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 10:54AM

Posted on: Jun 13, 2013 10:54AM

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 5/14/2013 Lumpectomy: Right Surgery 7/9/2013 Lumpectomy: Right Radiation Therapy 8/27/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 11/6/2020 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 1/4/2021 CMF
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Jul 12, 2013 05:09PM grammaB wrote:

As a newbie to all this, dx'd 7/8/13, I really appreciated everyone's input in making this decision.

I have met with the BS and next Monday I meet with both the RO and MO.  My dx is DCIS-MI, the path report said there were so few invasive cells that they lost them in resectioning.  I was told I am on the fence between Stage 0 and Stage 1.  I have had a previous biopsy about 9 years ago, in almost the same spot as this one, that was benign.  Since my mother passed from bc I am strongly leaning toward doing a MX.  But I am still going back and forth.  The surgery is set for Aug 13, I do my pre-op July25 so have to decide by then.  I know I will feel better when I make the decision.

In the back of my mind I have always felt bc was a probability, but at the same time telling myself no, not me.  Well, it is me now and I am overwhelmed.  I feel like I am living in jello and everything is in slow motion.  I've been reading so much my head is swimming!!  I've read alot here too and really appreciate all the info.

I went through similar emotions last year in Feb when I was dx'd T2 Diabetic, but that was a totally unexpected shock to me.  I've worked really hard getting that controlled and am at the low end of normal.  I plan to fight this the same way.

BRCA 1- BRCA 2- Dx 7/8/2013, IDC, <1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 8/12/2013 Mastectomy: Right; Prophylactic mastectomy: Left
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Jul 13, 2013 04:27AM Ariom wrote:

GrammaB, I am so sorry to hear what you're going through.

I too, had  a  Mother who had BC, she had a radical Mx in '94, just 4 months after my Dad passed  away.

I always had that niggling feeling that I would face BC too. I was fortunate, I was Dx early with DCIS grade 2/3.

I know it isn't for everyone, and I wouldn't presume to advise one way or another, but for me, a Mx was a no brainer. I didn't even really consider a lumpectomy, and I knew I wouldn't want to do Rads, if there was any way to avoid it.

I was used to seeing my Mother with a UMX, so there wasn't any surprises, so to speak. She had a sensational attitude to it, and a great sense of humour, so she paved the way for me to have a good experience.

I can honestly say, apart from having a few  hiccups, an infection, seroma and hematoma, and a weird one called Mondors Cording, I really haven't had a bad day. I haven't experienced any emotional issues, and I have absolutely no problem with the way I look. I have settled into wearing a prosthesis, or not, depending on how I feel. 

There is definitely a difference, a "New Normal" to get used to, but it isn't all bad!

I wish you all the very best, and the clarity to make this decision. Once you've made up your mind, you'll feel better. Take care! 

Dx Mondors Disease (cording) after Umx and "Dog Ear" removed 14 months post UMx .................. The Dx shuffles you like a deck of cards and then deals you a new hand! Dx 11/2012, DCIS, 1cm, Stage 0, Grade 3, 0/1 nodes Surgery 12/18/2012 Lymph node removal: Right, Sentinel; Mastectomy: Right
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Jul 13, 2013 02:31PM grammaB wrote:

Thanks Ariom!  I appreciate you sharing your story.  As every day passes, I am leaning more and more toward MX.  I have never had an issue with the left breast so I don't think my ins co will go for a BMX, but if they would I would go for that and be done with all the worrying.

I was just thinking today that I may not even go the recon route.  I so seldom wear a bra anyway and the few times I "dress up" (which isn't often here in the boonies in MT) I could just wear a prosthesis and not subject myself to the additional surgeries.  You can tell I am not overly attached to my breasts!!  Wink

BRCA 1- BRCA 2- Dx 7/8/2013, IDC, <1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 8/12/2013 Mastectomy: Right; Prophylactic mastectomy: Left
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Jul 13, 2013 03:29PM Ariom wrote:

I am in Australia grammaB, so our medical insurance is quite different, but from my experience here on BCO, I believe your insurance companies will do BMX for symmetry. It is something you could investigate.

If you aren't really motivated to go the recon route, then your surgery will likely be easier to recover from, it will certainly be much shorter in duration.

As I mentioned above, I have had absolutely no regrets about not reconstructing, and that's with a "D" cup still on the other side. I can contain that "puppy" with a firm shapewear tank and go prosthesis free and bra free whenever I want. It isn't a big deal at all. I have been known to duck out to the supermarket only to discover I am prosthesis free, and hadn't really noticed. No one ever seems to stare or appear to notice.

