Lumpectomy Lounge....let's talk!
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For those of you that chose lumpectomy, why did you choose that instead of mastectomy?
Any second thoughts? What about the long term benefit
Thank you.
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Katie218- I chose LX because my tumor was small, and healing time for LX is much less than MX. A full MX may also have drain tubes, I didn't want to deal with. I had a re excision and let my BS know at that time if she deemed I need a MX I was ok with it. My breast has a divet where they removed the tumor, I'm ok with that too. (58 yrs old)
Long term benefits, I don't really know. My research didn't take me there. Best wishes to you.
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Kati, I was one who chose LX, but ended with BMX. I was content to have LX &radiation. My sister had that treatment and did very well, 5yr survivor. Unfortunately, genetic testing revealed after the LX that I carry two rare gene mutations that caused my cancer. This would mean a lifetime of close surveillance and the higher probability of recurrance. My MO strongly advised preventative BMX. I don't like being flat and I had a LOT of complications from surgery--i wouldn't wish it on anyone. BMX is no guarantee that cancer won't show up again, but it's all I've got.
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Katie218-- I chose lumpectomy because my surgeon laid it all out for me that my chances of recurrence are not reduced by a mastectomy.
In fact, after treatment (including chemo and radiation) are all done, I will have a 3% less chance of recurrence than the general population will have of getting a first breast cancer. It had to do with the grade, size, and hormone receptors (based on the biopsy and radiology results). She said that, for me, the science was very clear. Good luck and hugs to you.0 -
Katie - Here’s what’s the problem for some of us who might have regrets with a LX. When I was diagnosed, I was told I had a grade 2, 1cm tumor, and would most likely just need radiation. That was the biopsy report. My bs insisted a lumpectomy was the best thing to do. (Although there was a risk of losing the nipples). Then when the pathology report came back after surgery, everything changed. The grade went up to 3. The size went up to 2cm and then my Oncotype ended up much higher than expected. I was told if margins weren’t clean and if my lymph nodes had been invaded, that there would be a chance of a total mastectomy. There was a hyperplasia spot found by the pathology report in the opposite breast tissue that was removed for a total breast reduction. It was never (although bs never explained) seen on all the mammograms, sonograms or MRI prior to surgery. When I realized I had a somewhat aggressive cancer, I now somewhat regret I didn’t have a mastectomy. However, I’m 68, and my breasts aren’t as important to me anymore. If I were still young, I’d opt to have them reconstructed, but it’s a very personal choice. I just now have some fear that what’s left of me will form a new cancer, but as others have said here, they claim local recurrence in the breast isn’t much worse than a total BMX. I believe statistics say, there’s a slight higher recurrence threat with lumpectomies, because after all, you have more breast tissue that’s vulnerable for it. Everybody is different. I do like being smaller, but that’s about all I like about it. I also feel I had no time to make up my mind about the choice
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I went with LX+rads because at Stage I (turned out IA) and Grade 2, it made more sense to me than mastectomy. I know too many people for whom mastectomy, even BMX, did not prevent recurrence. And if MX becomes necessary, it can always be done. But there's no going back. I'm a surgery-wuss, but am seriously considering getting a reduction on the "good" side (a cup and a half bigger even before LX) for symmetry (as well as easing shoulder & upper back pain). My BS and MO heartily approve.
I don't know where anyone got the idea that BMX means no further treatment--except in cases of hormone-negative and node-negative DCIS because chemo isn't done for totally non-invasive bc regardless of what surgery is chosen. True, in most (but not all) cases rads are not necessary after BMX; but in cases of invasive bc (80% of all bc), chemo has nothing to do with MX. That's not just talking apples & oranges, but apples & chainsaws.
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Lumpectomy w/sentinel node biopsy + radiation was the "prescribed" treatment by my BS due to size & early detection of tumor. BS advised that mastectomy was too radical at this stage. And, I, too am a surgery-wuss & agree with ChiSandy's "no going back" viewpoint. Had clear margins, so no re-excision, 1 node removed with no issues & chemo not warranted based on BS opinion of Oncotype score. There are so many variables with a BC diagnosis, so it can be a daunting decision.
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I was kind of talked into it by the breast surgeon. She said if it were her, she'd choose the less radical surgery and rads, which she said are very very safe. She also said I can change my mind right up to the minute they wheel me in to the OR. That comforted me. I hope your decision is pondered and you come to the best one for you.
