Lumpectomy vs mastectomy
Hey everyone, I finished chemo on the 4/4 and right after the Easter long weekend I was kind of ambushed with an early surgical appointment to sign the consent forms for surgery. I didn’t have my normal support person (my sister) with me and I don’t know how I feel about my decision. To give some context, when I was first diagnosed in October last year my opinion regarding treatment was to go hard and fast and just kill this damned thing so I can move on with my life. The surgeon wanted to initially do a lumpectomy and I refused and asked for a mastectomy. Then on a subsequent appointment once I had gone and done some research I asked the surgeon if he wanted to do a lumpectomy because I was going to have radiation and he said yes, that is would protect my lung tissue to keep the breast tissue. I then asked if I could have a mastectomy after and he said yes. Then in my previous appointment before Easter he said mastectomy and not lumpectomy, and there was a bit of confusion (and I felt I was being gaslit, not a term I use lightly) as I reminded him of what had been discussed previously and he told me I wasn’t in the right frame of mind to be making decisions (I am struggling mentally but with other issues, not the treatment plan as I understood it). So when I got to this new appointment, I tried to explain what had gone on and asked what my MDT had decided. The registrar I saw said they recommended a lumpectomy and clearance of 9 lymph nodes. The way he explained it to me was that it was better they take the most minimally invasive path as I wouldn’t likely get skin and nipple conserving mastectomy. That it was better to take a little with the option of more later rather than taking it all when it’s not considered necessary. I signed the forms at the time after stipulating that if I wanted one later that they could do that and he said without cancer it would be a low priority but yes. A week after this and I don’t know if the decision is sitting right with me- those who have had the lumpectomy and axilla clearance, how did you feel? And did you need to go back later and have revision surgery to take more margins or have the full mastectomy?
A MUST READ IF FACING MASTECTOMY EARLY BREAST CANCER DIAGNOSIS DCIS LCIS
I am writing this letter in the hope that the following story will help anyone facing a mastectomy or an early diagnosis of breast cancer. Women are being diagnosed with breast cancer every day and not all of them are provided with the information required to make informed decisions. A 42 year old mother of one is diagnosed with early breast cancer at a Brisbane Breast Clinic, August 2013. After receiving her diagnosis from a doctor at the centre she is advised by the doctor to make an appointment with her General Practitioner to attain a referral for a surgeon to have the cancer removed. Her referred surgeon performs a lumpectomy and then suggests the best treatment option for her cancer is mastectomy. She believes she has all information required to make a decision and elects to have a mastectomy four days later. SHE HAS THE RIGHT TO A BREAST RECONSTRUCTION AT THE SAME TIME AS MASTECTOMY. SHE HAS THE RIGHT TO A SKIN SPARING MASTECTOMY. SHE IS A POSSIBLE CANDIDATE FOR A NIPPLE SPARING MASTECTOMY. BUT SADLY SHE IS NEVER TOLD! This is the true story of my friend Lisa. She is currently enduring the emotional suffering caused by not being fully informed of her options. I now know that this is not an isolated case as I know many more women are having this same experience in Australia. Six weeks after Lisa's surgery I too went to the same Brisbane Breast Clinic to have a mammogram. I am a 38 years old mother of two, I had no known symptoms or lumps and no strong family history. Lisa's story saved my life. I was diagnosed by the same doctor with early breast cancer and advised to seek a referral from a General Practitioner. Through this experience I discovered that we currently have surgeons in Australia who are using advanced and accepted techniques like skin sparing and nipple sparing mastectomy that can effectively treat cancer without disfigurement. Both types of surgery combined with reconstruction are helping women preserve their breasts in a way that improves their quality of life after receiving a breast cancer diagnosis. I also learnt that the REFERRAL LETTER was the key determinant on whether or not I would be informed of my options. My first treatment recommendation from a surgeon was mastectomy with no reconstruction. A breast reconstruction, Skin sparing and nipple sparing mastectomy were not an option at the same time as mastectomy. My second treatment recommendation offered by a different surgeon was mastectomy with immediate reconstruction, skin sparing and nipple sparing mastectomy. How could two surgeons in Australia have such vast differences in approach to the treatment of early breast cancer and why didn't anyone tell me? I have leant that not all surgeons in Australia are trained nor practice the latest procedures that are widely accepted and used in Europe and America for the treatment of breast cancer. Receiving a diagnosis of breast cancer is one of the toughest moments a women will experience. You feel compelled to make quick decisions. Hence, I can't believe more guidance is not provided when first diagnosed to enable women to select surgeons based on known treatment alternatives. That's why it is so important to have complete, up to date information and know all of your options before you consent to any type of surgery. You are entitled to ask questions. Your breast care nurse will not tell you about known treatment options, nor can they tell you which surgeon to go to - they are not allowed. But if you want to know who performs skin sparing or nipple sparing surgery ask them and they will tell you. If you don't get the answers you need on a particular procedure then keep pushing for information. Keep searching for the information you need until you get the information you beleive that you need to make a decision. On August 17th, 2010 a new law was passed in New York to ensure that breast cancer patients from all socioeconomic groups are informed about their options regarding breast reconstruction. The law mandates that all women are informed, prior to undergoing a mastectomy, about their right to reconstruction and the types of reconstructions that are available, even if this means referring women to another facility or hospital system. This bill went into effect Jan 2011 and already other states are following with similar legislation. Breast cancer patients are being informed of their options and told where to get the procedures they prefer. Surely, in Australia we do not need to legislate or pass a new law to inform women with breast cancer of their options. It's a fact that in Australia, around 5000 women have a mastectomy every year, but only 6% to 12% of these go on to have reconstructions. This compares with 42% of women in the US and 16.5% in England. We need to ask ourselves - is this because when diagnosed with breast cancer women are not being informed and empowered to know all of their treatment options in order to make informed decisions. After being throgh this experience I hope that this information will help anyone who is facing a mastectomy. If you are facing a mastectomy get a second opinion and consult with a plastic surgeon as well as a breast cancer oncologist. Every women deserves to know there options and I am disgusted that women will continue to be blind sighted by certain surgeons, nurses and doctors who do not feel compelled to tell women about certain types of reconstructive surgery. If you are in a remote area of Australia my heart goes out to you. If you are facing a mastectomy it is in your best interest to see a Breast Cancer Oncologist who specialises in Breast Cancer in your nearest city. Knowledge is power. I wish anyone facing a breast cancer diagnosis all the best and I hope that I can prevent what happened to my friend Lisa from happening to anybody else.
