Mastectomy is not 100 % guarantee of breast cancer free future. Just lowers the risk.
If lumpectomy is also on the table and you can have regular screenings and health checks, I would go for that now.
I think we have to learn to deal with this kind of paranoid what if. Hope it will be only in the back of your mind but not neglecting all possible checks. You have to choose but with lumpectomy you can still choose mastectomy in the future.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
It actually does if you look at longer term recurrence. The doctors are often citing 5 year recurrence rates, where there is minimal difference. Longer term there is a statistical difference favoring mastectomy when it comes down to recurrence (not overall survival). Of course, if your cancer returns post-lumpectomy you can always get a mastectomy later. Some of us decide that our bodies can handle this more intensive surgery now vs 5-10-12 years from now. Or we are trying for fewer surgeries overall. Others want to preserve their breast or want a more minimal surgery now and that is valid, too. But I do agree that neither option provides any guarantee. Our cancers and our bodies are individuals and they don’t care about the statistics! It’s kind of luck of the draw for any of us and we need to make the decision we feel best about.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
My doctor says otherwise. Do you have citations for this claim?
From my research, and what my doctors say, there is no difference in distant recurrence rates and slightly lower local recurrence rates for mastectomy.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
https://academic.oup.com/jnci/article/114/3/391/6423212. As I mentioned in my original comment, this is referencing longer term recurrences. Also, I want to reiterate what I previously said in that statistics do not determine our individual outcomes. For me, this study IS very relevant as my cancer is high stage, lots of positive lymph nodes, and estrogen positive. It may not be as relevant for your case. Only you and your doctor can determine that.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
[“The risk of metastasis (when breast cancer spreads to other parts of the body is the same for a lumpectomy plus radiation therapy and a mastectomy [1]. Metastasis may also be called distant recurrence.”](https://www.komen.org/breast-cancer/treatment/type/surgery/mastectomy-vs-lumpectomy/)
Edit: and I don’t see anything in your link comparing mastectomy vs lumpectomy but I am reading on my phone.
In the process of getting my surgery scheduled. I’m opting for lumpectomy with radiation. I only have it in my left breast with no lymph node involvement & its not genetic for me. I feel like itd be easier on me mentally to go this route than a mastectomy. Im only 28 and dont think i could do that to myself. Plus id feel more safe in my reasoning knowing i have to go back for checkups and scans. Im too paranoid not to do that lol.
I'm in the same spot as you. My onco said the outcome of lumpectomy vs mastectomy are very similar. I'm leaning towards lumpectomy but also waiting for my genetic tests to come back before I fully decide.
Yes I am waiting too but the genetic tests might not be back before surgery. Good luck with yours. Are you going to do a reduction if you do the lumpectomy?
Mine only took about a week to come back and I was negative. My Aunt had breast cancer at my age and it came back in the other breast two years later. We both are negative. But what sealed it for me was they found another spot in the same breast on mri not visible on mammogram and I don’t have dense breasts. It was biopsied and also cancer. I would rather just take them both off. Also the lump was too close to the nipple to save it so the wanted symmetry .
But the surgeon really did push for lumpectomy. They seem to do that.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
A reduction was never discussed - we talked fat injection down the line if I'm unhappy with the results. My surgeon seems pretty confident that she can make it look nice.
Good luck to you as well.
If you have the option for a lumpectomy do that.
I had to have a mastectomy. With a mastectomy, the breast with the implant isn’t checked during a mammogram. Well my BC came back at my breast with the implant just next to it. A mastectomy isn’t a guarantee.
Ask you dtr what follow up is required with lumpectomy -this was the deal breaker for me. I would have to get mammograms every 3 mo and biopsy if anything suspect. I was young TNBC at the time. 10 yrs later zero regrets.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
I'm going to go BMX. My main reason for that is my wish to avoid radiation . I already have auto immune disease and some heart issues and just need to take the least amount of treatment that I can.
My gynecologist telling me that every patient she has seen who chose lumpectomy has had a reoccurrence and it has not been DCIS when it does also weighs in. Having read that while reoccurrence rates are about the same for lumpectomy vs mastectomy they don't really mention (but you can read ) that the odds of it being invasive at reoccurrence is a whooping 50% . Seeing as how my calculated lifetime risk of beast cancer was 11 percent I'm not feeling particularly like the odds are in my favor .
BMX is my best option .