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I had my two month check today by my plastic surgeon. The left nipple that has been what I call the “pointy one” due to excess tissue above it, can be corrected. He said to wait until after radiation. As I mentioned before, it’s not that big of a deal, but it told me that even with a reduction lumpectomy, they can correct anything you’re not happy with as far as symmetry. I think it just needs a slight tuck, but not sure how the scaring would work on correcting it. I’m not really worried about it now anyway.
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My BS advised removing the lump instead of doing a needle biopsy, when we first found it. Because he got it out with clean margins, that basically made the decision for me to have done with the LX. I really didn't have a decision to make; I think having to decide would be a tough call.
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I still marvel at how normal my right breast looks 2-1/2 yrs. post op. Rounder, nipple points only slightly downward. Left breast (the original equipment one) is half again as big and droops nearly to my waist. Fatty enough that when I stuff it into my bra, you can't really tell... but I can! Now, my BS does not list oncoplastic surgery as a specialty, but if the breast PS she recommends for the left reduction is half as good as she is I'll be delighted. It'll be so nice to be able to buy cheaper bras in normal stores. (Don't get me wrong--those Empreintes and Prima Donnas are gorgeous and come in colors most US brands don't make in cups larger than DD or even D. But there's something totally wack about a bra that costs more than the entire rest of my outfit)! Currently wearing 40F or G. Oh, to be back in a DD! (I'd be able to wear the pretty colors by ThirdLove--right now, I'm limited to Nude 1, 2 or 3--not even black).
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That reminds me ChiSandy. I really thought that I would be two sizes smaller after my LX. I was a DDD, but depending on the design of bra, I could wear DDs prior to LX. I always bought underwires for extra support and lift. Well, much to my surprise, I can still wear many of my DDs. The difference is that I’m lacking cleavage, because I’m not hiking up all that extra breast tissue that somewhat bubbled over the top of the bra, or got squeezed together to produce the cleavage. I like this, because I’m more comfortable lacking the excess weight I used to have. Don’t miss the cleavage at all. So when my leftover bras wear out, (and fortunately, the wires donot bother me), I might try a size D without underwires and see if they produce cleavage just for fun. I bet a padded bra would do it, but as I said before, I don’t miss the cleavage that much. It will just be interesting. I’ve got to get my chemo and radiation out of the way first.
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I still have cleavage, but the difference is that before LX it skewed a little to the right; after rads and until the seroma shrank, it skewed considerably left; and now skews right again. There was a time about a decade ago when I didn't have cleavage, just a gap into which crumbs would fall (and during one memorable folk festival, a moth took refuge while I was singing). I was convinced my bras were garbage, because the underwires would pop out and the front center would pooch out (giving a uniboob look under my clothing). I knew I could no longer wear DDs, so I was buying DDDs, first 40, then 42 amd even 44. No matter how I'd try to bend & shape that center it would not cooperate. And the back band kept riding up. After Oprah did an episode about how most women are wearing the wrong bra size, I visited her favorite shop to be fitted. I found out I was wearing several cup sizes too small and several band sizes too big--the most common fitting mistake. (I had no idea there was even such a thing as a non-maternity/nursing bra in anything larger than F or G). And that unlike American bras, European ones come in all colors (and sexy styles) in even the largest cup sizes. Until that fitting, I had no idea that if the cups are big enough, the center of the bra should lie flat against the center of your sternum--and in the right size cup, I had cleavage again. The straps are almost an afterthought (I have round narrow shoulders so I've always had slipping straps): if the band fits properly, it (and not the straps) provides most of the support and although slipping straps are annoying, they don't impair support.
The reason most American women wear the wrong bra size is that no discount stores and few dept. stores carry any cup larger than DDD (and Victoria's Secret used to stop at DD--they may have a few DDDs now); and that they keep going up a band size until they stop falling out of the cups. (A given cup designation will provide a bigger cup as the band size increases: the cup of a 32DDD is the same size aa that of a 40C). Of course, a too-large back band rides up unless it is shortened and the hooks re-mounted.
That concept is called "sister-sizing" and it can work to your advantage if you need a softer bra after surgery & during rads to "hold the girls up." I was a 38H by then, but I found if I went into Kohl's I could buy an ugly white 42DDD or 44DD in Playtex or Exquisite Form that would keep me from flopping around even if the girls were at half-mast rather than pointing straight ahead. I did that because I was told before my biopsy that I wouldn't be able to tolerate underwires nor maybe even reach behind my back to fasten the hooks--but turns out I was able to wear my back-hook underwires just fine. I wore the soft-cups (as well as stretchy Leading Lady leisure bras) for sleep--for comfort, being able to hold "Swell Spot" seroma-reducing pads in place (it worked), and so I could answer the door in my PJs without looking ridiculous.
