Lumpectomy or straight to mastectomy

Be guided by your medical team.  Mine was multi-focial with lymph node involvement so had no choice but to have a mastectomy.

4 months on from lumpectomy surgery and in the thick of chemo I also wonder if I made the right decision too 😥

My reasearch when i was looking into treatment of my own bc, which is different to yours by the way was the survival rates for both are simular but there is a very, very slight difference in the recurrance rate i n favor of masectomy. I had lympectompy and rads which is what the surgeon and team suggested..i was so scared of everything at the start and listened to my team, as I move along this bc road I am learning they are my decions it's my cancer after all..what feels right for you will be the right desicion!..i have no regrets with the lumpectomy though!..Xxo

Thank you so much. 

@Lynn1 This is a big decision & one that I laboured over & I'm sure most of us have. I am really bad at making decisions so this "journey" has tested me big time!! Some dont get a choice but I did & like you, my surgeon suggested lumpectomy/breast conserving surgery & I was happy with that decision as the cancer was caught early. I had DCIS stage 1 but aggressive with no node involvement. As it was aggressive, I guess the thought of a little cancer cell re-emerging in the future, was always a possibility but then we do have to rely on the intuition of the medical team & also playing the "odds". As @arpie said, have you got a family history, as this could impact your decision. I lost my mum to ovarian cancer when she was only 46 y.o. so my team wanted me to have the BRCA gene test to see if I had it as this may have impacted my treatment going forward. My test came back negative. One thing I learnt after my surgery was that if you have rad & you require a recon in the future, if the cancer returns, the recon is very difficult as the underlying tissue is damaged following the rad. This is why my rad onc wanted my gene test results before he went ahead. I am happy with my decisions & followed my medical team, the test results & my gut! I had lumpectomy with clear margins, ovary removal & 3 weeks of rad treatment & have passed my first yr anniversary mammo! It really is a game of chance & playing the odds & we hope we have made the right decision. I dont regret any of mine & they were all hard & at the end of the day, you have to sleep at night & be happy & at peace with the decisions you make. Love & hugs xx

The other bit of information that may help guide the decision is your her2 receptor status. These days, with tripple negative breast cancer, many oncology teams are leaning towards chemo before surgery (known as neoadjuvant chemo).  This can have the effect of shrinking the tumour to make a lumpectomy more possible. It tends to work well with the more aggressive cancers, too. 
I think it would also be worth asking about this as a possibility. Tumour response is monitored throughout chemo.

Although I  had oestrogen & progesterone receptor positive cancer, I was node positive, so that was my treatment path, which I was happy with.

Take care.
PS were you aware of the quake offshore the other day, when it happened?

Good luck with it Lynn. We are all cheering for you. 

Hi @Lynn1  It is a hard to make any decisions when your mind is in overload.  Like you I was Triple Negative.  oestrogen & progesterone negative. I was also (Invasive Ductal Carcinoma ) grade 3, also no node involvement.  I had 3 surgeries last year I started off with Lumpectomy, then re excision for safety margins.   It was after this that I was sent for an MRI were they picked up high level DCIS  ( cells in situ ) so it changed everything for me. I had chemo (TC regime )   and then Mastectomy.
Have you had an MRI.  If not perhaps ask your team for one and would it be of any benefit to you.  ( I'm no expert but I was thankful I did or it would be a whole different story for me ) plus my team were on top of it.
You really have to be your own best advocate and ask heaps of questions.  I was quite prepared to throw the kitchen sink at it if it would mean a cancer free life looking at the big picture (not that there are any guarantees) 
The one thing I was told however by my Onc was that chemo was generally really effective on aggressive IDC  .
Good luck with whatever you decide. If you have any questions just fire away.    xo

It’s a tough decision, and only you can make it. Are you confident in your treating team? Do you have an option for a second opinion before you have to decide? In some ways I find it easier not having an option, my type of cancer means it has to be a mastectomy. I said that to my surgeon the other day and he agreed that trying to make decisions is really hard. Good luck whatever you decide x 

Hi Lynn1, it is a very confusing,anxious time when first disgnosed.You are like a deer caught in the headlights. You are also on a steep learning curve and need to read as much info as you can.
Don’t rush your decision,get all your questions answered so you feel more sure one way or the other.It can depend on all sorts of things such as your age,size of breasts,family history,your pathology,your views on reconstruction etc.
I had a lumpectomy and radiation and it still came back in the same spot 7yrs later. I then had a mastectomy and chemo but because of previous radiation,I have very limited recon options so I remain lopsided.I’m a c cup so find it abit annoying- not as bad with an a cup.All the bc decisions are awful and you just have to go with what feels more right for YOU. I would probably ask your dr if the cancer is aggressive and what are the stats of it coming back after lumpectomy/radiation?
I was horrified to lose my breast at 47 but at 54,it didn’t seem as bad- menopause? or second time around?? I guess I’m saying we are all different and we even feel different at various ages.I’m sorry you are on this bc ride- there is no right or wrong so ultimately go with your gut.