• If I should have a partial mastectomy or a full one.

    Asked by LuLux4 on Friday, March 29, 2013

    If I should have a partial mastectomy or a full one.

    On Tuesday March 26th, I was diagnosed with infiltrating ductal carcinoma. I am now at the point where I have to decide what type of procedure I want to get. My sister had a partial about 3 years ago and had a hard time with the radiation therapy. When I first talked with my husband and children we agreed that I should go for the full mastectomy on the left side. This discussion was just hours after we had received the news, but now I am having second thoughts after taking a day to let the news sink in. Can anyone share their experience with radiation therapy?

    20 Answers from the Community

    20 answers
    • karen1956's Avatar

      A partial mastectomy/lumpectomy were not options for me as I had too much cancer in the BC breast...my only choices were single mastectomy or bilateral mastectomy. I chose to go with the bilateral after 2 surgeons suggested it (of course it was on the top it was on the top of lists of my questions)....I've never regretted my decision and I'm now 7 years past Dx.
      Have you met with a surgeon yet? If so, maybe a 2nd opinion will help you decide....all the best to you

      over 4 years ago
    • nancyjac's Avatar

      I wouldn't make too much of a connection between the extent of surgery and the need for radiation. Whether or not you will need radiation is independent of the type of surgery you have, so don't let that drive your decision. I have had breast cancer twice and I have had radiation twice (once after a lumpectomy and once after a total bilateral mastectomy). Both times I thought radiation was the easiest part of my treatment. It is a bit inconvenient because it is 5 times/week for anywhere up to 7 weeks, but as far as side effects, it was a piece of cake compared to chemo. Towards the last week or so, I experienced some skin burn but I have had sunburns worse than it was.

      I hope you have discussed all of this with an oncologist, or will be, before making any decisions. A lot of people go being diagnosed by a radiologist (mammogram) or surgeon (biopsy) straight to surgery before ever seeing an oncologist and by then it is too late to discuss options and treatment plans.

      over 4 years ago
    • smlisboa's Avatar

      Hi lulux4
      I had similar situation. I was given choice of single or double mastectomy. Radiation not an option because of type of cancer(triple negative). First find out what your oncologist says. Find out if your lymph nodes are clean. When you have all that info......it all comes down to what you can live with. I chose a dbl mast even though my lymph nodes were good. I had chemo just to make sure any cancer cells that were not detected can be destroyed. There are times that I wonder if I should of not done the dbl mast or not done chemo......but if I do ever get a reoccurrence ....I know it won't be because I didn't take all precautions. I am at my one year anniversary since diagnosis......so far so good. God bless you. Keep us posted on what you decide.

      over 4 years ago
    • Mel's Avatar

      Hi, When it comes to these decisions I went back and forth alot!!... I ended up doing the bi-laterial mastectomy I wanted to cut out any reoccurence, chemo, it all of course that didn't pan out being Triple Negative also I ended up having to do chemo. for preventative measures. They said I could talk to radiation doc. but I chose not to for the fact I felt radiation for what you took everything and supposed to be gone plus chemo. is supposed to kill everything. (That was just me and my thinking). Best of luck...

      over 4 years ago
    • leepenn's Avatar

      UGH - I'm so sorry you've received this news. You are definitely in the most difficult part - the huge expanse of unknown facing you....

      Do you know whether you need to have chemotherapy? If the answer is yes, you need chemotherapy, then ask if you can do the chemo BEFORE the surgery. I suggest this because then you can know whether the chemo is WORKING. Also, this approach is becoming more and more common.

      If you have the partial mastectomy, it sounds like you will have to have radiation. If you have the full mastectomy, then radiation is only a possibility, depending on whether you have positive node and/or margins that are not adequately clean (meaning, cancer cells potentially remaining). However, I disagree with Nancyjac on this one - if you can avoid radiation, why not?

      My story - I had a triple negative tumor. I had 5 months of chemotherapy. I then had a double mastectomy. I decided that I did not want to have to do radiation, although I knew it was still a possibility depending on the pathology report after surgery. Happily, I had a complete pathological response to the chemotherapy - this means there was no cancer tissue remaining after that treatment. Happily, I did not have to do radiation.

      I did not opt for reconstruction. So, I'm just a flat chested person now, which is alright. I did not like the idea of assymmetry, which is why I went for the double. Also, I had fibrous and dense breast tissue, which means I had higher risk... So, for me, that was a total no brainer.

      Good luck - these decisions are hard to make. But, your health care team should be able to answer them! And help you come to a decision you feel most comfortable with....

      over 4 years ago
    • nancyjac's Avatar

      Just a couple of clarifications:

      Whether radiation and/or chemo is an option or recommended or not has nothing to do with whether your cancer is triple negative or not. The primary difference regarding negative/positive status is whether or not hormone therapy with tamoxifen or an aromatase inhibitor is an option and/or targeted therapy with Herceptin.

