Topic: Lumpectomy and recurrance

With mastectomy the chances of local recurrence, ie in the same breast, are reduced to 2-4% whereas with lumpectomy+radiation the chances of local recurrence are 5-12%.

Chances of distal occurrence or metastasis are the same.

I had a lumpectomy 3 years ago - found a reoccurance just about two months ago...now waiting on double mast with TRAM recon....  doctors said chance of recur after lumpectomy was 1/10 and if I had another lumpectomy 1/3 (however really a higher number because I am only 38).  I think you are right - this site is for breast cancer - after I started treatment I never logged back in - so in never shared the positive story!  your question reminds me how important it is to share the good news along with the fears.  Hang in there!!!!!!!!!! 

I am sorry to say that persistently on this site negative  regarding lumpectomy, recurrence etc is posted and the info is not always accurate.  IF someone has elected to go the MX route, that is absolutely their choice and may come about for a number of reasons, but it does become monotonous having to post to point out the upsides of lumpectomy.

Oddly enough, I am not a fool and I wouldn't have gone for a lumpectomy if I had concerns.  I am by profession an economist and so am comfortable with stats. I am more than happy that I made a good choice.   IF I have a recurrence or a new tumour at some future time, then I would have an MX.  IF.

In Britain, where I live, mastectomy is pretty much last resort and far fewer women in Britain choose to go that route (except of course where unavoidable).  Our survival rates are very similar to the US.

Maybe the best thing you can do is to go back to your doctors and ask them to go ove the op with you again. 

 I sympathise with Jean above, but the standard would normally be to have ~SNB ~WITH your op, not separate to it.

You are node clear which is a great thing for prognosis etc.  Take heart and be of good cheer. 

PLEASE MAKE NOTE :

saying : " I also feel the more I read that women who have a masectomy have less recurrence than women who have had a lumpectomy.  I just have to pray that if there is a recurrence, they find in time before it spreads..."

IS NOT FACTUAL, NOR A QUOTATION OF FACT.  It is kindly meant, and someone sharing their thoughts, but it is not a presentation of fact, it is a presentation of someone's feelings in her own context (which is perfectly her right)..

 If your doctors provide you facts to deal with that you aren't content with, then you will know what sound and well judged choice will work for you.

But don't get frightened to bits by so many different things we read on this site, because many of them won't be relevant to you particular diagnosis or situation.

You and me have fairly similar diagnosis, stage etc.  I reckon ~I am ok.  And I hope very much you are too.

good luck, and talk to the doc!!

 .

PS 73 - have you been to a medical oncologist? My mistake in getting a mastectomy was in listening to the stats given to me by a breast surgeon - who told me, even though my tumor was less than 1cm, Stage 1 and Grade 1 - that I WAS a candidate for mx - and that a mx would reduce my risk for recurrence to nearly 0%. Later I found out (from breastcancer.org) that recurrence rates are EQUAL for mx and lump with rads. I'm so sorry I bothered with the mx - which led me to get a free-tram reconstruction - which then led to mrsa in my abdomen - and continuing problems from then on. If only my BS had referred me to a medical oncologist (if only I hadn't been soooo scared) I wouldn't have suffered so much from the mrsa. Please be sure you speak to an oncologist (or two) before deciding on what kind of surgery you need............more than anything, early stagers should be advised that "the greatest thing to fear is fear itself." Good luck and stay well!

My Mom is a healthy 84 year old, 15 year BC survivor.  She had a lumpectomy and rads only. 

But I'm kinda screwed though, see my sig line.  Sometimes it's a crap shoot, sometimes your pathology is the best indicator on how you will fare.  You just don't know.  If I were in your place I would be very comfortable and content with the lumpectomy and rads.  If your onc recommends chemo, do it.  And try not to dwell on a recurrance that may never happen.  You have a life to live!  Best wishes,

Elizabeth

Edit to add:  I'm going on the assumption that I will be in the survivor side of the stats.  No matter where you are with this disease assume that you will be well, that you will not get a recurrance.  Consider your glass is half full, not half empty.  It helps emotionally.