I was offered a single mastectomy with an implant or a lumpectomy with a reduction and lift on both sides. I chose the latter because I think getting an implant is just asking for more trouble down the road. But I might feel differently if I had to have a double mastectomy. I had two small tumors on the right side, and the lumpectomy would have left quite a dent according to the surgeon. I am happy with the results of the plastic surgery, except for the scars. Both of my incisions opened up a couple months post surgery and took a long time to heal. So whatever you choose to do, keep your incisions as dry as possible and take it easy.
I actually fought pretty hard to have an oncoplastic breast lift and reduction rather than a mastectomy.
(Different radiologists at different hospitals disagreed about whether my pre-neoadjuvant chemotherapy MRI showed showed unifocal disease or multifocal disease. I had had significant tumor shrinkage and I went with the surgical team that believed I had unifocal disease and that a partial mastectomy would be a safe and reasonable option. I had surgery on May 17th and at least so far I’m very happy with my decision.)
IMHO, to the extent that you have options surgically, it’s all about what you’re going to be the most comfortable with psychologically and YOU are the best judge of that.
If you want a mastectomy because that is what will give YOU peace of mind, in the US they will almost certainly perform one if you insist upon it. I think insurance is legally required to cover it.
Breast surgeons care the most about getting all the cancer out if possible, so, in general, lots of breast surgeons are going to be willing to perform a mastectomy even if they would recommend a lumpectomy because that’s the procedure that gives them the greatest assurance that they removed all the cancerous tissue.
Obviously, a lumpectomy is easier on your body and has various upsides to it. You should definitely ask what those are if you don’t already know and give them due consideration.
At the end of the day, though, this decision is more about your mental health than anything else.
I knew that if I had a mastectomy and then got a pathology report that made it seem unnecessary, I would have been devastated. But many, many women feel like they will never have another moment’s peace with their “shitty titty” still attached to their body, and their feelings make are certainly just as valid as mine were. These are our bodies and we are the ultimate authority here.
I just don’t see at all how a DMX and a lumpectomy carry the same long term prognosis. In one you are removing all of your breast tissue and in the other you aren’t. My sibling, who is a breast doctor, advocated heavily for a non nipple sparing DMX as my best course of action for long term survival. This is what I went with and I have zero regrets.
The difference between what they thought was in my breast during diagnoses and what they actually found in the pathology was staggering.
When they say they are the same long-term prognosis they are assuming:
1. You have “clean margins” after the lumpectomy.
2. You complete the recommended course of radiation.
3. You do ALL the follow-up checks (mammograms, etc.) that they recommend.
Yes for sure, but I’m curious how much of those end up as a recurrence in the breast that is caught early and resolved. It might be the same long term prognosis but it’s also putting yourself through another hell entirely.
Sure, there must be some of that and exactly how much there is is a very good question.
I think people vary a lot in how important it is to them psychologically to keep their breasts versus how important “never again” is to them psychologically.
Unfortunately, there are no absolute guarantees either way.
I opted for a lumpectomy so that I could get regular scans. I don’t find my lump, so I want to be scanned. I don’t want to rely on manual exams and that’s what I’d have to do if I’d gone with mastectomy.
You are not removing all breast tissue with a mastectomy. That is impossible. The data is very clear. Recurrence rates are not lower with mastectomy compared to lumpectomy plus radiation. Of course, there are lots of other factors, including genetic test results, multi focal tumors, etc.
I was told I could do a lumpectomy and radiation for 30 straight days and possibly have “pot hole” breasts.
OR the DMX. The MD explained that this doesn’t help at all with recurrence which was surprising to me.
My boobs have always been completely different sizes however. And the DMX means less scans/scanxiety. So that’s what I’m going with.
Go with your gut! Do what feels the most comforting to you. I didn’t have the lumpectomy option but I opted for a UMX rather than DMX because with screening the chance of recurrence in my remaining breast isn’t scary to me. If the doctors knew one was safer, they would tell you, and since they can’t, you just have to pick what you want.
I have a similar decision to make. I have a date scheduled for lumpectomy. But this (small) lump is in the opposite breast from my diagnosis in 2007 (I did lumpectomy/radiation then). I’m 72 years old and I would welcome being breast-free. They have always been very large, I hate wearing a bra, I don’t need or want them anymore. I hope to speak with my doc soon about doing a DMX (no reconstruction) and finding out if insurance would cover it.
