Lumpectomy vs Bilateral Mastectomy

[boca468]

I am 42 yrs old and was diagnosed HER2 positive in June 2010. Estrogen/Progestine negative, lymph node negative, and my Genetic testing came back negative as well. No family history of BC or Uterine Cancer. I am trying to decide whether to have a Lumpectomy vs Bilateral Mastectomy. Of course there is fear in choosing the wrong way....I'm concerned with recurrence but statistically I'm seeing it's the same with either course. My oncologist (as well as a cousin who is an oncologist) feel the lumpectomy and radiation will take care of the tumor, which has shrunk considerably with the 4 rounds of AC I've had so far as and I'm just now starting 12 wks of Taxol/Herceptin. So many emotions but don't want to make a decision based on that vs facts. I know there is not a 100% guarantee out there but sure could use another opinion. Meeting w/a plastic surgeon next week to consult on surgical options and have all of my ducks in a row before a decision. Thoughts?

[katarina777]

I would be very wary of consulting  a plastic surgeon, and expect for him/he to advise you without prejidice.

generally, any doctor will advise you according to their specialy, and I am pretty sure a plastic surgeon will be eager to do the bilateral mastectomy.

It's just that I have heard too many horrorstories, and if you end up with  bad results then suddenly no oither plastic surgeon will be eager, or even willing to offer help?

It's a major, and painful procedure.

Katrin

[Cleveland Clinic]

Dear boca468:  In general, survival with lumpectomy + radiation and mastectomy (of the affected breast) are the same.  There is a slightly higher incidence of local (within the breast) recurrence with the lumpectomy + radiation.  When there are absolute right and wrong approaches, the surgeons will generally not provide both options.  (as an example a person with small breasts and a large tumor may not be a good candidate for lumpectomy - aesthetically speaking).  Talk to your oncologist but also have discussions with the surgeon and plastic surgeon as to what you can expect the cosmetic result to be either way.  A bilateral mastectomy is usually an option when it is determined that a woman is at high risk of developing breast cancer in the other breast and this is really a separate question from the lumpectomy/mastectomy question.

[cookie1951190]

A related discussion, her2 breast cancer was started.

[mamamusso]

I would get a second opinion or third , even if you have to pay out of pocket!