Anyone have a lumpectomy?
I am closing in on the end of my chemo treatments and will be meeting with the surgeon next month. I have Stage 3a DCIS. My tumor was 14 cm and I had at least 3 lympnodes with cancer. Has anyone had a lumpectomy with such a large tumor at the beginning? I know that it's shrunk because I can tell a huge difference. Most of the info I find says stage 1 and 2 has options, stage 4 is mascetomy but I find very little infor about stage 3.
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I had a lumpectomy because after chemo, scans showed that both my breast and compromised lymph node were cancer-free. My pathology after surgery did show that all my active cancer was gone, though there was a tiny pocket of non-invasive DCIS that was successfully removed.
My tumor was smaller than yours, 5 cm. with a lovely satellite, and I only had one positive node. Did you have a PET scan or MRI before chemo? Your doctors could order a follow-up scan after chemo to see whether or not much active cancer is left. Then, you could decide on lumpectomy vs. mastectomy.
I know the terminology is confusing, but if you had chemo, your diagnosis would have been IDC, not DCIS. Good luck, making your decision!
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Thanks Elaine!
The terms are so confusing! And i don't think anyone told me about the IDC. My first appointment they sent me home with paperwork that had the DCIS on it but later we discovered it was much bigger and had moved into my lymphnodes. So that's good info to have! I have had trouble finding people that have had lumpectomies. There's LOTS of people talking about mascetomies so I feel like the info I'm getting is very one sided.
I had all the scans after they biopsied my nodes and it came back positive. Which I'm so glad I did because it didn't show on the mammo, it was less than 2.cm on the ultrasound. I wasn't happy with how fast things were progressing in my town so I went to a treatment center over an hour away. When they did the ultrasound it was 8cm and positive nodes. It wasn't until the breast mri that they saw it was 14 cm.
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Ember, your invasive cancer also could have been ILC (lobular), not necessarily IDC (ductal). You need to obtain copies of your pathology reports and keep them for future reference so that you know the important details. It is not at all unusual for only DCIS (or lesser atypia) to be the only thing found on initial needle biopsies but then more “junk” to be present on final surgical pathology. Ductal cancer is more common, but I don’t think the initial DCIS guarantees that the invasive cancer is also ductal
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Hi Ember, and welcome to Breastcancer.org.
We're so sorry for the reasons that bring you here, but we're really glad you've found us. As you can already see, our Community is full of super helpful members always willing to lend advice, information, encouragement, and support -- we're all here for you!
In addition to the posts above, you may find some insight on the main Breastcancer.org site's page on Stage IIIA, IIIB, IIIC Treatment Options, which outlines the circumstances where a stage IIIA tumor might be eligible for lumpectomy.
We hope this helps. Please let us know how else we can assist you, and we look forward to seeing you around the boards!
--The Mods
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Ember - as Elaine & Melissa posted, DCIS is Stage 0. If you are Stage 3, you have either IDC or ILC. You need to find out which it is.
It's really important that you get copies of all your diagnosis & tests results. You also need to find out if you are Hormone negative of positive (ER/PR + or -) and if you are HER2+. All of those things will impact your decision about lumpectomy vs mastectomy and your future treatment.
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Hi Ember
I had neoadjuvant chemo as my tumour was large. By the end of chemo I felt nothing, so I had an MRI, mammogram and ultrasound. All showed nothing. I then had a lumpectomy, which showed there were still cancer cells. Then I had a mastectomy which also showed there was about 15% of tissue with cancer. So all i can advise from my experience is don’t trust scans. My onc advised to get all cells having one left is one too many. I took his advice.
Good luck with your decision.
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I had a lumpectomy 11 years ago ( stage 3a). No regrets...had 10 nodes removed, 4 positive. It was a very easy surgery - outpatient, no pain, quick recovery. I think your surgeon will have an opinion as to your best option...best wishes as you continue through treatment
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@ Amanda 6, I had a lumpectomy because they thought I had stage 1 cancer until I went to surgery, they found 7 lymph nodes were positive which boost my stage to a stage 3. I am devastating and now wondering if I should go through a mastectomy. Did they offer a mastectomy to you at the stage 3?
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I had a 6.5 cm tumor and had a lumpectomy with a breast reduction. Oncoplastic surgery they called it. No lymph node involvement. I too did neoadjuvant chemotherapy which did shrink the tumor. I had large breasts (d-dd) so the reduction was an option. I am about 6 weeks out and the surgery was a piece of cake. No drains either!!
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Hi
I agree do not trust scans!! The true story is not until surgery. I was diagnosed with Stage 1 that turned to Stage 3 after lumpectomy surgery and pathology came back
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No, a mastectomy was never mentioned. I had 10 nodes removed, 4 positive. Truthfully, I went into my treatment not as educated as I should have been. I was diagnosed as a stage 2 before surgery, then " upgraded" ? to a stage 3a after - that increased my chemo time from 4 sessions to 6. Would having a mastectomy mean that you did not have to do radiation? And what side was your surgery? Mine was left side, 3:00 position, & I have had heart damage due to the radiation - but this is not the norm of course, just a possibility, & not a likely one. I'm so sorry that you're going through this, I know the feeling...wishing you the best!
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Hi Ember,
Like Newnorm, I had neoadjuvent chemo as my tumor was large - and that was only what was palpable. I have very dense breast tissue and mammograms and ultrasound didn't show anything for nearly 2 years, though a mass could be felt. By the time the scans showed abnormalities, a biopsy confirmed IDC in 2 lesions and at least 1 lymph node. After 5 months of chemo my scans looked great. I reminded my doctors that they looked great before too, but my surgeon gave me a choice and I went with a lumpectomy in Nov 2017. My surgeon was very disappointed to find a 5.5cm tumor and 2/4 sentinel lymph nodes with cancer. (I can only imagine how big my tumor was prior to chemo.) My surgeon is known to prefer breast conservation; I asked if she would've offered a lumpectomy had she known how much cancer was left. She said I was close to what she considers the “borderline" - 5cm, and would've told me that and still given me a choice. As for the outcome, she left it to me to decide whether I wanted to go back to surgery for a mastectomy or further lymph removal or both. After discussing this with my medical and radiation oncologists I decided to forego additional surgery for the time being, start an aromatase inhibitor (Letrozole) ASAP, and radiation therapy as soon as I was healed (about 1 month). I had 36 sessions of radiation and except for slight burns in the last week, had no problems. Although my cancer was on the left, radiation has not affected my heart.
It's been 3+ years since the lumpectomy and almost as long since I began taking the hormone blocker. As far as I know - and I see my medical oncologist every 6 months and have a mammogram and ultrasound every May - I'm doing alright! My Best Wishes to you. This is a difficult decision but talk with your medical team and make the choice that feels right for you
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