Lumpectomy or not?

ok well, in 2005 they found a cystosarcoma Phyllodes of borderline status in my left breast. They removed that one, then last week I actually saw a lump in my breast (I am 22 weeks pregnant) and went in .... they biospied it and it is another phyllodes tumor. When reading about these it looks like the reccommended treatment for borderline or malignant is mastectomy I am worried that when I go to the surgeon he is not going to just let me get the lump out this time. What have you heard in reference to these kind of tumors?

[BhumikaMD]

Hi,

A wide local excision surgery is usually performed depending on the size of the tumour. Also the tumour is known to increase in size in pregnancy.

A wide excision with a 2cm margin of normal breast tissue is appropriate therapy for benign and borderline phyllodes tumors unless they are so large that this is not cosmetically feasible.

In the past, many authors have advocated mastectomy for the management of malignant phyllodes tumors. Since phyllodes tumors are not multicentric, there is no clear-cut biologic rationale for mastectomy, and series have reported the successful treatment of malignant phyllodes tumors with wide excision.

You could take a second opinion and then decide about the further plan of management in your case.

Let us know if you have any other doubts and post us about how you are doing.

Regards.

[lhughes]

Just to let you know, if they need to do a full mastectomy, the reconstruction after the baby is born is not so bad.  A tram is very similar to a c-section, a little more painful and difficult to get over.  There are so many options, even more than a year ago...just find you a good plastic surgeon who comes highly recommended.

If they need to remove the breast, then by all means, let them have it.  It won't be long before you can get the reconstruction, no one really knows that you'll be boobless for a short period.  I went without a boob for a year and a half and I swear, even those that KNEW I had a mastectomy didn't realize there was only one breast.  See my pics with Lauren...the breast exposed is the one that's missing.  Yes, it's emotional to lose that breast, but you can get through it.

Let me know if you want to talk, I'm here to help, if I can.
Lisa