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
- @noosa_blue150 So great to hear that you have great support & have been recommended the Mepitel film. If used correctly, it will save your skin so its worth been wrapped like a "cryovac chicken" for a few weeks to have a great outcome in the end. My 2 y.o. great niece used to call it my "plastic skin" as she gently rubbed it. let me know if you need any advice on it. There are others here that have used it & also rad therapists on the forum who can answer any questions. So lovely to hear you so positive & thankful with such a great outcome. Love & strength to you xx
@Locksley Great to hear you are going well with the Mepitel & are getting it checked daily, like I did. I guarantee it will be worth it in the end. I have seen horrible photos & heard stories from others who have not been able to use it & I feel very blessed that may onc recommended it for me. Good luck & stay strong xx - I'm 4 days into radiation and they are using the metipel film on me. Its working quite well. I get patched up after my radiation session so I try to make sure there are no major rips or tears beforehand. Good luck @noosa_blue150
- Hi anne65. Our BC support group and this forum had mentioned the mepitel film so I’ve got that noted down for my radiation consultation. Sounds like I’ll be referred to private radiation service close to home (but my health service will be paying ) and I know that they’re using it . Thanks for the reminder though . I may be lucky and be clinically ok for have 3 weeks hypofractinated radiotherapy if I’ve understood feedback post surgery ( 6 lymph nodes clear, only tumour with cancer and reduced in size due to chemo response). I’m ticking off those boxes and feeling very lucky to,be emerging out the other end of the treatment pathway with a excellent prognosis.
- @noosa_blue150 Great news to hear that all has gone well! I too had DCIS 3 years ago & following advice from my surgeon, had a lumpectomy & during the surgery she moved some tissue from under my breast to fill in the gap & now, you wouldn't even know I had surgery!
As my margins were clear, the surgeon recommended i only have rad treatment for 3 weeks so I didnt have to have chemo.
One piece of advice i would like to share with you is that my oncologist recommended I use Mepitel film during my rad treatment. I know not all patients can have this & some hospitals dont have it. I had my treatment in a private hospital. This clear film protects you from the radiation burn. It covers the treatment area & you keep it on for the entire treatment plus a few weeks after, as that is when the rad is at its peak. You shower with it on but you need to keep it bubble free & make sure it doesnt tear. Every day before my treatment, I would pop in to see the nurse & she would check me out & patch up any film that needed repair work. Yes, it does take a few days to get use to it but eventually I saw it as my protective shield & after my treatment ended & I took it off, I had NO redness, burning or peeling. You wouldnt have even known I had rad treatment. 5 weeks of being wrapped up was totally worth it so you may like to discuss this with your specialist & I know there are other options available to help in this area too. Good luck with your next step & so glad you are progressing well & ticking off those boxes! Sending love, strength & prayers xx - That’s great @noosa_blue150! Good luck with your radio treatment. You’re getting there 👌🏻♥️
- Just a update - had a lumpectomy on 4th jan 2021. 6 nodes removed and all were non cancerous. Excision margins clear on lesion which had responded well to chemotherapy. Down from 4 cm to hard to find (despite marker) lump,requiring mammogram to insert fine wire prior to surgery. Little dispruption to,symmetry of left breast . I think I’ll be able to wear normal bras once healing complete. Now awaiting radiation treatment to,start, and ongoing three weekly herceptin and I think hormone therapy. Feeling positive about the future. It’s been a long six months. Thank you to those here posting their comments as it helped me immensely
- Hi @noosa_blue150,
I've just caught up with your post. These things are always such a big decision and you're never really sure you made the right one. I chose the lumpectomy, chemo, rads I had a full axillary clearance to level two with 5/24 nodes cancerous and a lovely spot that was breaking through the nodes into the surrounding tissue.
I had minimal problems with the radiation, actually I found it pretty easy compared to chemo. 4 years now and have no regrets as to my choice.
All the best with your decision xoxo - Oops -typo - sorry peripheral neuropathy
- Thanks everyone for your comments . I think I’m resigned to going along with medical recommendations with radiation if it’s warranted ( lumpectomy will,mean I have to,have it anyhow. ) I’m still to decide on whether I’ll,have a mastectomy , but now appreciate if cancer found in lymph nodes with a mastectomy I’m up for radiation as well. At the moment I’ve had 9th dose of taxel,and am battling signs of -web-herald neuropathy . Does 8 and 9 were reduced to 75%. Oncologist trying to,get me to dose 11 but we’ll have to,see how the PN goes each week .
- Hi @noosa_blue150
I was diagnosed with early stage 2 breast cancer in April 2020 size was 52mm. I had a lumpectomy with 4 nodes removed. All 4 nodes were cancerous and then I was advised I needed to have a mastectomy. Had this and then had another 9 nodes removed. In total 9 out of 13 nodes were cancerous. I had 4 rounds of AC chemo and I am currently have weekly paclitaxel chemo. After this I will be having radiation but I don't know all these details yet, I am meeting the radiation team next week. Hope all goes well for your remaining treatment.
