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Topic: Are lumpectomies disfiguring?

Forum: "Middle Age" 40-60(ish) Years Old With Breast Cancer —

Meet others in this age-range who share similar life issues.

Posted on: Apr 25, 2012 10:02AM

tamrie wrote:

I am 41 and just found out I have a 3cm malignant tumor in my left breast. At first the surgeon told me I should have a double mast. but after talking to the pl.surgeon I decided to go with a lump. Today a co-worker told me that she had the same thing I have and was disfigured after they removed her lump. I am terrified of this surgery because I do not feel confident in orthodox cancer treatments. I am only 41 and I have a fiancee and a 10 year old daughter of my own, so I want to heal myself in the least invasive way possible because I'd like to live for lot longer. I just want to know what other people have experienced so I can decide how to handle this. I appreciate any advice or just your stories. Thank you :)

Dx 4/2/2012, IDC, 3cm
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Apr 25, 2012 10:10AM Claire_in_Seattle wrote:

I have a scar and a slightly different shape on the surgery side.  You can't tell when I wear a bra.  I am thrilled with the cosmetic results.

Some of this depends on breast size.  You would hardly notice with someone well-endowed (assuming a 3 cm tumor), but would be very obvious with a AA cup.  I had about the same size tumor, and I am a B-C cup.

The real question is why your surgeon initially said "double mastectomy"?  Is there something about your tumor that made your surgeon recommend a mastectomy vs lumpectomy?  This could be very important.  So make sure that your surgeon believes that a lumpectomy + radiation would be equally effective in preventing recurrence.

You also might want another opinion here.  (Unless your surgeon agrees that you would be fine with a lumpectomy.)  And in fact, that is what I would most likely do in your shoes.  Good luck.

Completed all treatment (AC +T, lumpectomy, radiation and 5 years of AIs - anastrazole). Now celebrating every single day for the wonderful life I have been granted. Dx 8/2009, IDC, Left, 2cm, Stage IIB, Grade 3, 1/21 nodes, ER+/PR-, HER2- (FISH)
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Apr 25, 2012 10:55AM marjie wrote:

I had a 4cm tumour removed ( I am a C cup) ..I have a scar which isn't too bad and a slight dent where the tumour was - you can't tell when I'm dressed and it's not too bad naked either except that my nipples appear to be slightly cock-eyed now.

When I first met with my surgeon, I wanted both breasts removed right away!!  After a discussion about outcomes and prognosis and the pathology of my cancer, I opted for a lumpectomy and did chemo, radiation and Herceptin.

I think a lot depends on breast size as well as size and location of the tumour, and how you have a tendency to heal up...some people scar worse than others.  Don't be afraid to get a second opinion so you can feel more confident of your decision - whatever you decide.

Treatment: Rt Lump/SNB Aug 2010, FECx3/Tx3, radsx25+8, Herceptin x18 Dx 7/13/2010, IDC, 4cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR-, HER2+
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Apr 25, 2012 10:59AM jancie wrote:

I had a lumpectomy for a 4 CM tumor and I was a large B-cup.  My tumor was located at the 9 pm position looking directly at the breast.

I assumed that I would come out with a huge divet, etc. but my breast surgeon was good and other than a slight scar that has faded to almost nothing you can't even tell that I had breast surgery.

As Marjie said - it depends on location, size of breasts and of course your surgeon.

I am very pleased with my results.

Never Alone - My TaTa Sisters are always with me! Dx 12/30/2008, IDC, 4cm, Stage IIB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Apr 25, 2012 11:05AM Dianarose wrote:

I think it is the radiation that makes you disfigured more so than the lumpectomy. I had a lumpectomy over 7 yrs ago and it didn't look bad until about a yr after rads.The radiation makes the tissue really hard and heavy. That side always hurt even though it had been over 7 yrs. I don't miss my breast at all. Loloking forward to the exchange and getting my new girs. I just had a bmx and it looks better with just the TE and I haven't even had any fills yet.