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Oh ChiSandy, you're singing my song. Life with monster boobs. I have always had big boobs and when I gain weight I gain it in the gut and boobs. Many years ago I went through a stressful time and quit eating. And my boobs got smaller. It wasn't until they got smaller that I fully grasped just how much they impacted my life. They were CONSTANTLY in the way! It's like doing every single daily task with an infant strapped to your chest. I cannot imagine how much they weigh. I am also up those mid-range alphabet sizes. I was MORTIFIED when the specialty bra lady opened her mouth to announce my size after doing her magic with the measuring tape. "Stop! Stop! Do not utter another word. Just bring me bras and a Jack Daniels straight up."
"I'm sorry, we don't serve alcohol here."
"Well what the hell is wrong with this place? Okay then, just the bras. Oh god, I don't think I can do this sober."
I am rolling around the idea of a reduction. God I would be ecstatic to get to a DDD. Considering my large shoulders, sprung ribs and almost 5'8" height, I can carry DDD quite reasonably. Like a walk in the park! But the thought of more surgery. More cutting. More recovery. More pain. And I admit here that after my lumpectomy went so horribly wrong I was in so much pain I cried and almost threw up from the agony. So I am absolutely not willing to subject myself to that kind of suffering again. It was awful and it scarred me mentally.
I also look at this leather face of mine, wrinkled and crepey not just from the last year of stress but I think also from the tamoxifen sucking my skin dry of hormones and I think, ewwww. I will never win a beauty pageant, but do I have to hate what I see in the mirror every morning? Then I think about getting some work done on my eyes and youtube a few surgery videos and EEWWWWW! So, I am a surgery wimp, like you. But then I think, can it really be any worse than what I lived through? And at least I'd have boobs that don't flop around in bed like a bassets hound's ears. Sometimes when Hub rolls over I have to wake him up and say, "Hon, can you move? You're laying on my boob." I mean, come on. Enough already.
But I do worry that if I have reduction my boobs will be so scarred up that reading mammograms will be impossible. I worry what more surgery will do to the lymphedema. My bad boob is already constantly swelled up. Maybe you and I have to cheer each other one, ChiSandy? Because these big boobs are getting to be too much. (even after a surgical biopsy that took out a hunk and a lumpectomy that took out an even bigger hunk!)
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runor, I used to commit attempted golf. When people would ask me my handicap, they'd be truly amazed when I'd reply "Three." Then after they'd pick their jaws back up off the floor, I would elaborate: "Two big boobs and a bad back." Then there's the icky fungal heat rash from going braless for too long.
Remember those old Buck Brown "horny Granny" cartoons in Playboy? (C'mon, how many husbands think you don't know they read it)? She'd always greet people at the door in a sheer ostrich-feather-trimmed baby-doll negligee, through which were visible two pendulous appendages hanging from clavicle nearly to kneecaps. That's how I feel if I'm still in my T-shirt & PJ pants picking up the mail, or in a nightie letting the room-service breakfast waiter into the room. Except one boob is half again as long as the other. The bra goes on within ten minutes of my rolling out of bed, if I haven't been sleeping in one already.
I was "big" even when I was thin. In college, during the height of the Virginia Slims ads, bra-burning early-feminism pre-Ms. Magazine days, either Glamour or Mademoiselle had a quiz: "Can You Afford to Go Braless?" There were the usual cautions about muscles stretching irreversibly, but assurances that not every woman need worry about that. The touchstone was, when you placed a pencil beneath one of your breasts, whether it would stay put or fall out. Stay put? Better keep wearing bras. Fall out? Congrats: you've come a long way, baby. Just for spits & giggles, I skipped the pencil and tried a Magic Marker--stayed put. Orange juice can--stayed put. Quaker Oats box...you guessed it. Didn't bother to try the coffee can...
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ChiSandy, ha ha! I can so identify! That pencil test, oh please. I can hold a 64 pack of Crayola Crayons under my boob, never mind a pencil.
Ah, the heat rash. I know it well. Or that between-the-boob smell that I get on hot summer days. I swipe deodorant under each arm and a swipe between the boobs. That'll give you a rash too. Or .. and this is a favourite ... when my flapping arm flab and loose boob collide as I move quickly and make a clapping noise, as if they are cheering me on as I rush to do something. Oh my god. My flab applauds things.