I think you'll do just fine!

Let us know how you're doing......((((hugs))))

Dx Mondors Disease (cording) after Umx and "Dog Ear" removed 14 months post UMx .................. The Dx shuffles you like a deck of cards and then deals you a new hand! Dx 11/2012, DCIS, 1cm, Stage 0, Grade 3, 0/1 nodes Surgery 12/18/2012 Lymph node removal: Right, Sentinel; Mastectomy: Right
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Jul 13, 2013 04:28PM grammaB wrote:

When I asked my surgeon about BMX she was pretty sure ins wouldn't cover the other breast unless there was a dx there too.  But I will call my ins company after I get through all of Monday's appointments just to be sure.

I'm already visualizing myself with a flat chest (hopefully both sides) wearing my tank tops and not worrying about anything. With prothesis/prostheses if I need "boobs" for anything. 

BRCA 1- BRCA 2- Dx 7/8/2013, IDC, <1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 8/12/2013 Mastectomy: Right; Prophylactic mastectomy: Left
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Jul 13, 2013 04:38PM Ariom wrote:

You have a great attitude grammaB!

If you do go BMX, you can decide what size "Foobs" (fake boobs) you want at any given time:) We have some threads on here that have lots of advice on lingerie, foobs, swimwear, shapewear etc. I have been researching for the past 6 months and have found many great options.

Good Luck with it all. I'll look forward to hearing how you are doing!

Dx Mondors Disease (cording) after Umx and "Dog Ear" removed 14 months post UMx .................. The Dx shuffles you like a deck of cards and then deals you a new hand! Dx 11/2012, DCIS, 1cm, Stage 0, Grade 3, 0/1 nodes Surgery 12/18/2012 Lymph node removal: Right, Sentinel; Mastectomy: Right
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Jul 14, 2013 01:29AM Ariom wrote:

grammaB I just happened upon a thread here called "Will Insurance Cover a Double Mastectomy"

If you search for it you'll find information that the writer posted about your Federal Law.

It may be of help to you when you speak with your insurance company and Surgeon.

Take care!

Dx Mondors Disease (cording) after Umx and "Dog Ear" removed 14 months post UMx .................. The Dx shuffles you like a deck of cards and then deals you a new hand! Dx 11/2012, DCIS, 1cm, Stage 0, Grade 3, 0/1 nodes Surgery 12/18/2012 Lymph node removal: Right, Sentinel; Mastectomy: Right
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Jul 14, 2013 10:05PM bjham wrote:

Sorry to be slow in answering.  I healed up pretty well from both lump and reex but now 3 weeks out having some pain just in a tiny area of the incision.  But not terrible.  Think I may have it looked at tomorrow.  I had a PET scan to make sure I could have the rad done at my close cancer center vs having to drive 40 min. to hosp that has more sophisticated machine but onc-rad called and she feels we can do it here.  They made my mold and marked me up and hope to start rad next week.  I just want to get on with it as we've had vacation planned since before all this and I want to be finished and feeling good.  The onc will discuss which estrogen inhibitor after that.  Keep us posted on your situation.  I am feeling positive and have a strong faith which helps.  Good luck.

Dx 5/2013, DCIS, 4cm, Stage 0, Grade 3, 0/1 nodes, ER+, HER2- Surgery 6/6/2013 Lumpectomy: Left; Lymph node removal: Left, Sentinel Surgery 6/19/2013 Lumpectomy: Left Radiation Therapy 7/22/2013 Breast Hormonal Therapy 9/16/2013 Aromasin (exemestane)
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Jul 15, 2013 08:42AM dlb823 wrote:

Bumping for CultivateGratitude

Deanna "The soul would have no rainbow if the eyes had no tears" Native American proverb Dx 2/1/2008, 1cm, Stage IIA, Grade 3, 1/16 nodes, ER+/PR+, HER2- Dx 1/3/2014, Stage IV
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Aug 9, 2013 07:47AM - edited Aug 9, 2013 12:50PM by Rosesark53

This Post was deleted by Rosesark53.
Surgery 10/1/2008 Lumpectomy: Left Dx 7/5/2009, DCIS, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 7/5/2009, IDC, <1cm, Stage IA, ER+/PR+, HER2- Surgery 7/14/2009 Mastectomy: Left Hormonal Therapy 8/13/2009 Arimidex (anastrozole)

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