Decision conserving surgery or mastectomy? confused

Hi Kerrie

i had breast cancer in 2004 with a lumpectomy and radiation. In 2013 it returned in the same breast and I had a mastectomy and chemotherapy this time. Due to the muscle being removed and the radiation my skin was very tight. I had a TRAM flap and breast reduction/ lift on the other. My father had breast cancer first in our family and now there are 16 of us affected, some of which are no longer  with us. I tested negative for the BRCA genes but cousins were positive. My surgeon said there was no need to do a bilateral mastectomy even though the family history is strong. Choice is your and I wish you well. xx

Hi Kerrie

You've still got a bit of time to think about it. Big decision.

I'm 44 and was freaked out about getting a new cancer and the prospect of having to have regular lifelong scans, including MRIs because of the breast tissue being so dense.. Was 12DD and ended up choosing bilateral mastectomy after initial lumpectomy, rather than leaving it at that and having radiotherapy. The anxiety was more of a factor (re recurrence, young age, blah blah) than keeping my boobs. The other thing to consider is that if you do have radiotherapy and later require a mastectomy, the reconstruction may be affected by the radiotherapy. Just something to be aware of.

Very much a personal choice after taking into account what the specialist recommends. Wishing you all the best :)

Hi Kerrie, I was diagnosed with es+ Her2+ grade3 breast cancer in late December. The initial biopsy was a grade 2 but after removal and new testing it was classified as grade 3. I had an all clear mammogram  5 weeks before finding the lump and even knowing it's  location it wasn't  visible due to my dense breast tissue. So I opted on bilateral mastectomy due to high family incidence (awaiting genetic testing) and had immediate reconstruction done with a fabulous breast surgeon in the public health system. I am very happy with the decision and the result. I could have had breast conserving surgery but really didn't  want to have radiation if I could avoid it. I live 500km from tbat treatment. Fortunately my nodes were clear. I am also having chemo as the her2 cancers are more likely to return. Do some reading about it. Know though there is fantastic targeted treatment out there. It is your breast and your choice. As I knew my nipple was going due to the position of the tumour I couldn't personally see the point keeping part of my breast and then needing surgery to my other very large breast to balance. Goodluck on your decision and ask lots of questions. Kath

Thank you everyone for your support.  it is great to know I have somewhere that I can ask questions and get a response from women who have been in my situation.  The posts have helped a lot.  I have my surgery on the 6 April and I will ask my surgeon more questions.  But I feel at this stage that I will just have breast conserving surgery, as I do have quite large breasts and I feel I just could not handle losing one of them.  The surgeon has said the same as Nadine, so hopefully this is the right choice. Hopefully it has not spread anywhere else. I Suppose I will just have to wait and see. 

Feeling less confused.

Everyones story is a different one so i would suggest speaking to your surgeon snd oncologist and ask all the questions you need to in order for you to be comfortable with whatever decision you make. Thats what i did.

Maryrose  

Hi Kerrie,

my tumour was pleomorphic triple negative 5cm with 30% likelihood of recurrence. Not a hard choice for me really so I had bilateral (BMX).  Very liberating to be braless for the first time in 40 years.  I'm considering my options for reconstruction but not rushing into anything yet.  just letting my body and skin heal for a year or two after all the chemo, surgery and rads.   If I'd had a different type of tumour I probably would have gone for a lumpectomy but hard to hypothesize after the fact.  I found the greatest sources of real information were my chemo nurses and breast care nurse.  They all said ''you've made the best decision", I think mainly because they get to see all the 2nd and 3rd timers coming through their clinics.  It's a big decision to make and I did cry a lot the first 2 days because it is more confronting than you anticipate..  Best of luck with your journey...

xx

Debbie

Hi Kerrie

I was diagnosed at 47 last October with HER2 positive with a lump 1.9 cm and faced the same choice. I agree with Gurneys that deciding between a lumpectomy and mastectomy is such an individual thing and depends on a lot of factors.

There were a lot of things I had to weigh up. My particular surgeon specialised in breast conserving surgery and thought that she would be able to get good clearance but did warn that I could face a second operation if we didn't get good clearance.   Two reasons why I chose a lumpectomy were I have large breasts and was concerned I wouldn't get good symmetry if I were to choose a mastectomy and reconstruction; and I had a strong desire to keep my nipple. I know some surgeons can do this with a mastectomy but in the end I thought I had a better chance of keeping my nipple if I had a lumpectomy.  Luckily I had good clearance with no cancer in the lymph nodes and got to keep my nipple with only one scar that runs under my armpit and which is barely noticeable when my arm isn't raised.

From memory I think my surgeon said the chance of recurrence was about the same for HER2 patients whether they have mastectomy or a lumpectomy but you may want to check that with your surgeon.

Everyone is different and you should choose whatever you feel comfortable with in consultation with your surgeon.

Good luck with whatever you decide.

Take care, Nadine

I had to recently make the same decision. My tumor was triple negative and 3cm (and I had 2 more growing). I was considering a lumpectomy until I discovered I had the BRCA gene mutation. Now I am getting a double mastectomy, as I want to do everything possible to avoid going through this again. 

What does your surgeon recommend?  If you have had good things said of your surgeon by other patients or friends, go with what he/she recommends, perhaps.  My cancer in my right breast is hormone receptive and not HER2 receptive, but the tumour which appeared to be two small tumours turned out to be one very large underlying one.  Two operations failed to get it all, and I am having a mastectomy in a week, and accept that it is necessary.  If your surgeon is as confident as is possible under the circumstances that  a lumpectomy will suffice, that could be the way to go.  Another factor to take into account is if you have private health insurance, as this will greatly shorten your waiting time if you have a mastectomy and wish to have a reconstruction. It can be quite a long wait for a subsequent reconstruction if you are going through the public health system.  In the end, go with your gut feeling after listening to your surgeon.  The best of luck in making your decision.

Hi Kerrie,

I just wanted to say hello and welcome you to the Online Network. If you are wanting to do a bit of reading from other members that have posted about HER2 click here.

If I can help you with anything just ask away.

~Ann-Marie