      It did not intend to infer that all breast cancers will require radiation, but that whether or not you have a lumpectomy vs a mastectomy is not the determining factor. For instance, a mastectomy with non well define tumors or positive lymph nodes usually is followed by radiation, while a lumpectomy for a very small single well defined tumor with no lymph involvement may not. So bottom line is, whether or not radiation is needed is not based on type of surgery.

      over 4 years ago
    • Ydnar2xer's Avatar

      So you've just joined the club that no woman wants to join---I'm sorry this has happened to you, too. My decision for a bilateral mastectomy was a no-brainer--this was my second breast cancer, and I sure don't want a third occurrence. The first time I had a lumpectomy, 35x radiation (honestly--more of a nuisance getting there every day than a difficult or unpleasant (hurting) experience) and 5 years of Tamoxifen. I never burned at all during radiation. This time, bilateral mastectomy, 5 months of chemo and am finishing out my year since diagnosis with Herceptin every three weeks. Like smlisboa, I want to always do EVERYTHING possible to avoid any more cancer; this way I honestly can say, "Well, I did everything I could." BREASTS, in my way of thinking, ARE HIGHLY OVERRATED!

      Your LIFE is what matters! But this is your decision; good luck in determining what is right for you. We all send our best to you in this difficult time for you & your family.

      over 4 years ago
    • Nomadicme's Avatar

      Personally id do partial

      over 4 years ago
    • JennyMiller's Avatar

      I chose to be aggressive against this evil and elusive enemy so I had a bilateral mastectomy followed by 8 sessions of Chemo followed by 35 sessions of Radiation. I am now on Arimidex for 5 years. I wanted the peace of mind knowing that I did all that I could do. Radiation was much easier than Chemo. I had some fatigue and I did burn under my arm whereas I had to take a week off to allow some healing. Using Silverdene Cream and allowing a fan to blow on the area helped the healing process. Every one is different and you have to make the choice that is right for you - after all, you are the one that his to live with that choice. Your Oncologist will guide you. I wish you the best.

      over 4 years ago
    • Benge's Avatar

      So sorry you have to go through this too.
      Everybody has a different experience. I was diagnosed in December with cancer that was still in the ducts, but I went the aggressive way and went for a bi lateral mastectomy and reconstruction. That was after a lot of praying!! I'm so happy with my decision, because after the surgery the pathology rapport came back and there was another tiny cancer. The MRI even missed it because I have dense breast tissue and it was deep and tiny. I feel I made the right decision, because who knows when that would have been found. I have also been told that radiation does make the reconstruction more complicated because of radiated skin.
      I sent a prayer for you!! It's a hard decision and I pray that you find peace with it as I did!

      over 4 years ago
    • MarianneT's Avatar

      I had a similar experience to Karen. I too chose to have a bi-lateral mastectomy. Part of my comfort level making this decision was the confidence in my surgeons. It is very important to have a surgeon you are confident in and comfortable with. I started reconstruction right away and for me that was an emotional boost.

      over 4 years ago
    • Loafer's Avatar

      Hi luLux - this is a difficult, but personal decision. I had a lumpectomy, chemo and rads - and I'm glad I did!. The rads were a piece of cake! Don't let your sisters experience completely influence your decision. Most people have no problems with rads - it's just inconvenient. Good luck with your decision! Understand we are all here to assist. ((Hugs))

      over 4 years ago
    • CAL's Avatar

      I agree with all of the responses--it is always a personal decision. I had a "partial mastectomy" being reassured by my surgeon that he could "get all the tumor" and still leave me with plenty of breast tissue because I am so large breasted. I had some amusing conversations with the surgeon, the rad. oncologist, and the Med. oncologist as they all thought that having a single mastectomy with reconstruction would be somewhat hard because reconstructing to match my other breast would be nigh unto impossible. I told them if I choose to have a mastectomy I was going bilateral so I could get a reconstruction of the size of my choice and not have to deal with these large breasts anymore. Anyway, the partial mastectomy was an ok choice for me but if I ever have a recurrance, I am going with the bilateral mastectomy with reconstruction and throwing out this big bras. :)

      over 4 years ago
    • gwendolyn's Avatar

      I had a choice of partial or full mastectomy. Surgeon felt he could get clean margins either way (in the first surgery.) Unlike you, I knew I was getting chemo/radiation either way due to the size of the tumor (5+ cm) and lymph node involvement. The deciding factor for me was that the partial mastectomy would have taken a dramatic amount of tissue anyway and I didn't see the point of keeping "half" a breast. I don't know if that's a factor in your decision but I thought I'd mention it, in case it was something for you to consider.

      Like your sister, I did not find radiation to be a walk in the park. I would avoid it if I could. Having said this, it's possible you could have a full mastectomy and learn afterwards that you had to have radiation anyway, depending on what the surgeon finds.

      Don't hesitate to ask more questions from your surgeon before you make your decision. It's understandable that you would develop more questions after the initial conversation.

      over 4 years ago
    • Grandy's Avatar

      I'm sure I speak for others when I say that no matter what you choose, you will be supported! This is very personal, your journey.

      I listened to doctors' opinions, and fellow BC folk, and family, and then I decided to go bilateral... Ups my chances of it not coming back.. I didn't really want a lumpectomy considering how affected the one breast was. And If I'd done one and had reconstruction on it, a plastic surgeon would have had to work on the other anyway to make them balanced.

