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Aussie Girl · 11-24-2013, 08:50 PM

Hi, Kaa,

Difficult to give a definite answer - the exact findings on all the scans and site of the lesions make all the difference. MRI can over- and under-diagnose DCIS (It did both in my case.)

Remember that she has the option of having a lumpectomy with biopsy of any other calcifications/suspect areas that aren't included in the biopsy site. It does depend on how those lesions are scattered and whether the ones away from the main area have calcifications or not. An MRI only detected area in the biggest problem, if it isn't close to the main tumour, because MRI guided biopsies are very expensive (depending on your insurance) A sentinel node biopsy should occur at the same time as the lumpectomy (but if she has proven node mets already, then an axillary dissection straight up).

Should there be DCIS at the edges of the lumpectomy, she can then chose to have re-excision at the edges of the lumpectomy or move on to mastectomy.

Her invasive cancer, presumably measured on scans and core biopsy is small (good prognosis), but a lumpectomy +/- some extra biopsies should provide a fuller picture.

Given that you sister doesn't like the idea of mastectomy and reconstruction, a lumpectomy plus radiation plus probably chemo may suit her better. If the other breast shows nothing and there is no strong family history, then bilateral mastectomy is not required from a treatment stand point, unless there are emotional or particular physical reasons.

You have some thinking time, but occasionally tumors that are high grade can grow fast. Try to get some sort of therapy happening within the month.

I unfortunately had to go on to mastectomy because of the size of my invasive and in situ tumor and my terribly fibrotic breasts. I probably would have needed a bit of lateral padding if my large lumpectomy had been enough. I miss my left breast and haven't decided on reconstruction yet. I'm not comfortable with my prosthesis yet, but that's because the chemo makes the site tender. I'm glad I have a sensitive nipple remaining on the right side though.

Best of luck to your sister and good on you for finding her info when she must be overwhelmed.

Aussie Girl

11-24-2013, 08:50 PM	#12
Aussie Girl Senior Member Join Date: Jul 2013 Posts: 260	Re: mastectomy versus lumpectomy for HER2 Hi, Kaa, Difficult to give a definite answer - the exact findings on all the scans and site of the lesions make all the difference. MRI can over- and under-diagnose DCIS (It did both in my case.) Remember that she has the option of having a lumpectomy with biopsy of any other calcifications/suspect areas that aren't included in the biopsy site. It does depend on how those lesions are scattered and whether the ones away from the main area have calcifications or not. An MRI only detected area in the biggest problem, if it isn't close to the main tumour, because MRI guided biopsies are very expensive (depending on your insurance) A sentinel node biopsy should occur at the same time as the lumpectomy (but if she has proven node mets already, then an axillary dissection straight up). Should there be DCIS at the edges of the lumpectomy, she can then chose to have re-excision at the edges of the lumpectomy or move on to mastectomy. Her invasive cancer, presumably measured on scans and core biopsy is small (good prognosis), but a lumpectomy +/- some extra biopsies should provide a fuller picture. Given that you sister doesn't like the idea of mastectomy and reconstruction, a lumpectomy plus radiation plus probably chemo may suit her better. If the other breast shows nothing and there is no strong family history, then bilateral mastectomy is not required from a treatment stand point, unless there are emotional or particular physical reasons. You have some thinking time, but occasionally tumors that are high grade can grow fast. Try to get some sort of therapy happening within the month. I unfortunately had to go on to mastectomy because of the size of my invasive and in situ tumor and my terribly fibrotic breasts. I probably would have needed a bit of lateral padding if my large lumpectomy had been enough. I miss my left breast and haven't decided on reconstruction yet. I'm not comfortable with my prosthesis yet, but that's because the chemo makes the site tender. I'm glad I have a sensitive nipple remaining on the right side though. Best of luck to your sister and good on you for finding her info when she must be overwhelmed. Aussie Girl __________________ 31mm Infiltrating duct carcinoma Grade 3, ER/PR-, HER2+, Neg Sentinel nodes x 5 49mm field of DCIS 17 June '13: Screen detected impalpable mass, Mammogram neg, US. 25 June '13: Diagnosed after multiple biopsies and MRIs 28 June '13: Left lumpectomey 4 July '13: Left Mastectomy 12 August '13: Commenced TCH chemo Mid December '13 : TCH finished. Herceptin continuing three weekly. 4 August 2014- Herceptin infusions finished. END OF THERAPY - YAY!