Forum Discussion

Carissa_BCNA's avatar
4 years ago

Surgery decisions

@Sheeba original post copied from the activity section.

I was diagnosed with stage 3 breast hormone positive breast cancer in august 2021. The surgeon said because of the size of my breasts in relation to the tumour, 4cm, I would need a mastectomy followed by chemotherapy and radiation or I could have chemotherapy first in the hopes of shrinking the tumor.

The tumour did shrink after chemotherapy and I had a lumpectomy 1st February. This plan seemed to be going so well with only 3 lymph nodes removed (one had a dead cancer cell in it, killed by chemo) and not a bad looking breast left afterwards...
until...due to only 0.5mm margins, my oncology team that I needed a 2nd reexcsion for clearance...but then the 2nd surgery had pathology results with further dcis!?

The surgeon offered me the choice to do a 3rd reexcision (but if she can't get clear margins I will need a mastectomy and radiation) or to go straight to mastectomy and radiation. I was shocked my treatment plan had begun to go wrong/change...it was so mind numbing I had to ask my husband to decide what answer to give at the appointment and I am booked in for a 3rd reexcision next week.

Since then I have been anxious I made the wrong decision and have spent hours researching and talking about how to make the right choice. I am confused because I was prepared to have a mastectomy at diagnosis because the certainty of getting all the cancer out this way, but I was advised to go the lumpectomy route. I hadn't thought I would need to revise the plan again. My breastcare nurse has been very supportive and positive this week, and confirmed that a lumpectomy with radiation has the same survival rate as a mastectomy, only a slightly higher chance of recurrence. My breast is already visibly smaller than the other one and the nipple is pointing downwards. I found my padded bras compensate for this but don't know what it will look like after a 3rd excision and radiation. 

Am I at the point now where the pros of a mastectomy with reconstruction will outweigh a lumpectomy?
Does reconstruction after the lumpectomy defeat the object of less invasive surgery?
I am feeling exhausted and the thought of more demanding surgery in a mastectomy terrifies me.
I am overwhelmed by the thought of plastic surgery afterwards. 
Do I need to push myself and choose mastectomy now, because my lumpectomy route is clouded with so much uncertainty and unsatisfactory cosmetic results now?
Will I be dissatisfied with a 3rd reexcision in the long-term?
I may need a mastectomy anyway. 
I want to get the cancer out and survive so I am loathe to cancel my reexcision next week. 
Nobody said this would be easy but I honestly didn't know it would be this hard.
  • All the best with your results tomorrow, @Sheeba.  I hope you get clear margins & can move onto the radiation phase (which many of us actually found to be not to be as 'nasty' as our brains imagined!) 

    Try not to overthink things or get ahead of yourself - as your brain can play nasty tricks on you!   ...... Sadly, a percentage of us may go on to develop Mets/advanced cancer - but we also have plenty of members with Mets who are living full & happy lives, 10+ years past diagnosis .... as they are getting so much better at treating it now, looking at it more as a 'chronic disease', with advances in treatment being made every year  ... 

    Take plenty of Deep breaths .... Take one day at a time, one hour at a time, if needed  xx