Topic: lumpectomy vs mastectomy - why did you choose your route?

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

Posted on: Jun 13, 2013 01:54PM

Posted on: Jun 13, 2013 01:54PM

ealga wrote:

Hi all, 

i was wondering if anyone could elaborate on this question. i have multifocal, grade 3 DCIS, and am contemplating another lumpectomy vs a mastectomy. my surgeon is confident she can clear the margins with another lumpectomy, and recommends radiation afterward.  BUT anecdotally, so many women I’ve talked to, even with a Grade 1 single foci lesion, opted for mastectomy.   I don’t want to undertreat OR overtreat but I am struggling to figure out why women would make this choice and what am I missing?  I'm at a very cutting edge cancer hospital if that matters.  I'd love any perspective on this.  Many thanks in advance. 

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 11/7/2020 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Chemotherapy 1/5/2021 CMF
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Jul 9, 2013 01:22PM - edited Oct 15, 2013 01:32PM by moderators

i just did a biopsy yesterday, because of my first bilateral mammo one year after finding the cancer in my right breast, there was found in my left breast a branching linear microcalcification. i had just stopped arimidex 2 weeks before, because of excruciating bone and joint pain. also had just seen an arthritis specialist there who has ordered a bone scan, to find out what maybe going on there, had baseline a year ago, only pre-arthritic changes in both ankles! in my life, i have really pushed my bod! Glad i did! will always have memories of extraordinary leaps and bounds, catching a train boxcar and jumping off when it got close to my work, impressed the hell out of my co-workers, when they saw me jump off a moving train! not scared to move and use my body. am scared about how could i possibly have something wrong with my other breast, already? i did take a three month break from herceptin, oncs advice, since LEF fell greater than 10 %. So am waiting for results, and havent started tamox yet. they havent even done the blood test to find out if i am a metabolizer of tamox, plus i have fibroids, plus, in a lymphedema book i have read, tamox makes le worse. i am just disgusted. i am slender, and have been really healthy all of my life barely caught a cold. blech.

"I will sit right down, waiting for the gift of sound & vision" David Bowie, Rest in pax, my beloved changeling... Dx 6/8/2012, IDC, Right, 1cm, Stage IIIC, Grade 3, 25/30 nodes, ER+/PR+, HER2+
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Jul 9, 2013 03:16PM ballet12 wrote:

Hi ealga,

I had no issues with recovery from any of the lumpectomies, in terms of the early recovery period.  The re-excisions were no different.  I had the surgeries on a Friday and I was back in my ballet class on Wednesday and my other dance class on Thursday (and I'm 61-lol).  I even had stitches still in me from the first surgery when I was exercising, although the last two surgeries had steri strips.  I modified raising the arm and didn't do any weights for awhile. I did have issues after the third surgery, in that I have swelling in the breast (seroma and maybe even lymphedema), which became more prominent after radiation.  So, I have very mild discomfort in the axillary area from that.  You have to know that I have had a total of six surgeries on that breast over the years, so all of the scar tissue and tissue distortion is probably greater than most.  Cosmetically, ironically, the swelling has improved things. I will say that I do not regret doing lumpectomy at all.  I still have that breast. 

About the hormonal therapy, my oncologist was offerring Aromasin.  At this point, because we have somewhat of a choice with DCIS, I am holding off on taking an AI due to potential side effects.  I could also take Tamoxifen.  I feel great and want to continue feeling that way. If I did take Tamox I'd like to take that test to determine if I do metabolize it.

Best of luck to you.  I hope you don't have problems and you get the "all-clear" to go on to radiation.

Surgery 7/27/2012 Lumpectomy: Right Dx 8/2012, DCIS, Right, 5cm, Stage 0, Grade 3, ER+/PR- Surgery 10/5/2012 Lumpectomy: Right Surgery 10/26/2012 Lumpectomy: Right Radiation Therapy 1/11/2013
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Jul 9, 2013 03:19PM ballet12 wrote:

Hi kathec,

I am praying that they don't find anything in your other breast.  You have suffered enough.

