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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Mar 4, 2020 03:14PM theworkinghour2 wrote:

Thank you, Valerie. I'll look at my DCIS treatment a little differently now.



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Apr 9, 2020 08:19PM ijl wrote:

I had DCIS 12 years ago. The lumpectomy did not produce clear margins and DCIS was high grade. I opted for the mastectomy with DIEp reconstruction. The pathology report after my mastectomy found a small micro invasion. At the time I was considering double mastectomy but decided against it.

Well recently they found IDC grade 1 1.6 cm in my right breast with negative nodes. I had my lumpectomy and am still waiting for the pathology results hoping for clear margins that should be easier to achieve thanin case of DCIS. I am seriously considering another mastectomy just to be done with it: no more mammograms and biopsies. My first one went very well so maybe that’s why I am leaning this way.

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Jun 10, 2020 03:45PM - edited Jun 10, 2020 03:48PM by beep7bop

my invasive ductal cancer to start in left. I opted for double mx due to several biopsy on right in the past. turned out I had cancer in both breast wound up final diagnosis invasive mammary. six month after final reconstruction I am scheduled for another biopsy. I was stage 1 grade 1 and 2 last year. Hoping this knot turns out to be negative sitting just right of my left implant. had ultrasound today Bi rad 4, Back to the hurry up and wait game. Hope all of you come out of this with no recurrence.

Dx 3/11/2019, ILC/IDC, Both breasts, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right
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Jun 20, 2020 07:10PM ldowns99 wrote:

Hi All. I chose the lumpectomy/radiation route because my DCIS was only in one area of my breast (lower/underside) and nowhere else, and I also tested negative for any cancer mutations on a 67-gene panel. If either or both of those things had been different, I may have opted for mastectomy. Mastectomy seemed very drastic to me for what it was, and there's very little distortion to my breast from my excisions (had to have three total). I start radiation (4 wks.) in a couple weeks on July 2. Hope this is helpful!

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Jul 28, 2020 10:43AM - edited Jul 28, 2020 06:47PM by TaraLeeOm

This Post was deleted by TaraLeeOm.
Dx 3/15/2018, DCIS, Left, <1cm, Stage 0, Grade 2, ER+ Surgery 5/23/2018 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Dx 5/29/2018, DCIS, Left, <1cm, Stage 0, 0/3 nodes, ER+/PR+
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Aug 3, 2020 07:17PM livinlife wrote:

Thanx so much for pulling and putting all this information together Beesie!!! I have no idea what my "new" docs will recommend. The initial surgeon conveyed I could choose either option. Rads is also not likely an option for me. I've been thinking about some of the things you listed in this lump vs. mast list. You had even more than I could've come up with at this early stage of diagnosis and pre-treatment. I believe I will come back to this list many times before my surgery date (to be determined yet) Thanks! I can see you are quite an asset on this site and very appreciated. I have come to appreciate you already - just on here a few days or so!

with expansive comedo necrosis & weak ER/PR Dx 7/2020, DCIS, Left, 2cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR+ Surgery 8/31/2020 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right)
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Aug 11, 2020 07:00PM renbird wrote:

Again, Beesie- You are so wonderful! Thank you for this!

-Renbird

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Aug 25, 2020 12:31PM Sallison wrote:

I chose a BMX for the simple reason on grade 3 along with not wanting weeks and weeks of radiation.

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Aug 25, 2020 05:41PM livinlife wrote:

I made the decision, just over a week ago now, to go with BMX vs. lumpectomy. I have DCIS, Grade 3 with comedo-necrosis and 2 foci on biopsy. The area is also 4.8 or 4.9 cmx2.8cmx1.8cm. I am not able to have radiation due to having scleroderma. All docs were in agreement with that. I am also ER+ at 2% which is more like negative. So that left with me with mastectomy. My BS was clear that no 58 year old woman could have a lumpectomy without radiation. Though I had made my mind up about BMX days before talking with my BS for the first time. I've also lost both my parents and three siblings to various cancers (primary brain, lung and kidney). As I've said before I am large enough that I would not be comfortable with one large breast left. I am also not a candidate for reconstruction given scleroderma and healing issues, let alone all the risks with the additional surgeries involved. So between physical discomfort and I believe emotional discomfort I would experience with one large remaining breast I decided to go flat and embrace the freedom I've heard other women talk about on this site. I imagine it will take some time to adjust though I think I will be more focused on my recovery during the adjustment. I do not believe I will miss my breasts - age, gravity and size.... I'm already buying clothes I would have never dreamed of buying before b/c I was too self-conscious...

with expansive comedo necrosis & weak ER/PR Dx 7/2020, DCIS, Left, 2cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR+ Surgery 8/31/2020 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right)
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Sep 6, 2020 02:34PM MandaSkier wrote:

I decided on a B/L nipple-sparing mastectomy for many reasons. My other treatment option was 5 lumpectomies (1 for the DICS and 4 for areas of atypical ductal hyperplasia) and then radiation for any DCIS. Plus I had dense breasts and have had 6 or 7 rounds of biopsies over the past few years...I was on a first name basis with the breast radiologist, who was my rock through that stage--very empathetic and compassionate. He said my tissue was already difficult to image and scar tissue from lumpectomies and radiation would make it even more challenging and would probably lead to more biopsies out of precaution. The relief of no more anxiety about imaging, biopsies, and the future is huge for me! I also did not want to undergo radiation.

Tomorrow it will be four weeks since surgery, and I am pleased with recovery. Two weeks post-op I started being able to take daily walks which were good for my spirits. I am normally a very active person...I have tissue expanders in place which are uncomfortable and I think will keep me from returning to some of my normal activities, but that's temporary and I am grateful for what I can do right now.

Dx 6/9/2020, DCIS, Right, 1cm, Stage 0, Grade 3, 0/4 nodes Surgery 8/10/2020 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement

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