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Mar 4, 2019 11:04AM
I asked my radiology fellow about this when I was trying to decide whether to go through with radiation - I had read that if they radiate an area once, they can't do it again, and I was concerned about sentencing myself to a mastectomy in case of a local recurrence.
For a whole bunch of very good reasons, I followed through with the radiation, which is excellent and well-proven treatment to prevent recurrence.
But it did help that she told me that no, mastectomy after lumpectomy is not a guarantee. She said that it had been the convention of care for a while, but it is not because of the radiation. The dose they give the breast is far lower than the lifetime maximum, so they *can* generally radiate again.
She told me that more and more, doctors are offering second or even third lumpectomies, with general success. She said that of course it depends on the exact nature of the recurrence and the history of the patient. She said that cosmetic impact had also often been a concern, but [some] doctors are now willing to be more open to the idea that some women might prefer asymmetrical breasts/differently shaped breasts to completely losing her breasts.
I don't know really anything at all about your new diagnosis. I had pretty bog standard IDC with about 4cm of DCIS. But based on that conversation it seems to me that if your doctor can't give you a compelling understanding of why he would prefer a mastectomy (and he may be able to!) then it would be worthwhile seeking a second opinion.
Dx at 39. 1.8cm. Oncotype 9.
9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH)
10/17/2018 Lumpectomy; Lymph node removal: Sentinel
12/2/2018 Whole-breast: Breast
Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)