I was told after lumpectomy to maybe not wear and underwire bra. Ha ha ha, that is so funny. For a time I wore a night bra with no wires and had that lovely loaf boob, like a big old hunk of bread in my shirt. My Grandma had that look going on. I have it 30 years sooner than my Grandma did. But for me, after surgery, a bra was crucial as the weight of my loose boob pulling down was utterly excruciating. My bra was the best pain relief I had.
I think maybe once, for 8 minutes, when I was 18, my boobs were spectacular. Then gravity came. And as they say, it was all downhill from there. I am going to have to Google pictures of reductions and freak myself out. Never look at surgery videos. Blah!
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I was a 36C once...before I got pregnant. Pregnancy took me up to an F and nursing to a G! Even postpartum depression anorexia couldn't get the girls down past a D. (And that was when I was almost 90 lbs. lighter than now). Even a 65-lb. loss on Jenny Craig took me down to only DD (when I was wearing a size 4 dress). The only "size 4" I can wear now is from Chico's (on top, of course).
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ChiSandy - Runor - You both cracked me up. I’m sure I was wearing too small of bras over the years, but I was never wealthy enough to afford $100 bras. So regular department stores made it impossible to find proper fitting bras. I was for many years 34 in circumference. I’m still 36, so to find even a DDD is next to impossible. Then there was always the bathing suit challenge! I lived in Daytona Beach in my 20s and 30s. (I’m 68 - also back in college, lived through the hippie dippie days). As a young mother in Daytona, lived every summer in a bathing suit. I had to try on probably 100 swim suits just to find one where the top even covered my boobs! I was so frustrated every time I shopped. Funny thing now is - I finally have the perfect boob size along with crepy skin, sags, wrinkles, bruises, sun spots - oh yeah - just look fab! (Well dang, just need to add some ostrich feathers).
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Ladies...my 34-36A's giggle with you! But even after rads and no bras for many many years, the rads breast is perkier. As for pencils...they'd drop & hit the floor. A girlfriend of mine ruins her shirts with spills, always land on her shelf of boobs. My spills end up on my lap!
Onward ladies, always good to laugh.
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Anyone here had positive node or nodes with their lumpectomy? I was told going into surgery I was node negative according to the ultrasound. With a onoctype score of 7 I am being told no chemo and to have rads and hormonal tx. I am getting a second opinion and so far they are saying a lot the same. I am scared because they only took one node to look at and it had extranodal extension. If I had known then I would have done a mastectomy. Now the lumpectomy kinda complicates things since just had the surgery jan 3rd. My tumor was 2.4 cm er/pr + , her2 - 1/1 node positive. I have to make up my mind for tx soon. Chemo ? Which they don't want to do .Mastectomy? With nod removal and rads with that ? That is scary to. Any input would be welcome. Thank you all !!
I will complete my profile later tonite as I am sitting waiting to talk to one of the sec opinion docs. I wasn't sure where to post as I am new at this. Hope I am in the right place.
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B"H
scrv - the oncotype score is for er\pr + and up to three positive nodes - and your score is REALLY very low!!!! The lumpectomy + rads + hormonal therapy is today considered no less successful than a mastectomy - its good of course to get a second opinion but i think you can feel quite confident that the opinion you received is fine. Feel free to PM me
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LOL about "spilling on the shelf!" I can't tell you how many stunning tops I've ruined that way in upscale restaurants or at banquets. I come home, look down at "Thelma & Louise," and scold, "THIS is why we can't have nice things!" At home, unless I'm wearing a tee or top that already has indelible grease stains, I've resorted to donning a bib apron when I eat. (Also keeps the kitty hair off my chest). When my mom was alive, she and her pals down in Boca/Delray used to wear these gold-lamé bibs to protect their clothes when they'd gather at restaurants--dry-cleaning can take a big chunk out of a fixed income. Tucking a napkin into my neckline looks stupid (sort of infantile, broadcasting to the room "I cannot be trusted to eat neatly"), and it falls out anyway.
But if I were ever to get a BMX, I'd just spill stuff on my "spare tire" instead.
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One worry I have over ever having a double mastectomy is that my gut is all you'd see. And my nose. I have a big, Italian nose. Nose and gut. Gorgeous. Right now I think my uppermost gut roll actually helps hold my boobs up.
All my life, with these big boobs, I bought department store bras and forever was oozing out. Over, under, through the arm holes.
Once, and only once, I went to the specialty bra shop where I tried on bras and quietly wept in the change room. Oh, do I truly need to see that much of myself in the mirror - so gross! In the end there were 3 bras that worked quite nicely, each with a price tag over $100. Sales lady was all perky, all you have to do is pick which one you're taking home.