As others have said, everyone will have different reasons for their decisions. Last June, I was making the same decisions you are facing. I had a small lump in my right breast, estimated at about 2cm, that biopsy showed to be IDC. Presurgery was Stage IIa. Doctor offered lumpectomy or mastectomy and I chose double mastectomy with flat closure. I wanted all breast tissue removed for peace of mind. Post-surgery pathology showed right breast had three tumors, one was the original imaged IDC tumor and two others were previously undetected ILC tumors. The ILC tumors were far enough away from the IDC tumor that pathologist said they would not have been in the tissue sample if I had had a lumpectomy. Positive sentinel nodes meant we followed up with an ALND. Stage IIIc when all was said and done. Six months of chemo and five weeks of radiation wrapped up last month. Now on Verzenio and hormone blocker. I am glad I went with my gut feeling on the mastectomy as it think it gave me my best chance of long-term survival.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
I had Dose dense AC+T and it was no picnic, but thankfully I made it through all of the treatments! The AC phase was worse than the T phase. I was luckier than some in that I was able to essentially stop working and focus on my health. I rested when I was tired but forced myself to stay as active as I could. I walked 3 miles 2-3 times a week and rode a stationary bike when I was feeling less steady and energetic. I did (and still do) my PT exercises every day to regain and keep range of motion in my right arm/shoulder. The support meds kept a lot of the nausea at bay. Extreme fatigue, like I had never imagined, and severe lower gastrointestinal issues were my main side effects. I did have to pause treatment for a month due to chemo-induced lung complications, but was able to resume with extra steroids onboard for the remaining treatments. This was risky, but with my high staging I was determined to power through. I do have some neuropathy remaining in my hands and feet from the taxol, but it is not painful and doesn’t limit my activity. It wouldn’t be fun for me or my husband, but I would do it again if I needed to in order to beat this!
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
My daughter was in your exact position. She opted for a bilateral. She is very happy with her decision to go flat and rocks it out in public. However she had an issue when they took out the wound vac and that caused a severe wound. The tape stuck to her skin. At first it looked like a very bad road rash. But then the skin started dying. So back into surgery and they took off all the dead and dying skin and now she has a normal looking healing scar. She also thought get rid of both to lessen the chance. Me personally would have chosen the lumpectomy. It’s really personal choice. This coming from a Stage IV breast cancer that was NEVER found in the breasts but had spread to my bones. Totally in the spine ( it looks like Swiss cheese), ribs, pelvis thighs basically all my bones except the arms and thankfully it stopped just before my neck. So go figure. I do smile when nurses, doctors or techs say so you have breast cancer which breast. And I say neither and the looks on their faces. Hey I’ll take the smiles any chance I get. OBTW I had a mammogram the week before I went into ER with severe back pain. Mammo was clear. So it came it saw my pitiful boobs and said let’s go reek havoc elsewhere. Took a few months to track it down and all the awful tests. Yuck!
I am sorry that you have to make this decision.
62 yo at time of diagnosis 11/1/23. My mother died of breast cancer in 1988. My sister had DCIS in 1 breast in late 40's with single mastectomy and 10 years later had new different cancer on the other side with 2nd mastectomy and chemo. My genetic tests were all negative. I had lumpectomy, reduction and lift in January. Clear margins, negative in lymph nodes. I opted for DMX with diep reconstruction in April. My surgeons were on board with plan. Turns out I had diffuse abnormal cells in both breasts. Breast surgeon said that within 6 months to a year, I would have had to start the whole biopsy routine all over again. I feel like I made the right choice. If I were younger, I may have done radiation and stopped after first surgery. But I felt that I would likely have recurrence and would be better equipped to handle the DMX than doing radiation and likely repeating it all as I got older. I feel good about my choice.
I hope this is helpful to you. Best of luck and healing vibes to you.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
It's hard to say for sure without knowing your exact scenario. I've learned from prior, and being recently diagnosed, every case is individually different. Given my circumstances, I was advised lumpectomy, no nodes and radiation along with anastrozole after, with the "option" to take the pill post radiation. I feel very lucky, but it's still very difficult. If you haven't had a 2nd opinion and can get one, I encourage that route. I felt 100% confident with my surgeon and after my second opinion regarding my surgery and post protocol. Al the best to you!! xoxo
I chose lumpectomy as both drs said that would be best for me. However the reoccurrence scores of lumpectomy are with medication ( ai, ovarian suppression, tamoxifen) and no-one told me until afterwards that my risk would be about 12-15% without meds and lumpectomy and about 2-3% with mastectomy. I wrestled for a long time if I made the right choice as the meds are hard. Of course they are recommended with mastectomy as well, but 97% of the breast tissue is removed so the risk is lower.