PS - the only woman I know of that had a recurrence with lumpectomy chose to not have radiation - her recurrence  was caught (both were dcis).  I had two opinions - surgical and oncologists - all said lumpectomy for me (one said she would not even do a mastectomy if I wanted one - it was that clear of a case) with the exception of brac testing - if I came back positive then it would have been a bilateral mastectomy, but that is a different issue all together in my opinion.  I am not brac positive (which I figured as I have no family history but with my age of 44 the docs wanted that test done). 

I had radiation, and do not worry too much about local recurrence - obviously - I will be vigilant about self exams and mammograms (which in my case did find my tumor - no one could feel it in my breast).  systemic, well - even at a stage 1 is something that i try not to worry about, but that is the scary one to me.

Good luck on your mammogram this week - I'm sure it will look great!

At my support group I was told the difference is 5 vs 10 percent for local recurrence, but the same for mets.

Which I think is really interesting, it's almost as if, if a cancer is determined to metastasize, the key factor is not which surgery you do.I think you also have to balance out the possible complications of reconstruction.

With lump you do have to be more vigalent, but that's not necessarily a bad thing.

I really feel for women who have a recurrence after mast, it seems so unfair.

Yeah, I guess there are a lof of reasons to go with one vs the other and its not so black and white.  My tumor I think was fairly large and Im a B chest.  It was a lot to take in at the time.  All I knew for certain is that I wanted the tumor out of me as soon as I found out.

suzny - that is odd, is that accurate? ..also, the % for local recurrance but what about a brand new cancer? i have concerns for both.  obv i need to be diligent but I also worry about false negatives on mammograms.

konakat, great!  i am excited for the new hair, my hair is was naturally curly so we will see how it comes back.  ..and I feel ya with the I have cancer but I feel fine.  Obv there are bad bad days w/ the chemo but on the days I feel good, it's like i need to re-read the path to believe it.

Thanks for all the input!

Me dear - I think you are suffering from Stats fatigue!!!  In my instance, Professor Smith of the Royall Marsden, London (our top specialist cancer hospital, and he's sort of  the Chief Exec too) told me last week I have an 85%  survival rate over 10 years, and a low recurrence rate etc.  I know I am not you and you are not me, but we are not dissimilar in dx.  Be of good cheer. (as much as it is reasonable or doable to be such a thing - if you feel fed up and pissed off, well, so do I quite a lot.  This is not a fun journey is it).

As for being more vigilant, we just do mammos etc etc on a regular basis same as anyone else would. 

You are not in any way monotonous - you are a fellow traveller going through all the mental  agonies we suffer.  But there is too much unsubstantiated chat on this Board concerning a number of different topics that ends up putting the fear of god into people when it doesn't need to be there and doesn't help.  I do not mean by this that people aren't entitled to their view, but as an example I have read some real twaddle about chemo which just doesn't help anyone having to go through that particular nasty thing  (including me and I am still doing it presently.).

To all ladies who have had to go the MX route, I mean no disrespect here at all, (my mother died of cancer when I was 12, and she had all the nasty ops) and dear Leah';s post is such a good example of a lady with few choices available to her at that time, most unfortunately. 

Ultimately you will make your own choice, but it seems to me that you need to grab hold of an onc who knows their stuff, and makethem go through all this slowly with you, and make really sure you take a good friend with you who can really help write down the info.

With regard to surgeons, doing surgery is their thing and mine would probably chop off anything and everything given half a chance - she is mentally that way inclined.  The trouble is,  when first dx we tend to get a lot of info from the surgeon.  Actually, what we need at that point is a good global overview from a bloody good onc.  And oncs don't always agreee with surgeons.

I have found most of this journey very contradictory and confusing and I wish I had made the oncs make some more straightforward statements somewhat earlier than I did.  Also, never make the assumption that they remember specific details of your own thoughts and queries because sometimes they don't. 

 For me, at the appropriate moment I am not anti having MX (except for all the reasons we none of us want an op anyway) it is just that moment hasn't come yet for me and I hope to continue in good health so it won't ever happen.

