Masectomy vs Lumpectomy

[tousled1]

I was diagnosed with advanced Stage III breast cancer HER2 positive estrogen/progesterine negative. Two tumors in right breast 2.5cm and 2.1cm. Also lymph nodes tested positive. I am going through neoadjunct chemotherapy now. Next week will be half way through. Next cycle will be with taxtore. After chemo is completed I will have surgery. Sister had DCIS, first cousin invasive ductual cancer, aunt invasive ductual cancer. I have had 2 lumps - one on each breast removed in previous years no cancer. Have fibrocystic disease of breasts. Would like to know individual experiences - masectomy vs lumpectomy. Thanks.

[lu ann]

If I had to do it today, knowing what I know now, I would have bi-lateral mast. I had my surgery 14 1/2 years ago. Since then I have had multiple abnormal mamograms, ultra-sounds, and 2 benign biopsies of the healthy breast. I too have very fibrosystic breasts, which cause much unneeded anxiety.

I had mast. with tramflap reconstructive surgery(tissue from below belly button is used). I'm sure they have fine tuned the process since I had my surgery, Nov. 1, 1991. I had 3 revisions since my origional surgery. They used more tissue then needed so they could go back and use liposuction to shape the breast. I also had the healthy breast lifted and the areola made smaller(I nursed 2 of my children). I waited a year to get the first revision, where they did the lipo and fine tuned the healthy breast. Six months later I had the nipple done. They did not transplant tissue from another area in my body. The plastic surgeon made a few cuts at the end of my new breast and created a nipple. I then went in and had the nipple tatood the same color as my healthy nipple.

I have mixed feelings about this surgery. I'll give the positives first.

I can go without a bra as my breasts are perky.I feel balanced. Mentally I think I did better then if I had opted out of reconstruction. I got a tummy tuck in the process.

I have much nerve damage from the surgery as they cut the tranverse abdominal muscle and nerves. The post-op recovery took a long time. I could not stand up straight or lay down flat. I was horrified post-op at the immediate results. I think the reconsructed breast could have masked the reccurrance.

In your situation I think you could go either way. They will be treating you systemically any way and might be able to clean up cells within the breast after your lumpectiomy. I wasn't a candidate for lumpectomy because they could not get clean margins free of cancer cells.

Take care and feel free to ask as many questions as you need. We all learn from each other.

God Bless You.
Lu Ann.

[Alice]

In my case I opted for the mastectomy. When I was first diagnosed there were 2 tumors visible on the mamo and ultra sound.When I had an MRI it showed another tumor on th other side of the same breast. I had neoadjuvant chemo as you are having. After the chemo had started to shrink the tumors it revealed that one of the tumors was in fact 2 tumors so close in proximity that they were undistinguishable until they started to shrink.
Having so many tumors and them being spread out as they were would have made lumpectomy very dificult and being small breasted to begin with results would be bad.I also would be in constant fear of local reccurance.
Every case is different and how you feel about it is an important part of it.

I think the best thing you are doing is to have the neoadj. chemo.When I had it I couldnt find anyone that had had it and I was forever questioning my decision. Now as I look back a friend of mine has gone thru cancer at the same time as me only she had the mast. before the chemo. When we are both done with treatment I can say with certanty that the chemo worked and she can not as she has no proof of tumor shrinkage due to the mass being removed before chemo.
Good luck, Alice

[Esther]

Four years ago I had a bilateral with immediate reconstruction with expanders. While I am pleased with the results, in looking back, if I had it to do over again, I would go with a lumpectomy instead.

I made the decision out of fear, even knowing that the bilateral did nothing to prevent mets, just prevented another primary.

It's a personal decision, either way.

[Alice]

Hi again,

I forgot to ask if you are going to have herceptin at the same time as taxotere?
If not ask your onc why not. The chemo I had was A/C dose dense x 4 carboplatin,herceptin,taxol x3. I know the carboplatin isn't aproved for stage 3 yet, I had it being in a study. But I'm pretty sure herceptin with taxotere is.
Take care, Alice

This is a recent post that is on essentially the same subject.

http://www.her2support.org/vbulletin...ad.php?t=22740

I included some links on the risks of Contralateral occurence and survival for BCT and masectomy.

I also included some links as to surgical impact risks etc.

Whilst looking for material on fats and BC I saw a "serious" book on breast cancer treatment and reconstruction options and risks. I forgot to look at the publication date, but there might be an upgrade anyway.

"A Womans Decsion"
Breast Care Treatment and Reconstruction"by Karen Berger and John Bostwick 111.


RB

[tousled1]

I will next have 4 treatments of taxotere - once every 3 weeks. I have one more cycle of adriamycin and cytoxan. I am going to have the herceptin treatment alone -- after the surgery. I will have it for 52 weeks. My major problem now is my blood counts -- they drop so low. I get neulasta the day after chemo and procrit once a week. I'm suffering from sever fatigue but I guess I shouldn't complain since I have no nauseau. My doctor believes that a lumpectomy should be just effective as a masectomy but I am personally leaning toward a double masectomy. I have large, very dense breasts and had my mammograms every year. I discovered the lump and last year nothng showed up on the mammogram.