Question Please help

[soccersarah2005]

My mother was diagnosed with Stage A breast cancer. She also has I believe its called her2neu or herperctin positive..sorry I do not know how to spell it. Her friends are telling her to have her breast removed because the cancer could come back. She is taking chemo and the herperctin for a year. Does she need to have her breast removed so it does not come back any where else.....please help?

[Jackie07]

Hi,

It's a very personal decision. Some patients chose to have breast removed and some would follow the doctor's advice to just have a lumpectomy.

Some would even have bilateral mastectomy so they could have breast reconstruction done. I chose bilateral mastectomy (without reconstruction) because mine was a recurrence and I was 'tired of' the whole situation (Mammograms had been misread for 4 years). Most doctors will tell you there's no difference statistically in 'overall survival'.

[Paty]

Hello,

I had a quadrantectomy, 1/4 Of my breast removed. After that i had chemo, radiation (32 sessions) and herceptin for a year. After almost 6 years i have not been recurrent with the cancer. My doctor explainded that lumpectomy plus radiation equals mastectomy. But i recommend that your mom discusses her options with her doctor and both decide what is best for her.

[BonnieR]

This is not a situation where one should be taking advice from well-meaning friends who don't know what they are talking about! The most important thing is that she is receiving chemo and Herceptin, the best drug for treating HER2+ cancer. Her doctors have hopefully discussed the options with her and explained why this course of treatment has been chosen.
She may be needing help during treatment as she will be tired and maybe have some discomfort. Perhaps you could be available to do chores, be sure she gets some nourishment in small meals. Maybe go to doctor appointments and help take notes.
I know you are worried for her. Keep the faith.

[karen z]

I agree with BonnieR. This is not her friends' call but that of her oncologist team. If there is any doubt in the team, one goes for a second (or third) opinion. These are some of the most important decisions she will likely make in her lifetime. That is why we go to docs and get more opinions if needed.

[sarah]

whatever she choses, a lumptectomy or mastectomy she must have herceptin and radiation and why not have chemo - horrible but who wants to risk a return??? also if she's ER+ she should take an aromatase inhibitor such as Femara. Cancer is serious, do more not less. As an oncologist here said to me we are going to treat this with an atomic bomb. Be safe not sorry.
health and happiness
hugs and love
sarah

[Lien]

I had a lumpectomy and radiation and am 8 years out from diagnosis without a recurrence.

Actually, a recurrance in the breast is not the worst thing. The doctors perform a mastectomy, as the radiated breast cannot be radiated again. What we worry about is a recurrance in a different part of the body. That would be much harder to treat.

As far as I know, there is no difference in the risk of distant recurrance between mastectomy and lumpectomy with radiation.

The chemo and/or herceptin are meant to reduce her risk of recurrence. So it seems like she is doing everything right. Unless she wants to have a mastectomy for other reasons, her friends are not helping her. If she has any worries about this, she could discuss them with her doctor or bc nurse.

Jacqueline

[ElaineM]

My suggestion would be not to listen to well meaning friends. A woman's decision about surgery should be as a result of what she has discussed with her doctors and the information her doctors have presented to her. Each person's body and situation is different. A doctor could have 10 patients with the same health problem, but each person's treatment might be a little different depending on that person's circumstances and condition.
All the best to your Mom. Blessings !!

[Mtngrl]

There's a perception that more surgery equals better outcomes. It's logical, but not evidence-based. Back in the day they used to take the breast, all the lymph nodes, the chest muscles--it was called "radical mastectomy," with "radical" referring to its old meaning of "root." It was always the wrong surgery. Either the cancer had already metastasized, in which case deforming the poor woman did nothing to help her get well, or it was contained in the breast and maybe local lymph nodes, and it went too far.

It's scary to have cancer. You want it all gone. But especially these days, with neoadjuvant chemo becoming more common, less extensive surgery is better--fewer adverse consequences afterwards, easier time healing, etc.

Those of us diagnosed at stage iv don't usually get any surgery. Psychologically that can be challenging, but physiologically it makes sense. It's not the original tumor that kills, it's metastasis. Chemo and radiation will help make sure to get any cancer cells that might already be wandering around in your mom's body.

[tricia keegan]

If your Mom has a lumpectomy plus radiation it gives the same overall survival prognosis as a mastectomy although the risk of a local recurrance is slightly higher.

I had a lumpectomy with rads and chemo plus hormone therapy almost seven years ago and doing fine so far and wish your Mom luck with her decision