Mastectomy after stage IV dx

Primary dx April 2002 (right breast). Mets dx May 2003 lung nodule in left lung. Lung nodule was removed (along with about 1/3rd of left lung) - did another year of chemo. I have been considered stage IV metastatic NED since that time.

Mammogram three days ago shows pea-sized mass in right breast. If it turns out cancer is back, do I have mastectomy? I always thought mastectomy was to stop metastasis. What would be the benefit?

Anyone have any experience or advice here?

Thanks,

Peggy in Florida

Dear Peggy,
This is out of my field, but this is just my opinion. I assume you had a lumpectomy the first time around and it spread to the lungs and now it is back in the same breast. When I was dx, mine was small but I had calcifications that where all over, and I am small breasted, so I had the mastectomy. For me, not everyone feels this way, but I just wanted it gone. If it was me in your shoes I would consider it. I wouldn't want the to take the chance of it coming back again or metting some place else.
What does your surgeon recommend? When I had my surgery she said she got it all, that the chemo and rads where just clean up and I hope she is right. In Oct. I hit 2 years of being NED. If loosing your breast is very hard for you to cope with talk with your surgeon about a skin sparring mast. and see if you would qualify for that.
Peggy, I wish you the best, I don't think I am the best to help you with this, since I have not met. but I hope this helps in some small way. TC. k

Hi Peggy~
I'm so sorry you're wrestling w/ another difficult decision. Hope & pray that the new mass is just some benign artifact...please keep us posted.
As for surgical options...I guess it just depends on what you'll feel most comfortable doing. If you do have a mastectomy & remove all the breast tissue, you won't have to deal w/breast cancer again, b/c you don't have breasts anymore.Unfortunatley, neither mastectomy nor lumpectomy can prevent metastasis- in fact, I don't believe there's anything out there that has been proven to effectively prevent the disease from spreading. Those little cells can break off at any time & make there way thru the body. I do remember reading some data that says that having a mastectomy does NOT necessarily prolong survival compared to a lumpectomy+radiation.
These are all such difficult choices to have to face. I hope you don't have to go thru it again.
Keep the faith,

Hi Peggy
This is out of my field of experience as well however.... Once you have stage 4 or metastatic disease your disease is systemic. A mast. will not prevent future mets but it will get rid of the mets in that breast. Chemo could do the same thing. Would you also get chemo after the Mast??

As well, a while back there was some discussion on surgical trauma and HER2 activation. I subscribe to that theory and if it were my wife, I would want her to take the least invasive or traumatic course of action possible.
I hope this doesn't confuse the issue even further.

Good luck,
Al

[Lolly]

Peggy....
I had a right mastectomy after left mastectomy, chemo and rads failed to prevent recurrence and spread to right breast. Two years after right mast. I recurred to right axilla, so my experience would support what the others have suggested and what you suspect...it boils down to personal choice, and although I still recurred I'm still glad I had the surgery. I believe Al raises another good point regarding surgical trauma and HER2 activation, as my surgeon and oncologist felt it was important for me to be NED and on Herceptin maintenance therapy before the right mastectomy...Good luck with your decision, and don't be afraid to ask the hard questions :)

<3,
Lolly