Forum Discussion
Lumpectomy vs mastectomy and lymph nodes surgery
I’m a stage 2 early breast cancer patient . Triple positive . Lump 4mm on detection now reduced down less than 2mm with 4 weeks of taxcel chemo to go ( previously completed r x fortnightly AC chemo). Herceptin Infusions has been weekly 8 weeks , another 4 to go then becomes 3 weekly in 2021 . I’m now at point of having to decide on surgery option. I’ll be clarifying these questions to my surgery team as well .
ive been told,I’m a candidate for lumpectomy , and this will require radiation treatment .the question of reconstruction I’ve decided can be left for later ( at present I don’t think I will bother but.....one doesn’t always know till you are really in that situation).
it was made clear to me that status of my lymph nodes is almost a separate issue . At present no sign of enlargement on physical,exam or scan or ultrasound .
Sentenial lymph nodes will be checked On day of surgery
has anyone been in same situation where lymph nodes were found to be cancerous- how many ? did you have wide clearance Of the breast lump with lumpectomy and radiation? ( with clear margins at lumpectomy).
What I suppose I’m trying to get my head around is a few issues
radiation therapy - it’s been a interesting time with chemo ( that I had to have ) and I’d somehow like to avoid radiation therapy . Q if I opt for
mastectomy -can I avoid radiation If lymph nodes clear ? Or if it’s in lymph nodes , they’ll do,a clearance/wide excision will I end up having to have radiation as well
Hope that makes sense . I do understand that radiation burns etc do not end up a major issue with everyone but I’m tending to think it’s one less,toxin to impose on my body .
Surgery isn’t easy either but......
ive been told,I’m a candidate for lumpectomy , and this will require radiation treatment .the question of reconstruction I’ve decided can be left for later ( at present I don’t think I will bother but.....one doesn’t always know till you are really in that situation).
it was made clear to me that status of my lymph nodes is almost a separate issue . At present no sign of enlargement on physical,exam or scan or ultrasound .
Sentenial lymph nodes will be checked On day of surgery
has anyone been in same situation where lymph nodes were found to be cancerous- how many ? did you have wide clearance Of the breast lump with lumpectomy and radiation? ( with clear margins at lumpectomy).
What I suppose I’m trying to get my head around is a few issues
radiation therapy - it’s been a interesting time with chemo ( that I had to have ) and I’d somehow like to avoid radiation therapy . Q if I opt for
mastectomy -can I avoid radiation If lymph nodes clear ? Or if it’s in lymph nodes , they’ll do,a clearance/wide excision will I end up having to have radiation as well
Hope that makes sense . I do understand that radiation burns etc do not end up a major issue with everyone but I’m tending to think it’s one less,toxin to impose on my body .
Surgery isn’t easy either but......
25 Replies
- Hmmm that second lot of chemo should read I’ve been having weekly paclitaxel , only 4 to go and herceptin . Herceptin will go to three weekly Infusions on completion of taxel.
- Hi @noosa_blue150, as @Afraser said, it can depend a lot on a number of factors whether you will need / be advised to have radiation.
I had 2 tumours (1 Invasive lobular tumour, ER & PR+ and 1 ductal tumour, HER2+) and had 1 positive node and so when I had my mastectomy I also had an axilla clearance. I went on to have chemo, Herceptin and radiation and am still on Tamoxifen. I had hoped to avoid radiation but given the size of the lobular tumour and its location close to the chest wall I was advised to have radiation, which I decided to have. That was 8 years ago now.
Best wishes for your remaining treatment. Jane xx - Hi @noosa_blue150 I think that if you have clear nodes and a mastectomy, then you won’t need radiation. Especially if you feel like the mastectomy will be enough. At the end of the day the choice is yours. I’m like you, I want to avoid as much poisoning as possible. I had radiation but didn’t have chemo, and also had a double mastectomy. I could’ve also avoided radiation if not for possible issues with mastectomy. Good luck 🍀
- Hi @noosa_blue150
I had a 12mm IDC, her2+ and Er+. I initially had a lumpectomy with sentinel node biopsy. I had clear margins with no affected nodes. After finishing chemo, when I saw the radiologist he mentioned that if I had a mastectomy then I would not need radiation. I chose bilateral mastectomy with no reconstruction. I did not need to have radiation.I had wanted to have mastectomy in the first instance, however the surgeon felt lumpectomy with radiation would be a better choice.I had taxol weekly for 12 weeks and 3 weekly herceptin. I wasn’t aware that herceptin could be given weekly as well. Hope you are going well with your treatment and good luck with your surgery. - Dear @noosa_blue150
I think it can vary a lot depending on the type of cancer, stage and even surgeon’s preferences (for a good outcome). I wasn’t a candidate for a lumpectomy, had a mastectomy with axillary clearance (one known malignant node but several looking suspicious). Turned out the rest were just play-acting, one only. I didn’t have radiotherapy. I had six months of chemo post surgery. Get some ideas from other by all means but your oncologist (and surgeon) are an important starting point. Best wishes.
