• Am I a surgery snob?

    Asked by MarS676 on Friday, March 8, 2013

    Am I a surgery snob?

    I was diagnosed with Stage IIA TNBC last July. At the time it was the recommendation of 2 surgeons that I have a lumpectomy after chemotherapy. As reality set in and I progressed through treatment and while reading as much as I could about BC I decided to get a bilateral mastectomy. Now when I meet people who opted for a lumpectomy I can't help but think to myself with judgement "why would they choose such a simple procedure? Don't they know the cancer can come back?" I feel horrible every time I think it but I can't help myself. Even now after having chosen the most invasive procedure possible to make sure my cancer has been eradicated I still worry about recurrence or metastasis, I don't know how I would be able to sleep if I had chosen a lumpectomy. I would love to hear your thoughts on this.

    8 Answers from the Community

    8 answers
    • nancyjac's Avatar

      Maybe, but only because most types of snobbery are born out of misinformation. Based on the logic your are using, all girls should have a bilateral mastectomy as soon as they reach puberty to reduce the risk of breast cancer. Many women who have a lumpectomy are at no greater risk for a cancer recurrence than if they had had a bilateral mastectomy. And some women who have had bilateral mastectomies have had a cancer recurrence in their chest wall, bones, liver, or brain. The surgical choice is all about getting clean margins in the area of the primary cancer. If that can be accomplished with a lumpectomy, then why should a woman have a more invasive and prophylactic procedure? And if there are cancer cells beyond the primary location, it doesn't matter whether she has a lumpectomy or a mastectomy, neither will eliminate cancer cells in the liver or bone or distant lymph nodes.

      over 3 years ago
    • Ydnar2xer's Avatar

      It was simple why I chose lumpectomy the first time I had breast cancer--I had had reduction done a few years before that, and I figured, hey, I've worked too hard (with that reduction recovery) to just have one or both breasts removed when my cancer was isolated in a small spot in that one breast. I WAS cancer-free for 9 years after lumpectomy and when I got a new type of breast cancer in that same breast later, even my onc (who had practiced for 30 years) said I NEVER should have gotten it again--it was a total fluke. Of course, this time, mastectomy as there was no other option for me. I opted for bilateral this time because of my likelihood to get cancer again.

      over 3 years ago
    • AlizaMLS's Avatar

      Dear MarS676,

      The 2nd sentence of your statement says it all. Two surgeons (underline two) recommended that you have a lumpectomy. If you trust them and the institution where you were being treated, that says it all. If not THEN, there's a problem (and only then). nancyjac is right about reoccurrence. Many women have bilateral mastectomy out of fear (I didn't, I had a unilateral mastectomy). But she's right. If there's a reoccurrence, it could happen and it's more likely that it will in one of your other organs. You ( and we all-Bc patients) need to learn to LIVE with a certain amount of uncertainty while going about our lives, with the hope (and belief) that it won't return (otherwise you'll drive yourself crazy!).

      I'm a Medical Librarian (retired) and we don't give medical advice to people - it's unethical (and if we're working in a library setting, it's illegal as well [here well I can speak from my own experience and ther experience of other cancer patients who are friends), we offer referrals instead - to medical professionals, to instituions, to books, media, etc.

      The best place I can think of to refer you to is CancerCare. They offer counseling to Cancer patients of every stripe and stage (I'm going there now as well). It's not like regular therapy-they don't deal with your "toilet training" or "blame your mother"...;) it's specifically geared toward you, and the Cancer you have and where you are right now. I think they're great! I really recommend you call them!!

      The other good thing you can do for yourself now that this seems resolved for the moment is to start living and you start doing that by distracting yourself. Go to lunch with friends (try not to talk too much about your cancer because as one person on the site here wrote in, his/her friends are disappearing because he/she's dwelling on the cancer a lot [people get frightened about this often unfortunately, but it's a downer for casual friends]-(seek close friends to talk to about this at specific times,), go shopping with someone, go see a film, a concert, a play (even at a local college's theatre dept [doesn't have to be Broadway or the equivalent]), join a bookgroup - there's a virtual one I recommend called www.goodreads.com. It's excellent (I belong too!). You can track your titles there, write reviews, join small genre bookgroups, make virtual friends and read other's reviews. This is great in the event that there's no live bookgroup in your area, or your not up to par, or you like doing things on the internet (obviously you're on this site so...;)), but if you can live in the real world (as opposed to the virtual world), it's better to do that!

