind.  We all have to live with that possibility of recurrence and to learn how to live well and full of hope and happiness despite this fact. And we do, and you will too.

A big problem researchers are discovering that there are stem-cell-like cancer cells inside breast cancers that can  that can change between forms so they seem quite innocent, and back into a cancer seeding-form. They can move out into the lymph fluid or the blood, can stay in their innocent form in the blood or lymph and not be found. At some time later, they can find a suitable spot in liver or lungs etc and start to form a new tumor.

Researchers are learning how to find these cells, and how they work, and how to stop them. They are developing vaccines and other approaches, and in time to come, there will be many new and very effective ways to deal with them. I read that  Herceptin and its related treatments often seems to have some effect on these cells so even some current treatments can work on them.

So surgery is only half the story. This is why lumpectomies have radiotherapy with them. And why so many of us have chemotherapy to help clear out any rogue cancer cells possible. But it is also why despite that, an unlucky few still get recurrences, and why at present they cannot stop this happening.

I hope you get a chance to discuss things with the surgeon and to be sure you are happy with the choices you make together, and that it all goes well from here on.

best wishes

 

Hi JT I was diagnosed April 2014. I had a lumpectomy plus 5 month chemo, 33 radiotherapy sessions finished just before Christmas. I'm still having herceptin until June. I asked the surgeon to remove both breasts. Like you, I don't want this to come back. I had lengthy discussions with the surgeon over my surgery options, natural therapies and all the other treatments. I've also had these discussions with the oncologist. I ended up opting for a lumpectomy as there really was very minimal difference in the chances of it coming back. I needed to know all the options and what they meant for me so that I could make an educated decision about my health. There is no guarantee but I feel comfortable with the choices I made. You are going to have hard days and it's going to be a hard year but you will get through it and you will feel well again. I think we all have a worry of cancer hanging over our heads once we've been there and done that. We don't have a choice of when or how we will die, but we do have a choice to be happy and make the most of every day that we have. Take little steps at a time rather than looking at everything you have to go through in one hit. Plan some things that you enjoy to give you something to look forward to as you go along. Good luck with it all. Love Karen xox

Sorry to hear about your diagnosis but welcome to the website, it's so helpful and understanding. I was diagnosed Sept 2013 with two tumours, 15mm and 8mm early breast cancer. I went to the surgeon wanting a mastectomy to get rid of the whole thing. He told me a lumpectomy was possible as the 2 tumours were in the same quandrant of the one breast but it was my choice. He described it as my breast being a cake and he was going to remove a slice and join up the rest so it wouldn't be perfectly round but as I am a large breasted woman it would not be noticable. He was worried I would be very lopsided with one breast. I sat in the room looking from the surgeon to my partner and back again for what seemed an awfully long time trying to decide. In the end I put my faith in the surgeon and had a lumpectomy. It's such a hard decision but I had all the facts and went with it. It's all we can do really. Gather all the information and make informed decisions.The surgeon did everything he promised and managed to get clear margins and my sentinel node was negative, I know it doesn't always go that way, if they don't get clear margins they need to operate again, sometimes the choice is taken away from us. I am now 8 months post chemo (bad family history) and 6 months post radiation and back at work feeling really good. I am on a hormone tablet for 5 years. It is impossible to tell where he operated, the scar is at the bottom of my breast. My scans are all clear and If I do have trouble down the track, I believe it will be a whole new cancer. I won't regret my decision because it was the best thing to do at that time. I hope I have helped in some small way, As Natasha said, there are no guarantees unfortunately, the medical teams do the best they can with the knowledge they learn over many years and many patients. Survival rates are high these days, I'm sure you will see your little girl grow up. Once you have your treatment plan you will feel a lot better, wishing you all the best, stay in touch, big cyber hugs to you, 

Hazel xx

From your post I can see that they have picked this up quite early.  If they are considering lumpectomy they obviously think it's early bc and that's brilliant news for you.  I never had that choice.  

When you go to these specialists it's all very overwhelming.  I found it helpful to take someone with me as a backup for when I forget things or in case I zombie out.  

People give us all sorts of advice but I know that my surgeon and oncologist deal with this all the time and are going to give me good advice.  In the end it's my body, but I'm glad somebody else studies this all the time, weighs up all the odds and knows enough to give me professional advice about my best options.  There's never any guarantees and they are not always 100% right I know, but they are in a good position to be right most of the time. 

I am also terrified of the year ahead because I know I'm in for chemo and radio, but even though my cancer sounds more advanced than yours, I know I have a very good chance of beating it.  Hang in there.  None of us know what's happening tomorrow, but I don't think you're dying any time soon.  Cry when you need to.  Actually for the first two weeks I think I cried every day.  Then you get past that and get used to the uncertainty.  Even just a few weeks on and it's getting better.  Once you have more information about your cancer and your lumpectomy is done you will be feeling a lot better and more focussed. They will do various test on your removed lump and they will find out all sorts of information about it to help your doctors tackle it.  That will help them plan your treatment and you will feel more in control.  You will feel better a lot of the time.  You will be able to do this.  

*Hugs*

From your post I can see that they have picked this up quite early.  If they are considering lumpectomy they obviously think it's early bc and that's brilliant news for you.  I never had that choice.  

When you go to these specialists it's all very overwhelming.  I found it helpful to take someone with me as a backup for when I forget things or in case I zombie out.  

People give us all sorts of advice but I know that my surgeon and oncologist deal with this all the time and are going to give me good advice.  In the end it's my body, but I'm glad somebody else studies this all the time, weighs up all the odds and knows enough to give me professional advice about my best options.  There's never any guarantees and they are not always 100% right I know, but they are in a good position to be right most of the time. 

I am also terrified of the year ahead because I know I'm in for chemo and radio, but even though my cancer sounds more advanced than yours, I know I have a very good chance of beating it.  Hang in there.  None of us know what's happening tomorrow, but I don't think you're dying any time soon.  Cry when you need to.  Actually for the first two weeks I think I cried every day.  Then you get past that and get used to the uncertainty.  Even just a few weeks on and it's getting better.  Once you have more information about your cancer and your lumpectomy is done you will be feeling a lot better and more focussed. They will do various test on your removed lump and they will find out all sorts of information about it to help your doctors tackle it.  That will help them plan your treatment and you will feel more in control.  You will feel better a lot of the time.  You will be able to do this.  

*Hugs*