Surgery options & decisions

Welcome, we are really sorry you
need to be here but you will find it a useful place to be in a confusing time. My choice was less appealing (if you can use that term about choices none of us want to make!) between a mastectomy and a partial
mastectomy (my surgeon recommended a full mastectomy and that's what I had). If I had been offered a lumpectomy I may have jumped at it then. Now I am not quite so sure. Many women have a lumpectomy and radiation and do really well. For some the initial result is not so clear and further surgery will be required. Your surgeon may be able to give you more information to help you decide and I am sure others will be able to provide more specific advice. A mastectomy is a daunting thought but for most, relatively painless. Reconstruction is a whole topic by itself  - I didn't take that path but there is a dedicated group on this site to provide you with heaps of information. It's such a lot at once to take in but take one step at a time and you will get through this. Best wishes.

Hi @Ella123, sorry you have joined us here, however I’m sure you’ll receive a lot of support and love. I was diagnosed with stage 1, grade 2, last year at 42. My husband found it. I did a lot of reading of medical research and journals. For early BC that hasn’t spread to the nodes, lumpectomy plus radiation is as good as mastectomy. The radiation should deal with any cancer cells that might be left behind. Check with your surgeon what they think clear margins look like. For me, my GP said my tumour was probably the size of a grain of rice, surgeon indicated taking a portion more like a strawberry. Surgeon was making sure tumour was well excised. Radiation treatment was manageable. Mental trauma was the worst, but that’s cancer. My skin held up well with the radiation, I started applying MooGoo 3 weeks before, used StrataXRT that was supplied during radiation  along with MooGoo. Take your time deciding what to do, with early BC your tumour is likely very slow growing, so an extra few days, weeks in deciding on your treatment plan shouldn’t affect your outcome. Best wishes xx

Hi @Ella123  Have you asked your team why they are giving you the option?  It may help to make things clearer.  My bc was diagnosed at 2.5cm with no node involvement and my surgeon advised a lumpectomy but said at the time that if after surgery it became obvious that more needed to come out, I would need to follow up with a mastectomy.  The lumpectomy was beautifully done and hardly noticeable but as bad luck would have it, I needed the mastectomy as the tumour was 4.5cm with no clear margins and 3 nodes were affected.   Regarding radiation, it's not particularly fun, but it's also not very difficult - of course, as with everything, there can be side effects.  Perhaps something else to ask yourself - would you stay flat if you had a mastectomy or would you want reconstruction and if so, what sort of reconstruction would be suitable for you?

Welcome @Ella123,

This whole thing is full of so many decisions.  Trusting your own instincts is the best way to go, although you will probably never be 100% sure you have made the right decision either way and that's normal.

I had a lumpectomy for 19mm  stage 2 Tumour and re excision a week later as the margins were too close for their liking.

The decision for me was easy.  The first words I said to my surgeon was I don't want a mastectomy unless there is no other choice. His reply "Ok, now we have something to work with" He didn't try to talk me out of it although I am sure for him it would have been easier as it was a shit of a thing to find. 

 We had to go searching for the breast tumour as 3 mammos and numerous u/sounds couldn't detect it.  We knew it was there because the lymph node (that's where I found the initial lump) had already come back positive.  MRI located it. 

So I ended up with the lumpectomy, axillary clearance, chemo due to the node involvement and 30 rads.
I had no problems with the rads, did not suffer any fatigue and my skin held up well until the last 5 or 6 treatments and healed very well afterwards.  The cosmetic outcome of the surgery is quite good and hardly noticeable to anybody but me.

The only after effects I have from rads (18 months on) is that if I am out in direct summer sun I can feel it burn a bit through my shirt.  

All the best with your choice sweet. Trust yourself.

xoxoxo

I was stage 2. I chose a single mastectomy because I wanted to make 100% sure they got it ALL. As it turned out, it had escaped into one of my lymph nodes so I also had all my underarm lymph nodes out but those were clear of cancer.
Since the lymph node was involved I was given chemotherapy however they said radiotherapy in my case wasn't required so I didn't have it.
My cancer was hormone positive so I am now on hormone therapy pills.

Hi @Ella123 i had similar situation to you with Stage 1 Grade 1.  Was given all the menu of options to start with and just couldn't decide as i had a small turmor in one spot and then DCIS in another spot and the surgeon was not 100% sure she could get it all with a lumpectomy.  I then had an MRI at her suggestion and my big cost to help with my decision and was lucky I did as they found another area of DCIS and it was decided mastectomy was the only way to get it all.  Probably my only regret now is not having the reconstruction done at the time because the thought of going back for more surgery is a bit daunting for me.  My husband / family had lots of advice but you have to go with your gut feeling of what you want done to your own body.  It certainly is decision and information overload at the beginning.  Good luck xx

Statistically they're basically the same with effective treatment between lumpectomy  with radio and mastectomy. And you fortunately have a smaller cancer with lower grade. 

Having said that I chose mastectomy.  I had a small cancer that was aggressive. Mine wasn't visible on a mammogram 5 weeks before and even ultrasound was challenging. I was just lucky it was near breast surface and nipple so I found it. My surgeon informed me of my breast density and due to family history (1 sister, 1 niece and 3 Aunts) the decision for me was bilateral mastectomy and reconstruction. My nipple couldn't be saved so a lumpectomy didn't seem a brilliant option. The surgery will reduce local recurrence or a new primary,  but not my risk of metastatic disease...which is unknown of course. 

Many women have little issues with radiotherapy. It often depends on location. 

Reconstructive surgery does take time and has risks so if you choose that option you should ask lots of questions. 

No answer is right or wrong. Only you can choose. Take care. Kath x

Thank you so much ladies for taking the time to reply and share your experience, really appreciate it! I have an appointment next week with with my surgeon, I’m getting there with my decision. Thanking you all once again. Xx

Hi @Ella123, welcome 😊 As you’ve already seen you will find loads of support and information here.

I was diagnosed in July 2016 from a routine mammogram.  Like you, my cancer was grade 1, stage 1 and 12mm.  Nodes clear.

My GP ordered an MRI so my surgeon knew the other breast was clear and had the size and location of the cancer confirmed before surgery.

I guess my choice was easier than some.  I’m only a small B cup so a lumpectomy would have left me quite lopsided and I was worried I may not get a clear margin with not having a lot of breast tissue to work with.  I would have needed radiation and to be honest my mind was reeling and I just wanted it to be over with.

I chose a nipple sparing mastectomy with an immediate implant.  I am completely happy with my decision but like all bc surgery it came with it’s own set of issues! Other than the mastectomy surgery pain, the implant goes under the pec muscle so there was some discomfort and tightness for a few months while it stretched. My fake breast look exactly like my real one but is completely numb and a few degrees cooler.  I don’t really notice it anymore though.

The decisions can be overwhelming, so much information and so many options!
Read our experiences but remember that we are all unique and even the same surgery can have different outcomes.

Be guided by your specialist team and go with your gut.

good luck with your decision.  Jane x

Dear @Ella123, Great advice above. I like what @sister said, "Have you asked your team why they are giving you the option? It may help to make things clearer" 

from jennyss in western nsw