Surgery 7/27/2012 Lumpectomy: Right Dx 8/2012, DCIS, Right, 5cm, Stage 0, Grade 3, ER+/PR- Surgery 10/5/2012 Lumpectomy: Right Surgery 10/26/2012 Lumpectomy: Right Radiation Therapy 1/11/2013
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Jul 9, 2013 03:48PM ealga wrote:

Hi Kathec.

I'm thinking of you and sending you all my best.  I hope things improve for you soon. 

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 11/7/2020 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Chemotherapy 1/5/2021 CMF
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Jul 9, 2013 03:50PM ealga wrote:

thanks Ballet12 - that's good to know that you recovered so nicely. i hope tomorrow goes well and i don't have the dizzy spells that i had after the first one. those lasted for more than 2 weeks. it was hard to walk around the city because i was afraid of falling and hitting my head. Anyway, so glad to hear you feel great! that is encouraging. all my best. 

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 11/7/2020 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Chemotherapy 1/5/2021 CMF
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Jul 9, 2013 04:38PM ballet12 wrote:

Hi ealga,  if you find you aren't in much pain, stay away from the opiate pain killers that they hand out like candy.  They can make you feel dizzy.  Stick with Tylenol if you can, as well as local icing of the breast (bags of frozen peas work amazingly well).  Also, compression with a sports bra 24/7 for a long time (month?).  I'm sure you know all of this stuff, but it's the meds that likely make people feel dizzy.  I don't know if you took those the first time around, and if so, maybe they stayed in your system for a long time.

Surgery 7/27/2012 Lumpectomy: Right Dx 8/2012, DCIS, Right, 5cm, Stage 0, Grade 3, ER+/PR- Surgery 10/5/2012 Lumpectomy: Right Surgery 10/26/2012 Lumpectomy: Right Radiation Therapy 1/11/2013
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Jul 9, 2013 06:33PM ealga wrote:

thanks, yes, i only took the oxy for the first day and half of the second day, and couldn't take any more. I still felt seriously dizzy for so long afterward. I'm going to try to avoid those drugs this time around. thanks again! 

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 11/7/2020 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Chemotherapy 1/5/2021 CMF
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Jul 9, 2013 10:37PM - edited Oct 15, 2013 01:32PM by moderators

Thank you, ealga, and ballet 12. i am truly impressed, ballet12, that you returned to dance class so quickly, (and @ your age! Naughty girl!) Wow! i am 53 now and hope to do as well! dontcha love BCO? i Dooooo! 

"I will sit right down, waiting for the gift of sound & vision" David Bowie, Rest in pax, my beloved changeling... Dx 6/8/2012, IDC, Right, 1cm, Stage IIIC, Grade 3, 25/30 nodes, ER+/PR+, HER2+
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Jul 10, 2013 12:36PM ballet12 wrote:

Hi Kathec, just to let you know, that my dance instructor, for these classes, is 62 years old She is a 17 year survivor of IBC in one breast and triple negative in the other (brca 1 carrier).  She has severe lymphedema in one arm, among many other long term side effects from all of the treatments (including a bone marrow transplant--done at that time).  You wouldn't know it by watching her.  Full of energy, never complains, amazing.  A true inspiration to me.

Surgery 7/27/2012 Lumpectomy: Right Dx 8/2012, DCIS, Right, 5cm, Stage 0, Grade 3, ER+/PR- Surgery 10/5/2012 Lumpectomy: Right Surgery 10/26/2012 Lumpectomy: Right Radiation Therapy 1/11/2013
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Jul 12, 2013 06:59PM candi07 wrote:

Thankful for this thread. My lumpectomy is July 18th, I've been wavering about my decision to have a lumpectomy. I've read many other threads and its seems there are a lot of women who opted for LX only later having a mastecomy. My lump is 1.6 cm and my cancer is grade 3 Triple Negative...hope I'm making the right decision.

Dx 6/25/2013, IDC, 2cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR-, HER2- Surgery 7/18/2013 Lumpectomy: Left Chemotherapy 8/16/2013 AC + T (Taxol) Radiation Therapy Breast

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