• How do you decide whether to have a lumpectomy or mastectomy?

    Asked by bballmomma on Friday, January 18, 2013

    How do you decide whether to have a lumpectomy or mastectomy?

    I have to have chemo and radiation regardless and the chances of recurrence are also the same regardless of the chosen surgery.

    15 Answers from the Community

    15 answers
    • karen1956's Avatar

      I didn't have to decide...it was decided for me....there was at least 3 tumors in the breast as well as the lymph nodes.....the decision was to have a single or bilat and I went with bilat...good thing as the prophy side came back pre-cancerous....I also had chemo, rads, ooph and AI's......

      over 7 years ago
    • gwendolyn's Avatar

      I had that choice. My surgeon said he thought he could get clean margins either way. I was going to need chemo and radiation either way. I don't know if this is a factor for you, but my lumpectomy was going to involve considerable tissue removal anyway, so I went with a mastectomy.

      over 7 years ago
    • nancyjac's Avatar

      The standard protocol is more or less based on stage of cancer, size and grade of tumor, and whether there are any risk factors (genetics, family history, etc.) for recurrence. If you oncologist is not recommending one over the other, then you probably meet the criteria for a lumpectomy, but a mastectomy is always an option if that is your preference.

      over 7 years ago
    • Nancebeth's Avatar

      I met with a few surgeons and I had the option based on size and location of tumor. I chose bilateral mastectomy because at 42 years old, I really didn't want to have to worry about it coming back in the other breast. A family history of cancer helped with that decision as well. I had 6 sessions of chemo, started Tamoxifen but couldn't tolerate it so now I am just living with NED.

      over 7 years ago
    • JennyMiller's Avatar

      I chose to be aggressive against this evil and elusive enemy -- I chose a bi-lateral mastectomy which was followed by chemo and radiation -- and now, Arimidex for 5 years. I had heard of women who had undetected cancer in the other breast and I did not want to endure a second operation in the future. I wanted to have the satisfaction of knowing that I did all I could. That was my choice -- everyone is different and their circumstances dictate their very own individual choice -- and that is the way it should be -- after all, they are the ones that have to live with that choice. I wish you the best!

      over 7 years ago
    • Debbie's Avatar

      I told my surgeon to do whatever necessary to save my life. She chose lumpectomy.

      over 7 years ago
    • DianaL's Avatar

      I went with the lumpectomy for my cancer and was going to have brachetherapy for a week following surgery.
      However, the final path showed a second cancer in that breast and two of the three sentinel nodes had some cancer cells. I was told with the mastectomy for my type of cancer the good news is that there would be no need for radiation! My oncologist talked with my husband and me and told us a mastectomy was not a bad thing--it is all about peace of mind. We chose bi-lateral since we both did not want to go through this ever again. I did have chemo and when he did the bi-lateral no cancer in right breast, no other node involvement and they had got it all with the lumpectomy. I would still go this way if I had to do it again. The path from surgery gave my whole family and me so much hope and then you go in for your final path and the rug gets pulled out. It is your choice and you must decide which is best for you both now and in the future.

      over 7 years ago
    • Mel's Avatar

      Hi, I first had my lump removed thinking it be nothing came back it was IDC/Triple Negative and did the gene testing came back positive so I decided on the bilateral mastectomy for the chances of it coming back or on other side. I also had to do the chemo regardless. I chose not to do radiation though. Best of Luck...

      over 7 years ago
    • SusanK's Avatar

      It can be a tough choice, that's for sure. I chose bi-lateral mastectomy and reconstruction w/tissue expanders and have not looked back with any regret. I wanted to be aggressive against triple negative breast cancer and, for my own peace of mind, chose to fight it off this way.

      over 7 years ago
    • laurie's Avatar

      I chose mastectomy with a tram flap reconstruction. Long recovery but I don't regret my decision. I saw three different plastic surgeons before deciding. I chose the option that would get rid of the cancer and make me look the most normal!

      over 7 years ago
    • SueRae1's Avatar

      I wanted a mastectomy, but because I was in active treatment for Kidney cancer I was told that I would have lumpectomy with a large margin and radiation therapy.

      over 7 years ago
    • virginiab's Avatar

      I chose lumpectomy. The surgeon had to go back in a second time in order to get clean margins, but it was all fairly simple. I don't like surgery and wanted the least invasive surgical procedure. The result is that the breast that had been bigger is now smaller than the other, but a pretty normal shape. I understand I can get a "filler" thing to put in a bra and even out the sizes and I might try that, but mostly it's fine the way it is.

      I think that if the surgeon has to remove so much tissue that the breast seems really, well, non-breast-like, then that might be a good reason to simply remove the breast. If you seriously consider removing one (or both) breasts, study up on the options for breast replacement, so you'll know the probable schedule and number of surgeries and other procedures involved. The more I read about people's experiences after mastectomy, the more content I am with my lumpectomy.

      On the other hand, some women seem to have breasts that are wildly prone to more cancers, and others just worry that this might be true for them. In that case, the peace of mind might be worth all the hassle.

      Or, if you've always wanted your breasts to be different than they are now, this is an opportunity to get a new look and thus get some benefit from this whole crazy detour your life is taking right now.

      Whatever you decide, in the end you just have to trust yourself and your own judgment. All the best to you as you decide.

      over 7 years ago
    • RMR's Avatar

      My plastic surgeon gave me the best advice when I was struggling with this decision. He suggested that I focus on what my life would be like three four years out. He said at some point this initial stage of diagnosis, deciding on treatment plan, and treatment is a small blip on the radar screen. Think about what your life will be like years after all of this. For me the thought of the anxiety I would have every with mammograms every six months was the deciding factor. I knew I could not deal with the anxiety. The anxiety I had with my initial diagnosis was really bad (really good for my stress diet - lost a lot of weight) but really it was not good for my mental health. So I decided on mastectomy , bilateral was suggested to achieve the best symmetry with reconstruction. For me it was a great decision as I had Pagets reuse see in both nipples. There is no wrong decision for you. You have to do what makes you feel best in the long run. Good luck to you. Here's to survivorship.

      over 7 years ago
    • Nomadicme's Avatar

      Survival rates are THE SAME whether you get a lumpectomy or a mastectomy (for those that qualify for a lumpectomy). There are hundreds of international and US based studies showing this.
      Personally if I could have just had a lumpectomy I would have.
      I don't think such a drastic measure is needed, and it is major surgery, absolutely not worth it. I've read about women "doing all they can" to not get BC back as a reason for a double mastectomy. It's ignorant, and it doesn't improve survival, not to mention making you weaker and delaying chemo if you need it.
      There's an exception for which I'd get it done, if I were brca positive (I had it done because my entire breast was compromised, it's not something I'd put someone through)

      over 7 years ago
    • SamanthaJB's Avatar

      It is a personal decision. I wanted the least invasive surgery and the thought of losing my breasts was terrifying. I knew I would have chemo and radiation regardless. My surgeon said he would not suggest a lumpectomy if it were not an option. I chose this as the location and size of the tumor made it possible. I could not imagine losing my breasts WHILE dealing with chemo and I consider myself lucky. However, a friend had a mastectomy and reconstruction as a lumpectomy wasn't an option and a year later she looks great! I would never judge anyone for their decision...listen to the surgeon, look at the pros and cons of each choice and go with your instinct. Stay strong!

      over 7 years ago

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