6/10/13 mets to ovary now. Now mets. To peritoneal stage IV Dx 3/22/2012, ILC, Both breasts, 1cm, Stage IV, metastasized to bone/other, Grade 2, 17/17 nodes, ER+/PR+, HER2- Chemotherapy 5/31/2012 CMF Radiation Therapy 12/3/2012 3DCRT: Breast, Lymph nodes Hormonal Therapy 8/10/2013 Aromasin (exemestane) Targeted Therapy
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May 3, 2012 03:33PM - edited May 3, 2012 03:37PM by pitanga

I think a lot depends on the size of the lump versus the size of the breast. My breasts were 34B and after my 1.2 cm lump was removed I had a re-excision. The side I had surgery on was definitely smaller than the other side. If only I had realized that my health plan would have paid for cosmetic surgery to make them more symmetrical. But I didnt. I did not notice the skin being any different after radiation, just a "tan" that took almost a year to go away.

Tamrie, I was 39 when I was first diagnosed and like you I was worried about the visual changes my body would go through from treatment, the possible debilitating physical effects of chemotherapy. It was hard to fathom making myself go through all that treatment when I felt just fine. Even after surgery when there was a positive lymph node I toyed with the idea of not doing chemo. Thank God my friends and my oncologists made me realize that was playing with fire. So I did chemo (it was a drag but before I knew it it was over and my hair was growing back) and was fine for nine years, when they found a tiny local recurrence and a metastasis to my spine. I am now stage 4 and have been in treatment for three years.

I know it is hard to think about one´s body appearance changing in a negative way, but please understand it could be your life at stake. You need to take a lot of things into consideration, like the size of the tumor and its characteristics. Some are more aggressive than others.

Good luck making your decision.

Round 1-- 1999, age 39, Stage IIA. Round 2-- 2009, local recurrence and bone mets. Dx 2/5/2009, IDC, <1cm, Stage IV, Grade 2, mets, ER+/PR-, HER2-
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May 3, 2012 07:49PM ruthbru wrote:

Mine was about 3 cm & on the bottom, so I am a little lopesided without clothes. I look perfectly fine in a bra (including a sports bra). Did not have any problems from radiation. One thing to keep in mind is that how you look after surgery is not how you'll look in the end. The fat shifts around and fills in for about a year.

"Invisible threads are the strongest ties." Friedrich Nietzsche Dx 2/2007, Stage IIA, Grade 3, 0/11 nodes, ER+/PR-, HER2-
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Jul 14, 2012 06:43AM - edited Jul 16, 2012 07:25AM by elimar

Felt like this thread could use a revival...because a majority of women do have to make this personal choice of lumpectomy vs. mastectomy.

The OP doesn't state the aggressiveness of her B/C, or if nodes were involved, and that is the first consideration.  If one surgery will give you a better survival outcome, obviously you will choose that.  However, now that lumpectomy + radiation = mastectomy, it is often a matter of choice.  

Yes, lumpectomy can be disfiguring, and I think the main factors are location of lump, and size of lump in relation to size of breast.  I had small lump in small breast, 6:00 position.  I notice a little hollow where the tumor was, but in a bra and clothes no one's the wiser.  I had no further work done.  My biggest disfiguration was a result of surface skin being removed and then skin was brough together to close the gap, so my shape is a little different but the size is approx. the same.  Many women who are left with an indent can opt for a fat transfer to fill in the area.  Got some abdominal fat to spare (who doesn't?)  It can be used for the fill, if you don't mind a little more surgery.

To me a big point is having feeling in the breast.  Many women who had mastectomy have had all those nerves severed and are left with numb or partially numb chests, whether they get reconstruction or not.  That more invasive surgery also carries more of a risk for lymphedma to develop.  The upside is almost no breast tissue left for B/C to return AND many get to skip radiation which has it's own S/E's AND no more mammograms.

Still, (and this is the personal opinion part) I just did not feel a 7mm tumor was worth losing a breast over.  The "hardness" caused by rads has dinimished over time.  My treatment side looks and feels 95% natural, with a noticeable scar.  I tell myself that minor disfigurement is a small price to pay for a surgery that quite possibly saved my life. 

Dx 6/24/2009, IDC, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2-

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