Lastly, depending whereabouts in my breast I got a recurrence, I would be fairly certain to go for MX in as much that if it were right near where the firswt tumour appeared, then I wouldn't be able to do Rads, so the choice would then be made for me really.

Anyway, very best wishes to everyone on this interesting thread, and may all of us take Elizabeth's advice and eat cake and ice cream!

n.b. an Australian firm has announced this week that they are making a special medicinal ice cream for chemo patients!!!  Sounds damn good to me............

xxx

Just got back from my daily 10k steps walk which I cunningly route to the Kings Road where there is an excellent ice cream parlour!  My walk through the park on the way was so lovely in the chilly sun and I really enjoyed kicking the leaves!  No chemo SEs today so set quite a decent pace too.

It has struck me, as you are doing chemo, do not underestimate the effect that has on your emotions.  In that regard, I have been very low indeed mentally and it was only when I saw Prof Smith last week  that my head cleared and I now feel a ton better.  I am not worrying any more about the stats because he gave me "the skinny" and it wasn't that complex - far less so than all my researching had made me think it was.  I won't state further exactly what he said as it may not be appropriate for you, (though it actually seems like it is to me!).  He was surprised I was so very down and frightened - really frightened (though not because of my op choice) and it turned out that another onc had made a stuff of the prog and recurrence info.  It took the Prof about half a minute to put me right and he was pretty cross that I had been given poor info.  .   So just be bloody peristent in getting clarity for YOUR OWN SITUATION.  I'd bet three large ice creams that the minute you have that clarity, many of your brain's manic wanderings will calm down; that's how it worked for me.  I suggest that you either write or type out exactly your questions, and bring copies of stuff you printed out if you feel it necessary.

I've made some lovely friends worldwide and we PM eachother.  This disease has no nationality, no boundaries and absolutely no sense of decency!

very best of luck to you all -

xxxxxxxx

With regard to ladies having MX, it might be they post for a longer period on this site as they might be waiting for reconstructions and all sorts of things.

Once I have done with Rads in January, I shan't be coming back on here very regularly other than to try to help "newbies".  With a bit of luck I;ll be starting a new job and I~ will be so bloody bored with this damn disease I want to just get on with living.

HI,

I had a similar dx as you:  ILC, 1.1 cm, 0/2 nodes, ER+/PR-, Her2- and I had a lumpectomy followed by radiation and Tamoxifen.  I just passed my 3 year mark and I'm doing great.  I have 4 girlfriends who had Lumpectomy with rads and they are out over 15 years w/o reoccurrence. I also had the oncotypeDX test and I think it would be a good idea for you also.  That made it easy for me to decide not to have chemo.  Good luck!!

Nancy and Diana, great news, now that's what I needed to hear.  Virginia, thanks for the information.  I have an index card full of bullets but perhaps more concise questions would be better. Apparently the onc test is pricey after chemo. Im a little miffed that he didn't do it in the first place when insurance would have covered it.  I know my decision to do chemo would have been the same but still...

I think the obvious as well as lack of hormones induced from chemo would be the culprit for my recent stress.  I need to work on it.  I think kicking leaves around in the beautiful autumn we have here should help.  ...what a gorgeous visual that you gave me :)

I do hope you will find the time to come back here and let us knowwhat happened when you do your visit to the hospital.

Good luck with it.

 You know, I never really wondered why I got cancer.  I have eaten healthy, organic food for donkey's years , etc etc.  That's the thing about this disease, be we saints or sinners in our habits, this unwelcome visitor can arrive.  Equally, it can go away again.  Either way, it is never ever our fault.

xxxxxxxxxxxxxxxxxxxxx

Hi younggranmaof2, I am not sure but just wanted to say good luck with your apt.  Follow up and let us know how it went. 

Virginia, yes, of course I will follow up.  Its tomorrow, Im nervous.  :)

Sounds like a heavy weight day.  Finges crossed for you.

xxxxxxxxxxxxx