There is so much to take in from diagnosis isn't there? I can only describe my experience for you, so hope some of this helps.
My tumour was at the far side of the breast, near the surface and away from the nipple. It looked like a good candidate for a lumpectomy, so that's what I had. From the ultrasound and mammogram it appeared that I had a 28mm tumour. Further tests on the breast tissue removed during the lumpectomy discovered that the tumour was actually two that had possibly fused so it was not isolated to a duct. It was invasive and it was also closer to 50mm in total, which is more serious but still early breast cancer. I also had an axillary clearance as the nodes had tested positive. Usually, the surgeon would go in again within two weeks to remove more tissue.
It was explained to me that if the margins aren't clear in the lumpectomy, then the surgeon can go in a second time to take more out and then you can have an MRI to see how things go but my surgeon said that if the margins weren't clear the second time, I would have a higher risk of recurrence. Since most of the affected tissue has already been taken, it would be difficult to guarantee clear margins and that would mean a third surgery for a full mastectomy. I chose to go with a full mastectomy because it simplified my risk factors. My original surgery was at the end of last November, so I expect further surgery was difficult to schedule in our town at the time and I was keen to get into chemotherapy before Christmas.
So I have a full mastectomy booked for after my chemo but before my radiotherapy.
Since my total tumour was larger, it was Stage 3, Grade 3, I had 5 out of 18 nodes affected, I am hormone positive ER and PR +ve, but herceptin negative. My chemo treatment involved 4 cycles of AC (every three weeks) and 12 weekly cycles of Taxol - I have three left. After surgery when they finally know what they are dealing with, your oncologist will figure out the best regime to suit your situation and also whether radiotherapy will be helpful - it usually is. I will have 5-6 weeks of radiotherapy after I've healed from surgery. It is a long road, but I am travelling fine, even with some delays in chemo from low white blood cell counts.
My McGrath Foundation breast care nurse has been fabulous to clarify what I don't understand and I hope you have somebody with similar expertise to talk to. I am talking again to my private breast surgeon prior to my mastectomy to clarify some issues relating to whether I go for a tissue sparing mastectomy for a reconstruction after radiotherapy.
Hope this long post has been helpful. Good luck with your surgery. It is surprising how "doable" it all is in the end.
