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Debbie L. · 12-06-2010, 10:29 AM

Joanna,

Sorry you're having these niggles of doubt. I think it's part of the process as we move thru this, those niggles. Our niggles may be about different things but I think we all have them. I remember so clearly how I studied others' histories with breast cancer in SUCH detail, as if I could find important answers there about what would happen to me. But over time, you begin to realize that no one knows what will happen. No one can tell us what will happen. We just have to find our way to live with that uncertainty, and keep moving forward. I will say that because of those niggles, I ALWAYS encourage newly-diagnosed people, and those at treatment crossroads, to get expert second opinions at an NCI-designated Comprehensive Cancer Center.

But on to your question. There have been many studies that have shown that unless the tumor is very large, survival statistics for mastectomy vs. lumpectomy are equal. These studies have not, to my knowledge, broken it down by pathology details (like ERPR, HER2, etc), but they were large studies and if there were a difference for some categories, that should show up as a small difference in the whole group (prompting them to look more closely at subgroups).

There IS a (very) slightly higher risk of a local recurrence (in the area of the removed tumor) with lumpectomy but as Becky noted, that can be dealt with and does not change (worsen) the risk of dying from the cancer. It could be argued that it's certainly not a pleasant thing to go through, but the studies do not show that changes the threat to life.

In the last year or so, there was a study that did show that for very young women (under 40), the risk of local recurrence after lumpectomy was higher than that shown in the other studies. But it didn't have survival statistics. In addition, it showed that chemo reduces local recurrence so that's good news also.

As for more mastectomies in women on this site - I don't know if that's true or not. You could ask us to tell you why that was our choice and I bet most would report that it was not recommended or chosen specifically because of HER2 status. There are many reasons for choosing mastectomy and not all of them are medically-indicated reasons, for example.

I had mastectomy because the tumor in my breast was "occult" -- it could not be found with mammography nor ultrasound.

Debbie Laxague

12-06-2010, 10:29 AM	#4
Debbie L. Senior Member Join Date: Jul 2006 Posts: 463	Re: mastectomy or partial mastectomy? Joanna, Sorry you're having these niggles of doubt. I think it's part of the process as we move thru this, those niggles. Our niggles may be about different things but I think we all have them. I remember so clearly how I studied others' histories with breast cancer in SUCH detail, as if I could find important answers there about what would happen to me. But over time, you begin to realize that no one knows what will happen. No one can tell us what will happen. We just have to find our way to live with that uncertainty, and keep moving forward. I will say that because of those niggles, I ALWAYS encourage newly-diagnosed people, and those at treatment crossroads, to get expert second opinions at an NCI-designated Comprehensive Cancer Center. But on to your question. There have been many studies that have shown that unless the tumor is very large, survival statistics for mastectomy vs. lumpectomy are equal. These studies have not, to my knowledge, broken it down by pathology details (like ERPR, HER2, etc), but they were large studies and if there were a difference for some categories, that should show up as a small difference in the whole group (prompting them to look more closely at subgroups). There IS a (very) slightly higher risk of a local recurrence (in the area of the removed tumor) with lumpectomy but as Becky noted, that can be dealt with and does not change (worsen) the risk of dying from the cancer. It could be argued that it's certainly not a pleasant thing to go through, but the studies do not show that changes the threat to life. In the last year or so, there was a study that did show that for very young women (under 40), the risk of local recurrence after lumpectomy was higher than that shown in the other studies. But it didn't have survival statistics. In addition, it showed that chemo reduces local recurrence so that's good news also. As for more mastectomies in women on this site - I don't know if that's true or not. You could ask us to tell you why that was our choice and I bet most would report that it was not recommended or chosen specifically because of HER2 status. There are many reasons for choosing mastectomy and not all of them are medically-indicated reasons, for example. I had mastectomy because the tumor in my breast was "occult" -- it could not be found with mammography nor ultrasound. Debbie Laxague __________________ 3/01 ~ Age 49. Occult primary announced by large (6cm) axillary node, found by my husband. 4/01 ~ Bilateral mastectomies (LMRM, R elective simple) - 1.2cm IDC was found at pathology. 5 of 11 axillary nodes positive, largest = 6cm. Stage IIIA ERPR 5%/1% (re-done later at Baylor, both negative at zero). HER2neu positive by IHC and FISH (8.89). Lymphovascular invasion, grade 3, 8/9 modified SBR. TX: Control of arm of NSABP's B-31 adjuvant Herceptin trial (no Herceptin, inducing a severe case of Herceptin-envy): A/C x 4 and Taxol x 4 q3weeks, then rads. Raging infection of entire chest after small revision of mastectomy scar after completing tx (significance unknown). Arimidex for two years, stopped after second pathology opinion. 2017: Mild and manageable lymphedema and some cognitive issues.