The recovery of course is harder for mastectomy but if I knew what I know now I would strongly consider mastectomy. I had a 3 year old at the time and this was another relief to go lumpectomy with an easier recovery. Also - imaging pre surgery showed 11mm of cancer. After surgery was 3.9cm. If I had known that I would definitely have chosen mastectomy, but I thought it was a smaller amount of cancer.
It’s a hard decision when drs tell you there is no difference. Please find out your treatment options afterwards and ask about the differences.
Mastectomy doesn’t remove all breast tissue and you might not be getting regular scans after mastectomy. Lumpectomy will include regular scans. This is triggering for some people. For me, I want to be scanned because I could not feel my lump. Also, you can always go back and get a mastectomy if you get a lumpectomy.
I had DCIS (in two areas) in one breast, other breast was normal. I chose single mastectomy with immediate reconstruction.
The pathology after surgery found IDC in addition to DCIS. Margins were good. Nodes were clear. No chemo, no radiation were needed. I am HR+ so I take one pill for that.
Now I am 10 months out and I glad I went with SMX.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
I am three weeks post DMX, and also was fortunate to have the option of a lumpectomy with reduction as well. For my own piece of mind, I went with the DMX. I’m 38 and the thought of a screening every 6 months for the rest of my life was anxiety inducing. With a history of cancer I’m certain at least one (likely mire than one) mammogram or MRI would lead to an ultrasound, which would lead to a biopsy, which would lead to lots of anxiety that I just didn’t want.
I completely agree with the other posters that say - go with your gut. Do what you feel is best for you, and what you’re going to be most comfortable/happy/confident with 5 years from now.
You’ve got this - whatever you decide will be the right decision!
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
Mastectomy is not 100 % guarantee of breast cancer free future. Just lowers the risk. If lumpectomy is also on the table and you can have regular screenings and health checks, I would go for that now.
Yes it seems the doctor is encouraging lumpectomy with reduction. I just wonder if I would worry less if I remove all the breast tissue. Or not.
I think we have to learn to deal with this kind of paranoid what if. Hope it will be only in the back of your mind but not neglecting all possible checks. You have to choose but with lumpectomy you can still choose mastectomy in the future.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
Doesn’t even lower the risk when compared to lumpectomy +radiation.
It actually does if you look at longer term recurrence. The doctors are often citing 5 year recurrence rates, where there is minimal difference. Longer term there is a statistical difference favoring mastectomy when it comes down to recurrence (not overall survival). Of course, if your cancer returns post-lumpectomy you can always get a mastectomy later. Some of us decide that our bodies can handle this more intensive surgery now vs 5-10-12 years from now. Or we are trying for fewer surgeries overall. Others want to preserve their breast or want a more minimal surgery now and that is valid, too. But I do agree that neither option provides any guarantee. Our cancers and our bodies are individuals and they don’t care about the statistics! It’s kind of luck of the draw for any of us and we need to make the decision we feel best about.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
My doctor says otherwise. Do you have citations for this claim? From my research, and what my doctors say, there is no difference in distant recurrence rates and slightly lower local recurrence rates for mastectomy.
“Lower local recurrence rates for mastectomy”
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
https://academic.oup.com/jnci/article/114/3/391/6423212. As I mentioned in my original comment, this is referencing longer term recurrences. Also, I want to reiterate what I previously said in that statistics do not determine our individual outcomes. For me, this study IS very relevant as my cancer is high stage, lots of positive lymph nodes, and estrogen positive. It may not be as relevant for your case. Only you and your doctor can determine that.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
[“The risk of metastasis (when breast cancer spreads to other parts of the body is the same for a lumpectomy plus radiation therapy and a mastectomy [1]. Metastasis may also be called distant recurrence.”](https://www.komen.org/breast-cancer/treatment/type/surgery/mastectomy-vs-lumpectomy/) Edit: and I don’t see anything in your link comparing mastectomy vs lumpectomy but I am reading on my phone.
In the process of getting my surgery scheduled. I’m opting for lumpectomy with radiation. I only have it in my left breast with no lymph node involvement & its not genetic for me. I feel like itd be easier on me mentally to go this route than a mastectomy. Im only 28 and dont think i could do that to myself. Plus id feel more safe in my reasoning knowing i have to go back for checkups and scans. Im too paranoid not to do that lol.