Post mastectomy swelling or seroma?
How did you guys tell the difference between post surgery swelling & seroma? I’m 3 weeks post mastectomy and have swelling well beneath my incision, it kind of looks like my boob is trying to grow back. I saw surgeon last Friday & he said it was potentially some fatty tissue that may have been left behind. My chest also feels quite tight, but I also have some cording. I’m not sure if the tightness/swelling is just normal for this stage of recovery or if I need any treatment to drain potential seroma. Should I contact BC nurse or see my GP or wait & see in coming days??
Experience with suction/negative pressure dressings
So last Thursday I had a bilateral "Goldilocks" mastectomy - it's Tuesday now, so today is the fifth day post-op. I had three nights in hospital and was discharged on Sunday, and every day has felt like a battle with these dressings. It's a system called Prevena that puts a foam layer over the sutures, and then a plastic dressing over that so that the attached pump can then apply a gentle vacuum. Even in hospital, every day has brought patches to the edges to try and maintain a seal. It holds if I'm sitting down but the moment I stand up, the pump goes off, and I hear a little whistle from a new leak somewhere in the dressing. It's getting pretty frustrating - I can't shower without it going off and even just doing a wash at the basin triggers leaks. And forget going for 'gentle walks' - I want to, but not if the dressing's going to leak the whole damn way. I'm due to have them removed on 9 December, so six more days with them. If I thought I was happy to have drains removed, that'll probably be nothing compared to the joy of getting rid of these dressings. Has anyone else had experience with suction/negative pressure dressings like this?
Mastectomy /post surgery pillow
Hi all, I have a brand new mastectomy pillow that I found really helpful that is basically as new. I would be really happy to post it to anyone that is about to have surgery at no cost. I just can’t bear to throw it away and would be happy for it to help someone else! Just dm me with your address if you would like it. I’ve attached some photos x
Scar Management for anyone finding them taking a long time to heal, red, bumpy, itchy...
Hey All, I just wanted to say in the past I haven't really worried about my scars from surgeries, however since doing my Diep Flap recon in February and subsequent revision surgery in July, I had my abdominal wound reopened. It was red, itchy and bumpy so thought I'd have a consult with people who specialise in scar management. Thanks to my friend @nikkid for the contact, I went today. I know in my post op visits there really wasn't much talk of scar management at all, so thought I'd pop a post for anyone who is finding them annoying red, itchy, bumpy and wanted some help with it. They use silicon dressings that I wear at night only, I then massage over 4-6 weeks in circular motions, (even an electric toothbrush) to break up the scar tissue about 4 times a day. My scars are so annoying and irritating,so that's why I decided to get some extra help. So I have a great recommendation in Melbourne for anyone needing that. Big hugs Melinda xo
Decision
I have been diagnosed a second time the first was DCIS 3.5yrs ago, had a lumpectomy without radiation or chemo. Cancer has now returned in the milk duct 2mm. I am having surgery soon was given choice of total mastectomy or total nipple and aerola removal. His recommendation was mastectomy, I have chosen the later. Now wondering if I was offered radiation after the first surgery would I be in this situation now. Also not recommended for radiation after this current one. Not sure if I have made the right decision.DMX or Lumpectomy
I was diagnosed in September 2023 as Hormone negative HER2 +. My first thoughts were DMX & get rid of it, surgeon said "no I needed chemo first" which caused my first & only meltdown pretty much all day if I was on my own as I wasn't in control. I finished my chemo on Thursday just gone & have surgery booked for 22nd Feb. I went back & saw surgeon on Tuesday just gone to discuss options, she has now said "it's my choice what I want" as my daughter made a point of bringing up I had my head set on a DMX. I'm now conflicted as to what to do, I'm swinging every few hours between the two. I don't have access to a McGrath Nurse & have relied on the support from family & work colleagues so far. My chemo nurses have been great but now can't help as it's my decision & not their speciality. Oncologist has said only 1% chance of recurrance if clear margins from the lumpectomy but then more chemo if not clear, I don't want to do that again even though it wasn't as bad as I was expecting. I will be continuing with Herceptin until September this year. Sorry for the essay.