      I will get surgery and begin reconstruction simultaneously in a few weeks.
      Hugs to you!

      over 4 years ago
    • AlizaMLS's Avatar

      Hi. I'm Aliza, a BC patient and a Medical Librarian (retired). I offer advice (usually non medical), referrals to doctors, hospitals, institutions, agencies, etc., and research for folks on this site and elsewhere. My training as a Librarian (we hold Master's degrees) allows me to look at questions a bit differently than other people here do and take them apart in certain ways, so forgive me if I do just that.

      You are actually asking two separate questions here. One deals with the type of mastectomy you're considering. You're not clear when you say a partial what you mean by that. 1) your sister actually had something closer to a lumpectomy which is why she had radiation? Radiation therapy is the usual protocol (in most hospitals) for follow-up after a lumpectomy (it certainly is for Memorial Sloan Kettering Cancer Center in NYC where I was treated.

      I'm not sure what you mean by a full mastectomy. You need to get clarification from your Breast Surgeon on what type of mastectomy she/he would perform based on the Stage of your Cancer, i.e., a skin sparing, a simple, or a radical (I'll leave it to you to discuss these terms with her/him). I'm not the person who should educate you re the different types of mastectomies. But there are sites on the Internet that will such as www.breastcancer.org, I believe. Your Breast surgeon is still the best source for you as an individual. You must find someone you trust (trust is more important than whether you "like" this person. You're not having this person come to dinner or be your friend, you're having them do surgery so you need to feel they're highly competent, that's all.

      Re radiation, I cannot help you there, because I had a mastectomy and didn't need it. I feel fine after my surgery, and am trying to lose weight now before I have my implant surgery (I had a fall and sprained my back badly so I have to wait 4-6 weeks to exercise, so it makes losing weight a bit tough right now).

      I wish you the best of luck in whatever choice you make. It's not easy, but there are4 many sites that you can use as a guide. Try researching (Google) Susan Komen and see what comes up for you.

      You may also wish to speak with CancerCare. The Social Workers there deal only with Cancer patients and their caregivers and issues surrounding the illness. Decision-making times like this can be stressful and they can be very helpful. I'd recommend giving them a call as well as clicking on the purple box in the lower right corner of this page to see more available resources for you.

      Warm wishes,

      I wish you luck

      over 4 years ago
    • Nonnie917's Avatar

      Take the full mastectomy decision. You won't regret it. Why try and save part of the breast when it is invasive and take chances on the cancer returning. I think the mastectomy decision is the best one you can make at this point. Maybe you can avoid radio and just have the chemo. Good luck to you and your family.

      over 4 years ago
    • debsweb18's Avatar

      I had a lumpectomy and didn't have clear margins so ended up with a mastectomy (skin sparing, chose to not spare the nipple). Since I had a small tumor in one lymph node I had full radiation treatment (28 with 6 boosts). However, I didn't have chemo because my oncotype score was very low and I'm menopausal. So everyone's situation is different and you may not know what treatments you need until after surgery. They didn't find out I didn't have clear margins or the lymph node tumor until the pathology was completed the day after surgery.

      BTW- there is a radiation option if you have a lumpectomy and no lymph node involvement-brachytherapy. That's where you have internal treatments twice daily for 5 days. I was going to have that until I had to have the mastectomy and found I had lymph node involvement.

      I did fine during radiation treatments. I worked 6 hours a day and was fatigued towards the end. I had a rash, itching and slight burning towards the end. I healed beautifully within a week after treatments and I have fair skin.

      Only you (with your doctors) can make the decision that's right for you. Good luck with whatever you decide!

      over 4 years ago
    • Nancebeth's Avatar

      When I was diagnosed, I did not even think twice about what to do. I decided on a bilateral mastectomy. My tumor was IDC-L in the left breast, 1.9 cm. So, I was stage 1a. I talked to an oncologist before surgery and found out that I might need chemo even after a bilateral, based on my Oncotype DX score. I did not need rads since my nodes were clear and my margins were clean. I had immediate reconstruction with silisone gel implants.

      Based on my Oncotype DX score, chemo was recommended but not required. I did six sessions of CMF. I dont like to second guess any of my decisions, however, knowing what I know now about the long term effetcs of the chemo on my mind and body, I would ahve chosen to forgo the chemo.

      Remember, this is YOUR cancer and so it is YOUR decision on how to best treat it for YOU.

      Good luck.

      over 4 years ago
    • Beannie's Avatar

      I had partial and 33 radiation doses. I had a hard time deciding between full or partial but chose to save my breast if it was possible. I could not personally deal with the thought of full mastectomy if I had an alternative. I know if future it comes back, I will not have a choice in the matter and I can deal with that. For me, radiation was easy. The only side effects I had were some redness (no burning though) and some fatigue. It is time consuming but I figure what is 7 weeks compared to the alternative. Good luck with your decision - I would not base my decision on someone else's experience because we all react differently to every part of treatment. Just make the decision that feels right for you.

      over 4 years ago

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