I bought them all. I thought, what the hell, this is the first time IN MY LIFE that I have treated myself to something that I need. I am tired of loaf boobing it all over the place. Amazingly, the right bra actually makes my boobs looks smaller, without being one of those minimizing bras.
I recall the moment Hub got the visa bill and the total price for all 3, taxes included, was just over $400 and he said, you spent $400 on bras? At which point I said nothing. I just looked at him. And in my head I was loading up his snowmobile and quad on a flat deck and selling them so that he would feel he had the spare cash to pay for my extravagant bra purchase. Go ahead, I said in my head, utter one more word. Wisely, he shut his yap. Hub is not an asshole, but he is sometimes too stupid for his own good. And we have clashed over who gets to spend what money on what things and 9 times out of 10, he gets to spend money on his things and I get to be frugal. Mostly that's okay. I don't want a lot of things. But when I do decide, on the rare occasion, that I need something, he has learned THE HARD WAY that yapping at me about it is a bad, bad, bad decision. Like that day he was coming home from work and a tow truck passed him with one of his 'project' trucks on the hook. He asks me, uh...was that my truck that just went down the hill on a wrecker? Why yes it was! You complained that we were spending too much money on things like groceries so I did my part to make sure we were fiscally responsible and unloaded that money sucking piece of crap for us. You're welcome.
He got the point.
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thank you thereisnodespair for your reply and support. Very much appreciated.I did leave out the fact it is stage 2 grade 2. The grade and node are the two things making me so nervous like I should be doing more. Like chemo or surgery. I should be happy they are saying not to, but... Now waiting to see a radiologist to see his opinion. Then back with the ono doc tomorrow to look over all the tests I have had done in the last two days to re-evaluate. Tho I think she will say the same. Then it's up to me ...
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B"H
<<hugs>>
from what i understood the characteristics of the tumor itself is more significant than how many nodes are involved. BTW the nodes are "taken care of" by the radiation treatment to the armpit. the oncotype results show how effective chemo would be - with a score that low i think the suggestion would be that the BC you have is not particularly aggressive and chemo would not be effective anyways.
hope your onc is patient and will answer all your questions and reply to your concerns so that you may feel truly comfortable about your final decision. good luck and good news!!!!
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Thanks, runor & Sandy, I never thought boob stories could be so entertaining!
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runor, here's my dirty little secret: I go to Rigby & Peller (formerly Intimacy Boutique) and try on a bunch of bras. I note the brands and sizes of the ones that fit best and feel comfiest. I buy only one. Then I go home and see if the others (or this bra in other colors) are cheaper on HerRoom.com, Figleaves.uk or BareNecessities.com. HerRoom has better fit & advice videos, and has come up with the Universal Cup Size system for large (DD and up) cup bras. You enter the brand and size of the best-fitting bra you've ever worn (assuming you're still that size), and the cup size comes up as "D" plus a number. DD is D1, DDD is D2, F is D3, G D4, H D5, I D6, etc. If you are curious about a bra you see on the site, enter your band and Universal Cup Size numbers and the site tells you the equivalent size in that brand.
But as to those Empreintes, I went down a couple of sizes and couldn't decide between four different shades of a sheer lacy one. Bob was waiting outside, and I showed him one. "You can buy them all," he said, "Happy Anniversary." I also needed a new T-shirt bra, and for the first time I was able to wear a size that online mfr-vendor ThirdLove makes. So that's my bra wardrobe until my size changes or the bras lose their elasticity.
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So as I was catching up on posts, I see one from "thereisnodespair." The first word that jumped out at me was "node." As in lymph.... a pair of them.
Cancer on the brain...
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I have stage 1 Grade 3 (triple negative) I caught it early and it is small. I chose, well we chose lumpectomy as my doctor stated lumpectomy plus radiation would be the same outcome as mastectomy, radiation and chemo. They hope to have clear margins and will check my nodes. Surgery is 1/26/18. Tomorrow is my Savi Scout. I wish you the best and I am new to this site as well. Much prayers and hugs to yiu
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Had my first mammogram post-surgery and treatment today as well as an ultrasound. The mammo was very quick and not bad at all; I was a bit worried as my BC breast is still sore. The two technicians spent well over a half hour on the ultrasound. One found an area she was concerned about in my non-BC breast but I think they decided it was just thick tissue. I’ll have the report on Tuesday.
MJ
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