      If you need more ideas for titles and other things-I'm the person to contact. I've also been a public Librarian as well as a Medical one, and have helped many people research and write papers, so I can recommend many titles you might enjoy.

      I hope what I said here has helped you and given you some food for thought. Statistics show that you'll likely be ok. Keep that attitude!

      Warm wishes,

      over 3 years ago
    • chutzpah's Avatar

      Wish I had a choice like yours. I had a bilateral last year and terribly miss my nipples and the pleasure they gave me and my husband.

      over 3 years ago
    • Nancebeth's Avatar

      I was told by a female surgeon to have a lumpectomy. She did not even discuss other options. I was told by another female surgeon that based on size and location of tumor, lumpectomy was possible but it was my choice. I was also told by my male surgeon (the one I ultimately chose) that based on size and location of tumor, lumpectomy was possible, but it was my choice. I decided, after a lot of research, to have a bilateral mastectomy. I wanted a TRAM flap reconstruction. The first PS I saw said it was not a problem, he could do it. I would have mastectomy first, then a few months later come back for TRAM flap procedure. The PS I ended up using is my friend from elementary school (he also referred me to my breast surgeon) and he said I was not a good candidate for TRAM flap. I did not have enough belly fat to make my new breasts the size I wanted and due to a very recent case of osteomylitis, I was at a higher risk of infection. I trust his opinion, as I have known him for 35 years. I do not regret my decision and he did an amazing job on my reconstruction. (pictures on my blog - www.breastcancerbattlescars.net) I don't miss my nipples, however, I do miss being to get releif by scratching when my breast itches. Since they are pretty much numb, I can scratch all day and there is no relief.

      The main reason I was glad, in the long run, that I chose mastectomy, was that once the surgeon got inside, the tumor was almost twice the size they thought. I also didn't want to worry about it coming back in the same breast or the other breast. I try not to worry too much about recurrence, but if it metastasizes somewhere else in my body, I'll deal with it then.

      Everyone's cancer is just that - THEIR cancer. Their decision to make. As long as you are happy with your decision, that is all that should matter to you :-)

      over 3 years ago
    • hogfan03's Avatar

      My mother was diagnosed 20 years ago with breast cancer. The first surgeon suggested a mastectomy with chemo and radiation. She went for a second opinion where the surgeon told her about the option of a lumpectomy with chemo and radiation. She went with her second opinion and had the lumpectomy. She is alive and still no recurrence of cancer after 20 years. It is a personal choice and having a lumpectomy does not mean the cancer will come back, my mom is a proud survivor!

      over 3 years ago
    • Nomadicme's Avatar

      As Nancy mentioned, the risk of recurrence is the same whether you get a Mx or not (this must have been discussed with you by your healthcare providers, as breast conservation surgery is the standard of care for that reason).

      What saddens me is the opposite of what you experience, women that are fine with just a lumpectomy being anxious because they didn't have their breasts removed.

      Unfortunately going through the ugly experience of a mastectomy offers no extra protection.

      over 3 years ago
    • gwendolyn's Avatar
      gwendolyn (Best Answer!)

      What bothers me is that women seem to feel the need to justify to each other why they chose one surgery over another. It's a complicated, personal decision. Tumors can be different shapes and sizes, and can be located anywhere in the breast. Breast size varies a great deal, too. Some women have hereditary factors that make them predisposed to BC. Aside from the physical considerations, every woman is entitled to her own individual attitude about her breasts and body.

      I think we would all benefit from avoiding comparing ourselves to each other. Be comfortable that you and your doctor made the best decision for you based on your individual circumstances (both physical and emotional.) Try to have the attitude that other women have made the best decision for themselves.

      over 3 years ago

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