lumpectomy or mastectomy?

[ndnyny]

My 88 year old mother is scheduled for a lumpectomy to remove 2 masses that encompass a large part of her right breast (DCIS, solid type, high nuclear grade, w/necrosis, and calcifications) at 11 o'clock (2.8 cm) and 1 o'clock (1.6 cm). Last year, mammography and sonography revealed microcalcifications (5 cm x 4 cm area) that for a number of years had been diagnosed as benign. Immediately following the stereotactic biopsy, my mother developed a clotting disorder which caused a huge hematoma which made her breast look and feel like an enormous eggplant that remained painfully hard for months making any surgery impossible. Two months later, on Mother’s Day, she had a stroke which seriously weakened (partially paralyzed on her left side) and in a nursing home for four months. Now, in addition to being barely able to see and move, having diabetes and vascular dementia, she has to deal with cancer coming back in the other breast after 10 years. Both surgeries have been recommended as she will not be having either chemo or radiation at her age but continuing Arimidex. We worry about whether to have a mastectomy with general anesthesia because she may not recover fully or at all from it or a lumpectomy with local which is less stressful on her already weakened state. It's taken her a week to recover from a week's worth of daily doctor and medical appointments.We will not opt to “do nothing” as the thought of it continuing to spread at this rate is frightening. What do you recommend?

[japdip]

Lets be optimistic and hope that your mother will suprise everyone and tolerate the surgery better than anyone expects. Best Wishes to the three of you .... hoping for an uneventful recovery.

[ndnyny]

Thanks for the understanding and vote of confidence. My sister and I hope we are making the best decision for her. Even with the local anesthesia plus sedation (didn't mention it, sorry) She will have a hard time recovering. Most of her breast tissue will be removed anyway; she'll need a prosthesis. But psychologically, we all expect it'll be less traumatic. It'll be stressful and difficult anyway but we'll make it through. Thanks again.
Peace.

[japdip]

What a dilemma!! I'm not sure that the lumpectomy would be done under strictly local anesthesia .... unless you have been told this for sure. There would need to be some other type of IV med. given .... according to the procedures I'm familiar with the pt. wouldn't be completely awake .... even an excisional biopsy isn't done under "local only". I believe I would opt for the lumpectomy in her case though. Sounds like it's going to be a very traumatic procedure (generally speaking) considering her fragile condition either way. Regards .....