Mastectomy or lumpectomy

[Nancy52]

Hi - I recently has a lumpectomy for invasive carcinoma, estrogen positive.  The tumor was small 1.2 mm and in the 2 o'clock position.  A sentinel node dissection was completed.  11 lymph nodes were removed, 8 from under my arm and 3 in my breast.  The 8 under my arm were free of cancer, 2 of the 3 in my breast had cancer.    I am scheduled to have additional tissue removed next week near the tumor site that may or may not be cancer.   Given the “spread” to the breast lymph nodes would a mastectomy offer a better prognosis?  Also would this be considered a stage II cancer?  Jumping ahead but chemo and radiation are the likely treatments.  What can I expect in terms of going to work and taking care of my family?  Thanks.

[Cleveland Clinic]

Dear Nancy52:  Whether or not a lumpectomy or mastectomy is done depends upon several factors:  Whether removal of adequate amounts of tissue (any cancer) will leave enough breast tissue to give a good cosmetic result; extent of disease; and choice.  If a lumpectomy can be successfully done, radiation will be recommended.  If a mastectomy is done, radiation may or may not be necessary depending on other findings.  Staging should be discussed with your doctor.  It is based on size of tumor and lymph nodes (and to some extent, the location of these nodes).  So without reviewing the pathology and surgical report, we cannot comment on staging.  Chemotherapy is often recommended in node positive disease but there are other factors that would be considered and should be discussed with your oncologist.  Likely, endocrine therapy will be recommended at some point.  How you will respond to therapy will depend upon the therapy that is given and your response to it (everyone is different).