Topic: Invasive Ductal Carcinoma

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: May 24, 2022 10:25PM

Posted on: May 24, 2022 10:25PM

collijr wrote:

I was diagnosed in March. I am 53 years old with no history in the family. I am Pro+/Est+/HER2-. The mass is close to my nipple (@1:00/2.5 cm deep). It is 11mm in size. I'm having a tough time deciding between Lumpectomy/Radiation or Mastectomy. Also not sure about reconstruction or flat. There's so many decisions to be made. It's tough!

Surgery 6/1/2022 Lumpectomy (Left) Radiation Therapy Left breast
Log in to post a reply

Page 1 of 2 (16 results)

Log in to post a reply

May 24, 2022 11:08PM sarahmaude wrote:

Hi collijr,

I’m sorry you are having to make these kinds of decisions. I think that it’s important that you feel confident in your decision. My characteristics were similar to yours, I’m a four years older than you are. Also had a tumor at 1:00 near my nipple. I found a Breast Surgical Oncologist who did an oncoplastic lumpectomy at the end of March. I had some delays between diagnosis and surgery, so my tumor ended up being 4 cm upon removal. I started out with plenty of breast volume, so even with that, I look symmetrical in a bra, and I’m very happy with my results.

I’m in chemotherapy now, and following that will have radiation. For me, I’m glad that my recovery from surgery was easy. I have full sensation throughout my breast and nipple.

I know it’s hard to decide. I knew that overall survival is the same with either lumpectomy+radiation or mastectomy. If positive nodes are found in surgery, we may still end up with radiation, so I knew a mastectomy didn’t guarantee no rads. I was not keen on expanders and implants, and though I was strongly considering DIEP, I had a blood clot during diagnosis, so I wasn’t a candidate for that option. I am used to my hourglass figure, and simple flat just didn’t feel right to me.

Other considerations are how you feel about post surgery screening. With a mastectomy, you won’t have mammography anymore, and with removal of all breast tissue, risk of local recurrence is low. I was okay with continuing my mammograms with ultrasound.

What are your concerns that have you feeling stuck?

Hormonal Therapy 2/17/2022 Arimidex (anastrozole) Surgery 3/31/2022 Lumpectomy (Left) Chemotherapy 5/4/2022 Taxotere (docetaxel), Cytoxan (cyclophosphamide) Dx IDC, Left, 4cm, Stage IIA, Grade 3, ER+/PR-, HER2- Radiation Therapy Left breast
Log in to post a reply

May 25, 2022 12:42AM k-gobby wrote:

Collier,

I hope you have a breast surgeon and a medical oncogist. The Size of the tumor is something to cover. I have Brca2 as well, so my small size and 5.4cm tumor meant clear margins not good to save my breast.. Before I did the genetic test, I was told a lumpectmy would not work for me. Choices. First get your questions answered. I talked with my team. I asked what is done with those like me. Brca2, and small breast, large tumor.

I also talked with my friend, who told me about this site. Real women and men walking through breast cancer. Like most. I never thought I would get it.

More will respond, like Sarah maude, we all have a journey that meets in different places. I was 60 at diagnosis. Be good to your self. This is your life and your body.

Chemotherapy 8/14/2021 Other Surgery 2/1/2022 Lymph node removal (Left): Sentinel; Mastectomy (Left): Skin Sparing; Reconstruction (Left): Tissue Expander Targeted Therapy 2/1/2022 Talzenna (talazoparib) Targeted Therapy 2/1/2022 Perjeta (pertuzumab)
Log in to post a reply

May 25, 2022 01:56AM cathy67 wrote:

collijr,

Sorry that you are facing all these right now. Personally I studied ncnn guideline for my discussion with oncologist, it is also good to understand the treatment options.

Oncotype 6, Dx 08/06/2019, IDC, Right, 2.1 cm, Grade2, 1/1 nodes,ER+/PR+, HER2- Surgery 9/10/2019 Lumpectomy; Lumpectomy (Right); Lymph node removal Hormonal Therapy 11/20/2019 Arimidex (anastrozole) Radiation Therapy 11/27/2019 Whole breast: Breast, Lymph nodes
Log in to post a reply

May 25, 2022 11:53AM salamandra wrote:

Here is a thread that may be helpful for you: https://community.breastcancer.org/forum/91/topics...

It can be very hard if your gut isn't pushing you in a particular direction. When the doctors ok either way though, it's ok to go with your gut.

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 10/17/2018 Lumpectomy; Lymph node removal Hormonal Therapy 11/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 12/3/2018 Whole breast: Breast Hormonal Therapy 12/18/2019 Fareston (toremifene)
Log in to post a reply

May 25, 2022 02:20PM gladis wrote:

I actually wanted (initially) to push for mastectomy. I'm small breasted and figured why bring these sad puppies to the dr over and over- I live far from medical help. (IDC 14mm left ER: Positive (Strong ALLRED 8/8 PR: Positive 7/8) HER Neg and Ki-67 HIGH and Luminal B :-(

I'm almost 60, no history, no ...nothing. I found my lump-my last mammo was almost 3 years before (ty pandemic)

My surgeon and husband were not on the same page.

Diagnosed in March, an April surgery with complications ensued, I've not seen or heard from an oncologist (It's Canada )

or my surgeon since April and am now wishing I'd of gone with my gut.

Please, don't misunderstand -I am grateful for the lumpectomy.

