Masectomy vs Lumpectomy

[Cynthia]

My heart goes out to you; we have all been where you are now. Like you, I had very dense breast tissue. Even after my lump was diagnosed via a biopsy (2cm just under my skin right there for the feeling), a subsequent mammogram still couldn't pick it up. I too had fibroid cystic disease, so there were lumps everywhere. While I heard the statistics about there being no difference in survival between lumpectomy and mastectomy patients, so little was said about the heartbreak of having to go through everything a second time should a new primary appear. Thus, recognizing that there was no right or wrong decision to be made, I did what I felt was best, and that was to do a bilateral mastectomy with immediate reconstruction via expanders. I had my initially surgery in 9/03, and I just recently finished the whole process (i.e., my nipples are done and my tattoos are dry). If it weren't for the faded scars running across each breast, no one would know that they are completely man made. I love having them (though all sensation is gone which is too bad but not horrible in the scheme of things). My husband really could have cared less what I did -- he is a wise man -- he just said he wanted me to live long and be happy. I like looking in the mirror and feeling sort of like me again (albeit with much more perfect breasts than ever before). Aside from the vanity stuff (for which I do not apologize), I feel like the procedure bought me some peace of mind in that I don't have to fret over each lump and bump that would have remained in my "good" breast had I not taken it off.

What you will see as people respond to you is that we have all made such different choices, though each of us seems quite content with the choice we made. I wish you the very best as you figure out what will work best for you.

Cynthia

[Ginagce]

I'm sorry you have to make this decision. It is indeed a tough one. Rather than repeat what has already been said, I will just add my two cents.

I chose bilateral mastectomies with immediate DIEP reconstruction. This surgery is similar to the transflap but no stomach muscles are used so you are not subjected to the side effects of cutting into stomach muscles. There are of course always issues with any surgery, but with DIEP, this is not one of them. For me that was important as I am a very young 50 and have always been quite active.

I am one year plus a little out from my mast/recon and I am satisfied that I made the right decision for me. In my case, when they did the masts, they found another tumor in the "unaffected breast" that had not shown up on the mammogram or with the ultrasounds I had. For me my decision turned out to be a life saver but I do understand that my case is unusual.

If you're not familiar with DIEP surgery, there are some websites that I can dig up for you, just let me know.

Best wishes in your process.

Ginagce

[tousled1]

I want to thank everyone for their replies. I know this will be the hardest decision I make in my treatment and your input really does help. I've seen a plastic surgeon and was told that I don't have enough fat to do tramflap reconstruction but would have to have spacers. I expect to have surgery in early June and will definitely be keeping up with the postings on this website. It's great to know that I'm not alone and that anytime I need someone to talk to it's only a click away.

[michele u]

it sounds like i'm the exception here. I had stage 3 and 35 pos. nodes. My surgeon stronger suggested to just have the lumpectomy. He said that there are so many surgeons doing the mastectomies and not giving the option. He told me then that the lumpectomy and radiation was just as effective. I haven't looked at the stats lately about the difference. I did think about having them both off now, being 2 1/2 years out, but i don't want to stress that arm anymore fearing lymphedema. I dont know what the answer is?

[lu ann]

I really don't think there is a right or wrong answer to this. Just like there are many kinds of breast cancers, there are many different treatments. We just have to go with how we feel about this from the depths of our soul. I know I would have felt like a freak if I did not get the surgery done when I did. I remember the way my mom looked when she had a radical mastectomy where they also take the muscle underneath the breast. I could count all her ribs. She even had her ovaries removed, but no chemo. She died 13 years later with mets to her spine from the either breast cancer or colon cancer. Blessings. Lu Ann.

[CherylS]

Here is a newly released article on the subject that I found just this morning. Hope it is helpful. I had bi-lateral mas. with implant reconstruction and am glad I did.

http://www.komen.org/intradoc-cgi/id...Secondary=true

This article needs reading very carefully.

The figures quoted

"172 (5%) of the women developed an isolated local or regional recurrence.

1182 (33%) of the women experienced another event (distant metastasis, death, or non-isolated local or regional recurrence)."

come from the WHOLE population of 3062, and so does not tell you very much, (except being rather depressing) and I did not see any reference to time frame.

I also do not understand the following comment in the light of a claim of an 80% increase. I presume the first line refers to the outecome of younger v older patients - an accepted fact younger women fare worse, and the second suggests that the type of surgery Masectomey v BCT I guess made no difference.

"Compared to women who were over the age of 50 at the time of diagnosis, women age 35 or younger had a more than two-fold increase in risk of isolated local or regional recurrence.

Young age was also linked with an increased risk of distant metastases, death, or non-isolated local or regional recurrence. Type of surgery, however, was not linked with these outcomes."

DEFINATELY and example of an article that is a best unclear. My first reading was that the tome was masectomy much better than BCT but closer reading suggests that the findings may well be in line with other trials which conclude not a lot of difference.

RB