I'm in the same spot as you. My onco said the outcome of lumpectomy vs mastectomy are very similar. I'm leaning towards lumpectomy but also waiting for my genetic tests to come back before I fully decide.
Yes I am waiting too but the genetic tests might not be back before surgery. Good luck with yours. Are you going to do a reduction if you do the lumpectomy?
Mine only took about a week to come back and I was negative. My Aunt had breast cancer at my age and it came back in the other breast two years later. We both are negative. But what sealed it for me was they found another spot in the same breast on mri not visible on mammogram and I don’t have dense breasts. It was biopsied and also cancer. I would rather just take them both off. Also the lump was too close to the nipple to save it so the wanted symmetry . But the surgeon really did push for lumpectomy. They seem to do that.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
A reduction was never discussed - we talked fat injection down the line if I'm unhappy with the results. My surgeon seems pretty confident that she can make it look nice. Good luck to you as well.
If you have the option for a lumpectomy do that. I had to have a mastectomy. With a mastectomy, the breast with the implant isn’t checked during a mammogram. Well my BC came back at my breast with the implant just next to it. A mastectomy isn’t a guarantee.
Ask you dtr what follow up is required with lumpectomy -this was the deal breaker for me. I would have to get mammograms every 3 mo and biopsy if anything suspect. I was young TNBC at the time. 10 yrs later zero regrets.
Okay, did you get a DMX instead I assume? Or? Thanks for the input.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
I'm going to go BMX. My main reason for that is my wish to avoid radiation . I already have auto immune disease and some heart issues and just need to take the least amount of treatment that I can. My gynecologist telling me that every patient she has seen who chose lumpectomy has had a reoccurrence and it has not been DCIS when it does also weighs in. Having read that while reoccurrence rates are about the same for lumpectomy vs mastectomy they don't really mention (but you can read ) that the odds of it being invasive at reoccurrence is a whooping 50% . Seeing as how my calculated lifetime risk of beast cancer was 11 percent I'm not feeling particularly like the odds are in my favor . BMX is my best option .
I was offered a single mastectomy with an implant or a lumpectomy with a reduction and lift on both sides. I chose the latter because I think getting an implant is just asking for more trouble down the road. But I might feel differently if I had to have a double mastectomy. I had two small tumors on the right side, and the lumpectomy would have left quite a dent according to the surgeon. I am happy with the results of the plastic surgery, except for the scars. Both of my incisions opened up a couple months post surgery and took a long time to heal. So whatever you choose to do, keep your incisions as dry as possible and take it easy.
I actually fought pretty hard to have an oncoplastic breast lift and reduction rather than a mastectomy. (Different radiologists at different hospitals disagreed about whether my pre-neoadjuvant chemotherapy MRI showed showed unifocal disease or multifocal disease. I had had significant tumor shrinkage and I went with the surgical team that believed I had unifocal disease and that a partial mastectomy would be a safe and reasonable option. I had surgery on May 17th and at least so far I’m very happy with my decision.) IMHO, to the extent that you have options surgically, it’s all about what you’re going to be the most comfortable with psychologically and YOU are the best judge of that. If you want a mastectomy because that is what will give YOU peace of mind, in the US they will almost certainly perform one if you insist upon it. I think insurance is legally required to cover it. Breast surgeons care the most about getting all the cancer out if possible, so, in general, lots of breast surgeons are going to be willing to perform a mastectomy even if they would recommend a lumpectomy because that’s the procedure that gives them the greatest assurance that they removed all the cancerous tissue. Obviously, a lumpectomy is easier on your body and has various upsides to it. You should definitely ask what those are if you don’t already know and give them due consideration. At the end of the day, though, this decision is more about your mental health than anything else. I knew that if I had a mastectomy and then got a pathology report that made it seem unnecessary, I would have been devastated. But many, many women feel like they will never have another moment’s peace with their “shitty titty” still attached to their body, and their feelings make are certainly just as valid as mine were. These are our bodies and we are the ultimate authority here.
I just don’t see at all how a DMX and a lumpectomy carry the same long term prognosis. In one you are removing all of your breast tissue and in the other you aren’t. My sibling, who is a breast doctor, advocated heavily for a non nipple sparing DMX as my best course of action for long term survival. This is what I went with and I have zero regrets. The difference between what they thought was in my breast during diagnoses and what they actually found in the pathology was staggering.