Yet -having that piece of mind and NOT having to drive these 'ladies' to the mainland for treatments etc

and the prospect of HT for years

(which helps only in about half the population with similar diagnosis at this stage and age)

I understand you being torn.

Trust your gut and good luck!!!!

I'm rooting for you collijr :-)!!


Log in to post a reply

May 25, 2022 04:40PM collijr wrote:

All of this information is very helpful. I have my pre-surgery meeting with the breast surgeon in a few weeks. During our first meeting she said either a lumpectomy or mastectomy was a choice. After speaking with two plastic surgeons they both recommended mastectomies. I feel like that may be their opinion because that's what they do! I'm not fond of the idea of radiation. Is it ever an option not to follow a lumpectomy with radiation? I'm concerned that the radiation may leave my small breast disfigured. I wasn't ever a person interested in breast implants. It was just never on my radar. The reconstruction seems like a big deal. I've asked to speak with the radiology oncologist because I have so many questions. The lump is on the left side. How does radiation affect the heart? What are the chances of disfiguration? It would be so much easier if I didn't have a choice. Right now I change my mind every other day. Just not sure what the "right" decision is.

Surgery 6/1/2022 Lumpectomy (Left) Radiation Therapy Left breast
Log in to post a reply

May 26, 2022 05:12AM rah2464 wrote:

Collijr yes it is a very hard decision you make in a relatively short period of time. I found it helpful to kind of list out my thoughts in order to assess my feelings better. My cancer was also on the left side but very deep into my chest wall so I was concerned about radiation effects. However, I also went into surgery for a mastectomy knowing that I might wind up with radiation anyway if they didn't get clear margins. I think your decision to have a discussion with radiologist will be very helpful for you. I wish you all the best as you decide and move forward.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 6/27/2018 Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Hormonal Therapy 7/27/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
Log in to post a reply

May 28, 2022 01:23PM ava55 wrote:

I had an implant recon mx and honestly it was not painful, no bruising and very little scaring and feels like myself - can’t tell in a bra or bikini. I was back to work in three weeks and was delighted I went mx route as didn’t have to get radiation. I am on tamoxifen now for 5 years (as they removed 0.5 cm of Invasive IDC) but on a brand with no side effects.

The worst part of this whole ordeal is waiting for results. I thought the surgery was way better than I had anticipated and re they are plastic surgeons so everything is extremely neat. It was such a relief to wake up to the same shape.

For me I didn’t want to wonder if a lumpectomy would leave something behind and the onc advised mx so it was the only option really.


Good luck

DCIS 8cm, intermediate, ER positive, mastectomy plus ADM reconstruction with implant plus sentinel node biopsy. 0/3 nodes clear. 5mm IDC. ER/PR positive HER negative
Log in to post a reply

May 28, 2022 02:49PM salamandra wrote:

Lumpectomy without radiation has such a higher chance of recurrence that doctors will not recommend it except, in some cases, for women in their 70s or older where it is thought to not have a life extending benefit.

I was nervous about it first but based on my own research and doctors I trust, the evidence supporting radiation after lumpectomy is about as solid and reliable as medical evidence gets.

It is frustrating that the long term risks of radiation therapy are based on older technology that was most likely not as safe as today's radiation tech, but that's the nature of longer term studies.

The radiation oncologist is the expert on the dosage and how it can be delivered most safely. It's good that you've asked for a meeting with them. My understanding is that even for left side radiation, they have techniques and positions that help protect the heart.

I am almost four years out from my radiation treatment after lumpectomy, and I don't see any cosmetic damage or disfigurement at all. I think that is pretty common.

FWIW, I think for many of us, radiation is pretty easy. It's a hassle with the logistics, and there is often fatigue especially towards the end, but that's about it. From what I have read here, the women who struggle with it most usually are dealing with the psychological aspects of the constant undressing and medical interactions, often because of prior trauma.

All that said, mastectomy can be a good choice for many women.

When I was first diagnosed and assumed that I'd have to have a mastectomy, I also assumed I'd want reconstruction and that having the look of breasts would be better for me emotionally.

Looking back now, if lumpectomy weren't an option, I do think that aesthetic mastectomy without reconstruction is the way I'd go. Reconstruction *is* a lot of hassle, risk, long term upkeep, a whole new set of things that can go wrong.

It's impossible to be sure about a hypothetical, though, and I know that many women are very happy with their reconstruction and either found it a smooth process or found that the out come was worth it.

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 10/17/2018 Lumpectomy; Lymph node removal Hormonal Therapy 11/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 12/3/2018 Whole breast: Breast Hormonal Therapy 12/18/2019 Fareston (toremifene)
Log in to post a reply

May 28, 2022 05:50PM cathy67 wrote:

For radiation, I totally agreed that it is very easy, and at least for me, there was no long term side effects before and after, I got nausea and fatigue during those weeks, but compared to my pregnancy, all those just cakes. The skin will be reddened, but it will back to normal after that.


Oncotype 6, Dx 08/06/2019, IDC, Right, 2.1 cm, Grade2, 1/1 nodes,ER+/PR+, HER2- Surgery 9/10/2019 Lumpectomy; Lumpectomy (Right); Lymph node removal Hormonal Therapy 11/20/2019 Arimidex (anastrozole) Radiation Therapy 11/27/2019 Whole breast: Breast, Lymph nodes

Page 1 of 2 (16 results)

Scroll to top button