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JessicaV · 09-21-2015, 05:24 PM

Two issues here.
First, with a lumpectomy you generally have to have radiotherapy so end up with damaged, non-stretchy skin for any breast reconstruction surgery. Which does not generally apply if you have only a mastectomy.

Second, I learnt that reason the outcome is the same for lumpectomy and for mastectomy is achieved via a step they fail to mention: there are a significant number of lumpectomies (from memory 25-30%)that progress to a recurrence requiring a mastectomy.

What they should say is that there are similar clinical outcomes for
a)those who have a mastectomy and
b)the combined figure of those who have a lumpectomy that progresses to a recurrence and needs a mastectomy plus those who have a lumpectomy that does not progress.

For many of those whose cancers progress after a lumpectomy, there is a deep sense of being on the path to death, hopelessness and despair. In fact, they are no more at risk that the matching 25-30% mastectomy patients who do not have the risk of that experience of recurrence to get to the post-surgery NED base one position. You are offered the possibility that you will retain your breast and not lose it, but at the risk of having to have a recurrence and then probably losing your breast anyway.

09-21-2015, 05:24 PM	#17
JessicaV Senior Member Join Date: Apr 2014 Posts: 206	Re: Weird Mammogram Report Two issues here. First, with a lumpectomy you generally have to have radiotherapy so end up with damaged, non-stretchy skin for any breast reconstruction surgery. Which does not generally apply if you have only a mastectomy. Second, I learnt that reason the outcome is the same for lumpectomy and for mastectomy is achieved via a step they fail to mention: there are a significant number of lumpectomies (from memory 25-30%)that progress to a recurrence requiring a mastectomy. What they should say is that there are similar clinical outcomes for a)those who have a mastectomy and b)the combined figure of those who have a lumpectomy that progresses to a recurrence and needs a mastectomy plus those who have a lumpectomy that does not progress. For many of those whose cancers progress after a lumpectomy, there is a deep sense of being on the path to death, hopelessness and despair. In fact, they are no more at risk that the matching 25-30% mastectomy patients who do not have the risk of that experience of recurrence to get to the post-surgery NED base one position. You are offered the possibility that you will retain your breast and not lose it, but at the risk of having to have a recurrence and then probably losing your breast anyway. __________________ 1997-2004 many cysts, many MG & U/S: polycystic breasts. Sept 2013 found lump,Cyst?? forgot lump. Dec 2013 GP check, Referred for U/S, MG,FNA. 7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail." Cancelled my psych clients for the week. 8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon. Cancelled my psych clients for the month. 13 Jan 14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan, 16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done. 19 Jan 14 discharged home with 1 drain. 22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment. 26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans. 30 Jan 14 HER2+ high amplification, 13 gene copies per cell. 21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up. Cancelled my psych clients for 6 months. Feb 14 First MUGA test: 71%, First C15.3 test: 20 7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and Claritin, reflux/indigestion helped by Somac. July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily. Sept 14 Second MUGA test: 69% Cancelled my psych clients for 2014 Dec 14 Third MUGA test: 70% Second C15.3 test : 20 Cognitive fatigue delays return to work. March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring. July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing Aug 2015 Heart good, no evidence of cancer, just Fatigue. May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets. Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.