Lumpectomy vs mastectomy decision
Diagnosed Feb 2026. IDC, Grade 1, HR+, HER 2 negative, Ki67 22percent
I think I am still in disbelief. No family history. Also did genetic testing, BRCA testing shows no mutations at all.
In addition, in 2019, was diagnosed with low grade, non muscle invasive bladder cancer. I get monitored every 3 months for that, it has come back 3 times, which requires a removal procedure and chemo in bladder. For that reason, I am becoming fearful of testing and test results I think .."Fear Of Finding Out."
For that reason, re: lumpectomy, and because the radiation and possible later heart/ lung / rib cage issues with radiation, and the ongoing testing w mammogram,or US follow ups over years, I am leaning towards double mastectomy . Still trying to get to the " cons" of double- like if chance of lymphedema is alot higher. Surgery date of April 7.
Any thoughts on things you considered when deciding what to do? My surgical oncologist said if I do lumpectomy and AI, but no radiation, chance of recurrence 30-40 percent!
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Hello @patrish44paws .
Thank you for joining the Breastcancer.org community. We’re sorry to hear about your diagnosis, but we’re glad you found your way to our community boards.
Making decisions about surgery is never easy, and it’s completely normal to have questions and concerns. We hope the resources shared below will provide helpful information as you consider your options.
Please feel free to ask questions here or join one of our virtual support groups for additional connection and support.
The Community Team Navigators
About Surgery:
Surgery forum: https://community.breastcancer.org/forum/91
Mastectomy: https://www.breastcancer.org/treatment/surgery/mastectomy
Lumpectomy: https://www.breastcancer.org/treatment/surgery/lumpectomy:
Lumpectomy vs. Mastectomy: https://www.breastcancer.org/treatment/surgery/mastectomy-vs-lumpectomy
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I was diagnosed with triple negative stage 2b grade 3 in April 2025. Did about 6 month of chemo and had surgery in February. No personal cancer history, no family cancer history, or genetic mutation. when diagnosed my first thought was get double mastectomy with flat closure. I was very much okay with that. Upset about cancer, not upset about possibly needing that solution, other than fear of any kind of surgery in general. I did a whole pro/con spreadsheet and came to the same conclusion. As time went on while getting chemo, I second-guessed myself and thought I must be crazy to get a surgery that extreme, when my doc said lumpectomy with radiation would do the trick. And I could get a bilateral reduction and lift too if I wanted. Well, I pick the lumpectomy with bilateral reduction and lift, even though I was still on the fence the whole time. The moment I woke from surgery I was regretful. My all standards my whole treatment was a slam dunk…chemo went smoothly, no evidence of disease at surgery, smooth recovery, and I look good. I do not want radiation. And I am seriously looking into going right back to surgery for a double mastectomy with flat closure. Just the thought of living the rest of my life (long or short) with the breasts that tried to kill me is more than want to deal with. I am just as terrified of surgery today and I was before my procedure last month, but this time I really want to go for it. Everyone is different. Make a list of the pros and cons for both for you, including how you feel about your breasts and how you feel about the followup. Imagine what your everyday life would be life the day after surgery and see what feels right to you.
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patrish44paws, I chose bilateral mastectomy based on my pros/cons list, my age (diagnosed at 57), my scan-anxiety. I also had the attitude that I was 100% going to do whatever it took for the best long term outcome. Two friends had lumpectomies only to end up with bi-lateral mastectomies later; I didn't want that.
It's definitely a personal decision and you're smart to get as much information as possible. I wish you the best in making the best decision for you.
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I went with lumpectomy and radiation despite brca2 mutation positive because I was afraid of mastectomy. After two years of surveillance, I couldn’t stand the anxiety of waiting for mammograms or MRI results. I went back to my surgeon to request prophylactic bilateral mastectomy. I woke up from the BMX and felt relief. I went flat and am happy with my decision. I still have to do self exam because there’s no such thing as 100% cure with cancer. I think survival rate of lumpectomy and radiation is the same as mastectomy, but the recurrence rate of lumpectomy and radiation is slightly higher than mastectomy’s.
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Hi, I have bilateral IDC (++-)T1bNO w/4cm DCIS one breast. Ki67 - 9% & 23%. No genetic or other risk factors.
I'm 58 very fit/healthy and they keep saying I had "bad luck."
I just had lumpectomy, reduction lift. They felt there was no advantage or need for Mx other than it meant no Rads. The tumor board reviewed my case twice and head oncology who did my surgery based on what they believe my tumors to be…. told me my chance of recurrence 20% or much lower with only surgery. She indicated could be like 5% but didn't want to go there until we get my surgery results back.
Here is what I have gotten so far and I have gotten at least 2 oncologists reviewing my case to say the same thing before I accept it as possibly true. :-)
Recurrence stats using highest figure given:
20% surgery only
14% Surgery + Rads
*they have indicated 5yrs of AI but I don't have a figure for that yetPredict model says I have a 98% survival (not recurrence) surgery only and Rads/AI offer less than 1% improvement.
They say my bilateral has no implications and it is treated as "single breast" so to speak but they look at the "worse" but in my case it kind of evens out as my "worse" side is the Ki67 so very slow growing.
Always had normal mammograms.
I had a mammogram/ultrasound 2 years ago and everything normal. Since they missed my right breast IDC twice after left was found.. I suspect it was there but too small or they missed it. I have never been told how long my cancer may have been there.
What I have been told so far and perhaps something is helpful. I wish I knew more of where all of these figures are coming from.
Take care, Ella
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I was planning to have a bilateral mastectomy, but my surgical oncologist raised concerns about the discomfort of expanders because I had / severe Fibromyalgia. (I wasn't a candidate for flap surgery.) I had 2 lumpectomies because DCIS was observed in the margins with the 1st pathology report. Between chemo and radiation, I had a bilateral reduction and lift. I was surprised that the revised Predict model showed that radiation contributed as much to overall survivorship as chemo for my highly aggressive cancer (ki-67 of 90% and 9/9 on the Nottingham scale). Radiation was tons easier than chemo although I followed a protocol that only required 15 treatments vs. the 30-35 that some have. The drive to the facility and undressing / dressing took longer than the radiation itself. My skin became uncomfortable by the last treatment, but it was very bearable.
One factor I considered is that the DMX doesn't mean we can't get a recurrence since it can still come back, for example, in our chest wall. I didn't find the periodic mammograms all that stressful, but everyone is different in that regard.
Wishing you peace with whatever you decide.
Lyn
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