Surgery decision, newl y diagnosed with cancer

[leah1234]

I have just been diagnosed with breast cancer and have to decide if I want the lump removed and 5 weeks of radiation or the whole breast removed. They do not know what stage or kind of cancer and I quess they will not until the surgery. I am pretified and do not know what to do. I am 40 years old.

[paigern10]

A related discussion, wondering.... was started.

[Under Forty Pam]

I am 39 and having a lumpectomy tomorrow 7/28.  I have DCIS and had 2 opinions from breast surgeons.  Both said a lumpectomy was plenty at my stage and size.  Get a couple opinions, it will help you decide.  Both surgeons told me the same thing, they never even mentioned mast. for someone my age, stage, size, etc.  Each person is different.  Good luck.

[boninclyde]

Thank You.

[muse2]

Ask what the pathology department calls a clear margin.  In my case the department expects to see at least 1 mm of benign tissue from any cancer cell to the edge of the removed tissue.  They take the tissue rmoved and slice it very thin so they can see clearly under the microscope.  I understand some pathologists require 2mm, others just want the edge to be clear of cancer cells.  It is how they can tell if all of the cancer mass has been removed by the surgeon.

[muse2]

The radiologist want the incision to be healed so that skin is not so sensitive.  I was lucky and healed well in about three weeks so could start a little sooner than some.  Ask to see the oncology radiologist now to get some of your questions out there.  There are many options for radiation, depending on the size of the department and the types of machines they have.

[boninclyde]

What are clear margins everyone here keeps talking about? Just searching post/net. Found lump in breast Sunday. Dr.s are scheduling me for mamo/ultrasound and possible biopsy.

[CCF-RN,MSN-JS]

Dear leah1234, The decision to have a lumpectomy or mastecomy can be a difficult one when both are viable options. Most research shows that lumpectomy (with clean surgical margins) combined with radiation therapy has comparable results to mastectomy. An important consideration is whether there is adequate breast tissue remaining after lumpectomy to produce a good cosmetic result. There are some situations in which lumpectomy may be associated with a higher risk of recurrence such as with large cancers and when it is multifocal (involving more than one area in the breast).  A surgeon with expertise in breast cancer would best be able to advise you of the pros and cons of each approach for your particular situation.

[leah1234]

I had a mamo and ultrasound which led to the biospy.
I became very sick during the biospy and they were only able to get one sample and I am not sure if that is why they do not know what stadge of cancer it is or if that is normal not to know until after the surgery.
I am leaning toward the lumpectomy because it seems a shorter recovery time. Does radiation not start right after surgery?

[muse2]

Leah,  How were you diagnosed?  Your surgeon can always talk to your again after the lumpectomy.  You will have 3-4 weeks before you can start radiation and time to decide with the doctor's advice if mastectomy would be better.

I am 45 and did not even consider a mastectomy because the surgical excision biopsy gave me clear margins the second time so radiation actually returns my risk to recurrance as very low in the same breast.  I knew that if they could not clear the margins, I would be going ahead with the mastectomy.

I also knew I would then have options for reconstruction, but was very relieved that I did not loose my summer to the recovery the mastectomy and reconstruction would have required over my two outpatient excisions.

You do have a lot of options, ask a lot of questions of surgeon, oncologist, and radiologist.  Now's the time!

[lizziecee]

I had a 2cm non palpable lump and initially was offered either lumpectomy and radiotherapy or mastectomy. I was told at that stage they would do lymph node sampling as SNB was not common in the UK 3 yrs ago. I decided to go with lumpectomy, figuring I could always go back for a mastectomy. It turned out that I had malignancy in 2 of the 8 nodes sampled and went back a month later (had infection at the lumpectomy site) for a total axillary clearance. Another 2 nodes were cancerous. My surgeon got clear margins on the tumour and I didn't need a mastectomy although it was quite a shock to find I needed chemo, then radiotherapy. I have a half moon scar under my nipple/aureola but it is not disfiguring at all. I am very happy with the decision I made considering I knew nothing about breast cancer.
Everyone is different, but it is good that you are seeking other patients' views. I only got onto the internet when going through chemo so really made my decisions on very little knowledge.
I wish you well and hope everything turns out okay.
Liz.

[who_is_this]

I was much younger, and had a mastectomy with reconstruction that looks really good.  Do what feels right to you.  Hope everything works out well for you.

[leah1234]

Thank-you for to all of you that have responded to me.

The doctor advised due to my age I have the lumpectomy but he said it was my decision. He told me that the survival rate is the same with both decisions except the fact that cancer can come back in the breast .

thank you all who have responded. It just helps to hear from others

[Happy4825]

Your choice, if you do choose a Mastectomy, with reconstruction   is a smart one.  I am glad I had a Mastectomy, it wasn't bad at all.  Good Luck.

[Lynn T.]

I was diagnosed in January of this year and I am 53.  I opted for a lumpectomy, but after the surgery it was discovered that a lymph node was involved.  I went ahead and had a masectomy and I have to tell you it was not that bad. It is just a scar on my chest and it really doesn't bother me a lot.  I am just glad to have the cancer out and the option of reconstruction down the line.  Due to my lymph node involvement, I am undergoing chemotherapy.  Since I only had one lymph node involved, and had a masectomy, I won't need radiation.  I will move on to reconstruction.

Be agressive with your cancer treatment - cancer is hitting you at a young age, so you want to fight with all tools available.  Get a second opinion if you feel more comfortable.  It's your life, your body, your future.

[Granny47]

5 years ago I was in your same situation.  I knew I had a small tumor but had no idea if there was lymph node involvement.  My family and I talked to the surgeon and I decided on the lumpectomy and radiation.  Surgery removed a 1cm tumor and lymph nodes were negative.  I had 36 radiation treatments.  While it was not fun, it was not the worst experience of my life. I believe your age will come into consideration as the cancer can be more aggressive the younger you are (I was 53).  Seriously consider a mastectomy and reconstruction.  I will keep you in my prayers.

[japdip]

Your surgeon should be able to give you some guidance as to the type of surgery that would best benefit your situation. No amount of advice from others can do much for you except to give you varied opinions and possibly increase your knowledge about lumpectomy verses mastectomy. I personally chose mastectomy but I was 25 yrs. older than you and I'm not sure how I would have felt about it at age 40. I didn't opt for reconstruction but that too is an entirely personal decision. I was fortunate that no lymph nodes were involved and I had no additional treatment following the mastectomy which by the way was no big deal for me. I actually had more discomfort after my biopsy than following the mastectomy. One thing I will advise though is TAKE YOUR TIME and explore all avenues of treatment; this is NOT the time to rush into anything. Best Wishes ......