Did HER2 Neu affect your decision about surgery?

Colleens_Husband · 02-05-2008, 03:14 PM

Dear Friends:

Colleen is scheduled to talk to the surgeon on February 11th about either her lumpectomy. Did the fact that you are HER2 Neu +++ affect your decision about a lumpectomy versus a mastectomy?

Lee

Linda · 02-05-2008, 04:50 PM

I went to a top breast surgeon in LA. For him, the criteria for breast conservation were clean margins and an acceptable cosmetic result. Pathology never seemed to be an issue. I had a lumpectomy.
Linda

Becky · 02-05-2008, 05:42 PM

I went to a breast surgeon who for several years was the #1 breast surgeon in NJ - she had the same criteria as Linda's surgeon. I also had a second opinion who said the same.

I had a lumpectomy.

Gerri · 02-05-2008, 07:47 PM

I had my surgery at a major cancer center and the pathology wasn't a determining factor. The size of the tumor and getting a clear margin were the criteria.

I also had a lumpectomy.

Chelee · 02-05-2008, 08:24 PM

As Gerri just said...I felt the same way. It was my tumor size, and making sure we got clean margins that was the deciding factor for me.

Being Her2 might of come into play a little bit. I knew I did not want to take any chances with such an aggressive cancer. Plus I really didn't like the idea of more surgeries if they didn't get the clean margins...I just wanted to be done with it and move on.

Chelee

mke · 02-05-2008, 08:27 PM

No, I had neoadjuvant chemo to shrink the tumour then a lumpectomy.

Paty · 02-05-2008, 08:40 PM

My doctors said that a lumpectomy plus radiation was equal to full mastectomy. I had a lumpectomy.

janet11 · 02-07-2008, 08:25 AM

I had a lumpectomy too. Same reasoning as above -- pathology didn't affect that decision or surgeon's recommendations.

DonnaD · 02-07-2008, 09:23 AM

Lee,
There is so much to think about when first diagnosed. As time goes on you learn so much. Later you are much better prepared to make your earlier decisions.

No, Her2 stats did not affect my decision. Many on the site have had a mastectomy. When I met with my surgeon, from a large teaching hospital in Chicago, he said exactly what Linda and Becky's surgeon said. I have attended several seminars since in the area and the general opinion was the same. The outcome(same chance of chance of survival) of a lumpectomy vs mastectomy is the same if the tumor size is small and margins are clear. I went in hoping for a lumpectomy but knew if those two criteria were not met it would be a mastectomy.

Remember if your wife has a lumpectomy she will have to have radiation, not so with a mastectomy(for most). Here are a few other things that should go into your decision
Feelings on loosing the breast
Time and place for radiation(about 6 weeks, 5 days a week)
Reconstruction surgery if you choose after mastectomy
Mastectomy gives some the feeling of - get it out as quickly as possible

I hope the appointment goes well on the 11th and you are happy with the surgeon. Remember there is nothing wrong with a second opinion and a good surgeon should welcome it.

If your wife ever wants to chat, I am available. A sister that has been there.
Donna

Linda · 02-07-2008, 09:59 AM

Lee:
I second all the above. Also, I was told that the size of the tumor wasn't as important as tumor size in comparison to breast size (again, it's about cosmetic result, if the breast is small, a large amount of tissue cannot be taken without defeating the purpose of breast conservation. And vice versa.)
I seem to remember that Colleen had neo adjuvant chemo, yes? This is only opinion (I had neo chemo) but I would recommend a really experienced breast surgeon, not a general surgeon. Post chemo is a less common way of coming at the surgery. My surgeon said that chemo sometimes shrinks the tumor from the outside in, sometimes it leaves pieces( probably requiring a mast) -- he didn't know what kind of surgery I would need until he got in there. I had to trust in that judgement -- which is why I wanted someone who was an expert at this particular surgery, and for me -- someone who also believed in breast conservation. Different docs do have different basic philosophies, so I'd also advise talking to 2 or 3 in Portland and Seattle.
L

suzan w · 02-07-2008, 12:34 PM

Contrary to most of the women who have responded so far...Her2+ DID play a part in my decision to have a bilateral mast. vs lumpectomy. My 2nd opinion doc (in Seattle) also recommended the bilateral. Invasive lobular carcinoma tends to recur, and that combined with Her2+ (an unusual combo for ILC) sealed the deal for me!

mimiflower07 · 02-07-2008, 01:09 PM

hi just to share, her2 did play a critical role in bilateral. Just the look on my local Dr's face gave me the heads up. He did state that herceptin has changed the story some what but said it had not been used for early bc long enough to get the full pic. Right there and then i made my decision both were coming off. Gut feeling guided my decision because in the surgery they found it was multi focal and a mast would have been performed anyway. No regrates now when i feel a little pain in the recon breast side i can easily settle down because i usually feel that pain or pull in the other recon breast. Both appear the same both look the same in a bra or in clothes.
suzanne

tricia keegan · 02-07-2008, 03:11 PM

I had a lumpectomy also for all the reason's already mentioned, no regrets! her2 did'nt come into the decision.