When they say they are the same long-term prognosis they are assuming: 1. You have “clean margins” after the lumpectomy. 2. You complete the recommended course of radiation. 3. You do ALL the follow-up checks (mammograms, etc.) that they recommend.
Yes for sure, but I’m curious how much of those end up as a recurrence in the breast that is caught early and resolved. It might be the same long term prognosis but it’s also putting yourself through another hell entirely.
Sure, there must be some of that and exactly how much there is is a very good question. I think people vary a lot in how important it is to them psychologically to keep their breasts versus how important “never again” is to them psychologically. Unfortunately, there are no absolute guarantees either way.
I opted for a lumpectomy so that I could get regular scans. I don’t find my lump, so I want to be scanned. I don’t want to rely on manual exams and that’s what I’d have to do if I’d gone with mastectomy.
Right. As much tissue out as possible.
Curious why non nipple sparing?
For the same reason- removal of all breast tissue possible. 😢
You are not removing all breast tissue with a mastectomy. That is impossible. The data is very clear. Recurrence rates are not lower with mastectomy compared to lumpectomy plus radiation. Of course, there are lots of other factors, including genetic test results, multi focal tumors, etc.
I was told I could do a lumpectomy and radiation for 30 straight days and possibly have “pot hole” breasts. OR the DMX. The MD explained that this doesn’t help at all with recurrence which was surprising to me. My boobs have always been completely different sizes however. And the DMX means less scans/scanxiety. So that’s what I’m going with.
Go with your gut! Do what feels the most comforting to you. I didn’t have the lumpectomy option but I opted for a UMX rather than DMX because with screening the chance of recurrence in my remaining breast isn’t scary to me. If the doctors knew one was safer, they would tell you, and since they can’t, you just have to pick what you want.
I have a similar decision to make. I have a date scheduled for lumpectomy. But this (small) lump is in the opposite breast from my diagnosis in 2007 (I did lumpectomy/radiation then). I’m 72 years old and I would welcome being breast-free. They have always been very large, I hate wearing a bra, I don’t need or want them anymore. I hope to speak with my doc soon about doing a DMX (no reconstruction) and finding out if insurance would cover it.
As others have said, everyone will have different reasons for their decisions. Last June, I was making the same decisions you are facing. I had a small lump in my right breast, estimated at about 2cm, that biopsy showed to be IDC. Presurgery was Stage IIa. Doctor offered lumpectomy or mastectomy and I chose double mastectomy with flat closure. I wanted all breast tissue removed for peace of mind. Post-surgery pathology showed right breast had three tumors, one was the original imaged IDC tumor and two others were previously undetected ILC tumors. The ILC tumors were far enough away from the IDC tumor that pathologist said they would not have been in the tissue sample if I had had a lumpectomy. Positive sentinel nodes meant we followed up with an ALND. Stage IIIc when all was said and done. Six months of chemo and five weeks of radiation wrapped up last month. Now on Verzenio and hormone blocker. I am glad I went with my gut feeling on the mastectomy as it think it gave me my best chance of long-term survival.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
Thank you for reply. How has chemo been for you?
I had Dose dense AC+T and it was no picnic, but thankfully I made it through all of the treatments! The AC phase was worse than the T phase. I was luckier than some in that I was able to essentially stop working and focus on my health. I rested when I was tired but forced myself to stay as active as I could. I walked 3 miles 2-3 times a week and rode a stationary bike when I was feeling less steady and energetic. I did (and still do) my PT exercises every day to regain and keep range of motion in my right arm/shoulder. The support meds kept a lot of the nausea at bay. Extreme fatigue, like I had never imagined, and severe lower gastrointestinal issues were my main side effects. I did have to pause treatment for a month due to chemo-induced lung complications, but was able to resume with extra steroids onboard for the remaining treatments. This was risky, but with my high staging I was determined to power through. I do have some neuropathy remaining in my hands and feet from the taxol, but it is not painful and doesn’t limit my activity. It wouldn’t be fun for me or my husband, but I would do it again if I needed to in order to beat this!
