lumpectomy/mastectomy
 

hello ladies,

i'm nearing the end of my chemotherapy and i've been considering getting a double mastectomy (and oophorectomy) done in order to give myself maximum insurance against this disease. i am 35 years old, staged at 2b, 2 nodes positive, her2+, er/pr+, extensive lymphovascular invasion. i've already had a lumpectomy followed by a re-excision to get clear margins. i know that lump + rads = mastectomy in terms of long term survival. But couldn't another local recurrence metastasize before I catch it? All this time I was ok with the idea of doing mastectomy but now after reading another thread on this board and also as the date of surgery approaches, i find that I am wavering.

Any advice?

Thanks,

Misha

Hi Misha,

2B too. Did lumpy, rads, chemo and Herceptin. Try searching past threads as there are valid reasons for going either way.

For example, I think even with a double mastectomy there are still small amounts of breast tissue remaining that could host a recurrence.

I've made peace with doing a lumpy only. Good luck to you, Bev

your comfort level...?
 

Hi~
Technically, a local recurrence is not metastasis - distal recurrence from the primary site is true metastasis. a local recurrence of disease does not necessarily change your prognosis. But it is a huge pain & i know we all would love to minimize how many rounds we have to go in the ring & start swinging again.

You may get lots of people offering their opinions (if I had a dollar for every time someone said "why didn't you just get a mastectomy from the very start" then having to explain the circumstances of Stage IV, blahblahblah...) Ultimately, it's a matter of what YOU are most comfortable with. As my doc said, "You can't get breast cancer if you don't have a breast."
Make the choice that's best for you- that you will be most comfortable with, whatever it is that will help you sleep at night & get on with life without feeling threatened by the potential of a recurrence.

I'm a Stage IV'er-(liver metssince primary dx in 5/02), so my breasts have been the least of my worries. I did finally have a Skin Sparing Mastectomy on the L side (after 1st lumpectomy in 5/02, then excisional biopsy after a local recurrence in 2/06, then mastectomy after another local recurrence & very high grade DCIS in 12/06) but chose to leave the R side since the R side has always been clean clean.
I could have chosen a prophylactic Mast on the R side, but my doc said he would just be altering healthy tissue & not necessarily changing my prognosis/survival. A local recurrence I can handle...distal mets again - ugh! I don't want to think about it.

Go with your gut...& as Bev said, you've got to make peace with your decision~

Best of luck & Keep the Faith~

Hi Misha!

Too bad we can't see into the future so we can make the best decision today. When I was first diagnosed in 2003 the mamo showed it was a very small tumor...could not be felt. I went through all of the options, talked to several doctors/surgeons, spent time with a breast cancer advocate, talked to those who had already gone through this process and then made the decision I felt was best for me. My doctor recommended a lumpectomy...I chose bilateral mastectomy thinking surgery would be all I would need.

In my case, I have not regretted that choice once...just the opposite. The small tumor had spread to the lymph nodes. We hit it hard with chemo and radiation. When it came back in 2005, we hit it hard again with chemo and started on Herceptin. After four months, NED; stopped chemo but continued Herceptin. Lymph nodes are involved again so have started on another chemo regiment.<O:p</O:p

All of this to say, I have never regretted my original decision and have never wondered "what if." That's really the question...what can you live with. Continue to explore all of your options and then make the decision that is best for you and the one you can live with...then don't second guess. May you find peace in the midst of this storm.

Carolyn<O:p</O:p

Hi Misha.

It's a hard and personal choice. I had no evidence of cancer in my second breast (about 5 weeks ago) but my initial left breast cancer - a total of 17cms of it, including a 4x3x3.5cm tumour - hadn't showed up on a mammogram or ultrasound. So I was worried it was in my other breast, or COULD grow in it, without me knowing until it was advanced. And the thought of that and more chemo was too much. So, it was an easy decision and not one I have regretted so far. I miss my breasts (of course) and I wish I still had them. But I much prefer being symmetrically flat to the feeling of being lopsided that I struggled with for the three weeks that I just had one. But above all, for me, the fact I have no ducts left (my cancer was ductal) and no remaining tissue that could be hiding tumours is the right decision.


And I found surgery easy and recovery fust fine - I joke with friends that the best sleeps I had post diagnosis came compliments of the anaesthetist!

Good luck coming to your decision- whatever it is.

Bx

Misha,

Wish I had a crystal ball but I don't. Your decision is a very difficult one and whatever you decide just make sure that you are comfortable with your decision.

I opted for a bialteral mastectomy and have no regrets. My reasons were many -- large tumor, extensive calcifictions in good breast, dense breasts, lymph node involvement, and an extremely extensive history of both breast and ovarian cancer on both my mother's and father's side.

I can not offer you an advice, just be at peace with whatever decision you make.