I've had both a lumpectomy w/radiation when I had DCIS and then, nine years later, a double mastectomy (recon will be this Spring) when I got IDC. Nobody expected me to get BC again. It depends on what kind of breast cancer you have...and what you decide after talking it over w/docs. My recovery from 2x mastectomy was more difficult emotionally than physically, but am doing fine now (had op in August). Hope this helps.
Breast Cancer Questions
Surgery options for breast cancer
Asked by yolie on Wednesday, January 2, 2013
Surgery options for breast cancer
I am having trouble deciding what surgery is best for me. Lumpectomy with radiation, mastectomy with recon or double mastectomy with recon. I'm leaning towards double but am worried about insurance and recovery. Any feedback would be helpful and appreciated.
14 Answers from the Community
I was not a candidate for lumpectomy as the breast cancer side was full of cancer...both surgeons I interviewed suggested I consider a bilat....Since that was one of my questions thats the route I went....luckily for me as the prophy side was precancerous. I had immediate recon with expanders then exchange for silicone implants....I would do the same thing all over again....and I had chemo and rads as well....chemo was a given at time of Dx and rads after bilat.....REcovery from bilat was about 2+ weeks till I felt really good then I got knocked back down when I started chemo....Maybe consult with a second surgeon to help make your decision...because my bilat was medically indicated by the docs, insurance covered it....
Before I even met with my surgeon, I had made the decision to be aggressive in my battle against this evil and elusive enemy. I also had a choice and I went for the bi-lateral mastectomy. I wanted the satisfaction of knowing that I did all I could do and I did not want to go through a second surgery in the future. I am extremely happy and at peace with my decision. As I have mentioned in previous posts, I know of a lady who decided at the last minute to have the double and lo and behold, the pathology report revealed cancer in the other breast. I am sure that is probably rare. Everyone is different and has to make the choice that is best for them. Recovery was very tolerable -- my biggest gripe were the drainage tubes. Your age will definitely be a positive factor. The Surgeon will know the diagnostic codes, etc. for the insurance claims so that you will get the maximum coverage. Best of Luck!
I had the same experience as JennyMiller. Wanting to be aggressive toward an aggressive triple negative cancer, I opted for bi-lateral mastectomy w/expanders. My doctors told me, however, that my chances for long-term survival weren't improved by mastectomy over lumpectomy and radiation. I needed peace of mind more than anything else; in my mind, taking all the breast tissue the surgeon could take seemed most logical. My parents both died of inoperable cancers, so I know my decision was motivated by that. