Discussion about surgery with Surgeon

RSVP​ I'm sorry to see you joining us here but it's great to be asking questions both here and of your surgeon.

In my experience, my GP had mentioned both but she wasn't sure which I would need. At my first meeting with my surgeon he talked about lumpectomy and when I asked about a mastectomy he said that was my choice however he provided reasoning around lumpectomy being enough in my case - the placement, type, size and grade of my tumour, recovery, etc.  I felt comfortable with trusting his experience and approach.

A year later I have a neat line scar on my affected breast but otherwise it looks exactly like it used to. There is the mental load of wondering what happens over the coming years however chats with my oncologist, surgeon, GP and a psychologist specialising in cancer have helped.

My surgeon has repeatedly said to me that I will be closely monitored for a long time - not what I expected in life but I'll take it as a big warm cuddle of care :)

HiRSVP​, Im also newly diagnosed but just one step ahead of you. I had my surgery (lumpectomy) two weeks ago and have an appointment with my surgeon tomorrow to see if the margins and lymph nodes are clear. If they are, I will move on to radiotherapy but if not, we’ll be having another discussion about what surgery is next.  
As I said, Im new to this too and can only speak from my own experience. There seems to be a lot they can tell from your biopsy and mammogram as to the size of the affected tissue, what type it is and how aggressive it is. They consider all of this when they make their recommendations but you should definitely question their decision if you’re not comfortable with it. I had the added benefit of an MRI as when my surgeon examined me, she could feel that the affected area seemed to be bigger than the mammogram was showing.  
I was upset and annoyed at the time as I was psyching myself up to having the surgery but having the MRI was going to delay it. Im now so glad I followed her recommendation to have the MRI as she was right about the size. Hopefully, this extra information gave her a clearer target area and I will get the result that the surgery was successful in removing all of the affected tissue.  
I’ll be thinking of you tomorrow and sending good vibes your way. xo 

Hi Slyvie,

Thank you for this. I can understand that the delay for MRI would have been frustrating for you but how good that in doing that, your surgeon had all the information she needed and wanted going in. What are are saying just reinforces to me to be intelligently (but not blindly) guided by the experts in this. 

How was/is your surgical recovery going?

I will also be thinking of you tomorrow and sending you good vibes for clean and clear results tomorrow. 
🌺

Hi SYLV1E​ 

Thanks for the heads up about the cushion and McGrath nurses. I know they are fabulous humans. 
Hopefully after tomorrow I will have a better picture of what I am heading into and will take thing step by step from there.
I'm in Qld so we wont bump into each other but I truely wish you the very best possible outcome for tomorrow and thank you again for being open to chat on here

HiRSVP​ I am sorry to know you’ve had this diagnosis. I had a “choice”— technically - my breast surgeon’s recommendation was for me to have breast conserving surgery/lumpectomy. Similar toMoomincorn​’s experience my surgeon’s recommendation was based on her assessment of a range of factors after she had the diagnostic information.
My surgeon and my oncologist recommended that I start 6 cycles of targeted chemotherapy prior to my surgery (Neoadjuvant treatment), as this would shrink the tumour size (it did shrink from 3.8 cm to <1 cm)  reducing the quantity of breast tissue she would need to cut out.
It might depend on your presentation and cancer type - I had HER2 positive and hormone positive breast cancers (triple positive) which has a very targeted chemotherapy and immunotherapy treatment. The outcome was that my surgery was very smooth and 3 years on from I have no evidence of disease. 
It’s hard to know if it’s the lumpectomy or the radiation but although I had a speedy recovery after surgery the breast remains sensitive and there’s a little bit of tenderness. The mammogram technician said to think of it like having a suitcase packed differently with parts of the breast contents packed back after surgery.
I didn’t but perhaps it would be useful to inquire about a genetic test in case that has interesting insights. 
I don’t regret my choice to go with the recommendation. 
All the very best!! 

Sorry to see you joining our select little group, RSVP​  ... whack up any questions that you may have & we'll do our best to answer them as we've 'been there, done that'.

I hope your discussion with the surgeon goes well today.Mine was Invasive Lobular - under the nipple.  My surgeon said straight up, that a Lumpectomy would be the best option - tho I suggested that if it looked bigger/worse than thought - to go ahead with a mastectomy if he thought it warranted it.  It didn't - I just had the lumpectomy.   I was actually glad that I wasn't 'given a choice' - most surgeons should 'lead you' to the best treatment (in their opinion.)   

My surgeon lifted my nipple, removed the ILC from underneath & moved some breast fat into the 'hole' and sewed the nipple back on.  Surprisingly, I still have almost full sensitivity!  I have minimal scarring - just an 'enlarged' nipple (compared to my other one.)  My GP did a check just yesterday and was full of praise at my surgeon's skill.

I'd suggest that you take a trusted friend or relative with you to your meetings from now on, for both physical & mental support -  and also consider RECORDING them too, on your phone xx. It is almost impossible to remember everything that is said & this way you can go back over it in the quiet of your home & take notes. xx

Also, Consider listening to Charlotte Tottman's Podcasts on her own experience with BC - as she explains it all very well xx  She is a specialist breast cancer Counsellor who had a double mastectomy following her own diagnosis, choosing to stay flat. She was surprised at her own reaction to the news/surgery/treatment, as she'd been counseling others for many years & thought she 'knew it all'!   She has done 2 ‘podcast seasons' ... check out the 1st season, right from her diagnosis onwards and how she coped, then move on to the 2nd season. She is very easy to listen to & you'll probably recognise your own reactions in many of the podcasts. 

http://www.drcharlottetottman.com.au/my-podcast.html

Check out this thread too - there is a lot of general info on the forum & what to take with you to hospital - even 'tick sheets' that you can fill in to take with you to your appointments on your mental & physical health .... this info has been gleaned from many of our members over the years ... I hope it helps you xx
https://onlinenetwork.bcna.org.au/discussion/23477/a-big-welcome-to-all-new-online-network-members#latest

take care & all the best xx

Hi RSVP​ sorry to welcome you to this group.  I am a couple of weeks ahead of you also.  I have invasive breast cancer, two nodules which were removed by lumpectomy 8 days ago. I also had sentinel lymph nodes removed.  I wasn't given the choice as such, but was guided by the surgeon and they pursued the least invasive treatment based on my presentation.  I'm also in Qld :)

We are waiting on margins, there is a lab delay in the reporting. Otherwise it's confirmed as grade 1, no lymph node involvement.  If there's good margins, it will be on to radiotherapy, if not, then more surgery next week.  My surgeon then talked about the possibility of mastectomy with reconstruction as further tissue removal will leave me looking quite asymmetrical.  That's my current hurdle, and like you, I like to consider all my options and see how I feel about them.  Currently thinking further volume removal without mastectomy, as I am a B cup and don't really want the extra procedures of reconstruction and don't really mind if I'm unbalanced 🙂 I'm going for least invasive.

All the best on this journey 💜

Thanks so much KalGal​ - sounds like we may be following similar paths. 
This morning the surgeon said most lumpectomy and sentinel node/s out and then radio, but first an MRI and scan to check everything before going in. If no other surprises then surgery at the end of the month. I actually feel so much better having had this meeting this morning and knowing a little more about whats ahead. 

I hope that you get good news about clear margins when you do get your results. As a friend said to me, whatever decision you make will be the right one 🌼 

Hi​RSVP​ 
I’ve just been reading the other comments about your appointment with the surgeon and I’m so pleased it went well. I’m glad you are having an MRI so that your surgeon has as much information as possible before proceeding. I really do feel that this should be available to all breast cancer patients. Having a solid plan certainly makes all the difference.  
My appointment went really well yesterday too. All margins and nodes were clear and I now have referrals to the radiotherapy and medical oncologists so now I can move on to the next stage of my treatment.  
This crazy new world we have found ourselves in really does mess with your head and we are so fortunate that medical science has progressed so much in this field and this support network is absolutely amazing!  
Hope all goes well with your upcoming tests and that you can finally have a plan in place. 

So great news for you SYLV1E​ - so pleased you have had such great results. 
Best of everything for your next steps x