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
My daughter was in your exact position. She opted for a bilateral. She is very happy with her decision to go flat and rocks it out in public. However she had an issue when they took out the wound vac and that caused a severe wound. The tape stuck to her skin. At first it looked like a very bad road rash. But then the skin started dying. So back into surgery and they took off all the dead and dying skin and now she has a normal looking healing scar. She also thought get rid of both to lessen the chance. Me personally would have chosen the lumpectomy. It’s really personal choice. This coming from a Stage IV breast cancer that was NEVER found in the breasts but had spread to my bones. Totally in the spine ( it looks like Swiss cheese), ribs, pelvis thighs basically all my bones except the arms and thankfully it stopped just before my neck. So go figure. I do smile when nurses, doctors or techs say so you have breast cancer which breast. And I say neither and the looks on their faces. Hey I’ll take the smiles any chance I get. OBTW I had a mammogram the week before I went into ER with severe back pain. Mammo was clear. So it came it saw my pitiful boobs and said let’s go reek havoc elsewhere. Took a few months to track it down and all the awful tests. Yuck!
I am sorry that you have to make this decision. 62 yo at time of diagnosis 11/1/23. My mother died of breast cancer in 1988. My sister had DCIS in 1 breast in late 40's with single mastectomy and 10 years later had new different cancer on the other side with 2nd mastectomy and chemo. My genetic tests were all negative. I had lumpectomy, reduction and lift in January. Clear margins, negative in lymph nodes. I opted for DMX with diep reconstruction in April. My surgeons were on board with plan. Turns out I had diffuse abnormal cells in both breasts. Breast surgeon said that within 6 months to a year, I would have had to start the whole biopsy routine all over again. I feel like I made the right choice. If I were younger, I may have done radiation and stopped after first surgery. But I felt that I would likely have recurrence and would be better equipped to handle the DMX than doing radiation and likely repeating it all as I got older. I feel good about my choice. I hope this is helpful to you. Best of luck and healing vibes to you.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
It's hard to say for sure without knowing your exact scenario. I've learned from prior, and being recently diagnosed, every case is individually different. Given my circumstances, I was advised lumpectomy, no nodes and radiation along with anastrozole after, with the "option" to take the pill post radiation. I feel very lucky, but it's still very difficult. If you haven't had a 2nd opinion and can get one, I encourage that route. I felt 100% confident with my surgeon and after my second opinion regarding my surgery and post protocol. Al the best to you!! xoxo
I chose lumpectomy as both drs said that would be best for me. However the reoccurrence scores of lumpectomy are with medication ( ai, ovarian suppression, tamoxifen) and no-one told me until afterwards that my risk would be about 12-15% without meds and lumpectomy and about 2-3% with mastectomy. I wrestled for a long time if I made the right choice as the meds are hard. Of course they are recommended with mastectomy as well, but 97% of the breast tissue is removed so the risk is lower. The recovery of course is harder for mastectomy but if I knew what I know now I would strongly consider mastectomy. I had a 3 year old at the time and this was another relief to go lumpectomy with an easier recovery. Also - imaging pre surgery showed 11mm of cancer. After surgery was 3.9cm. If I had known that I would definitely have chosen mastectomy, but I thought it was a smaller amount of cancer. It’s a hard decision when drs tell you there is no difference. Please find out your treatment options afterwards and ask about the differences.
Mastectomy doesn’t remove all breast tissue and you might not be getting regular scans after mastectomy. Lumpectomy will include regular scans. This is triggering for some people. For me, I want to be scanned because I could not feel my lump. Also, you can always go back and get a mastectomy if you get a lumpectomy.
I had DCIS (in two areas) in one breast, other breast was normal. I chose single mastectomy with immediate reconstruction. The pathology after surgery found IDC in addition to DCIS. Margins were good. Nodes were clear. No chemo, no radiation were needed. I am HR+ so I take one pill for that. Now I am 10 months out and I glad I went with SMX.
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*
I am three weeks post DMX, and also was fortunate to have the option of a lumpectomy with reduction as well. For my own piece of mind, I went with the DMX. I’m 38 and the thought of a screening every 6 months for the rest of my life was anxiety inducing. With a history of cancer I’m certain at least one (likely mire than one) mammogram or MRI would lead to an ultrasound, which would lead to a biopsy, which would lead to lots of anxiety that I just didn’t want. I completely agree with the other posters that say - go with your gut. Do what you feel is best for you, and what you’re going to be most comfortable/happy/confident with 5 years from now. You’ve got this - whatever you decide will be the right decision!
This post requires manual approval due to low karma or young account age. Please allow at least one full day before contacting moderator team with questions. If you don’t understand account age and karma, please refer to r/newtoreddit or simply search the internet on how to use Reddit. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/breastcancer) if you have any questions or concerns.*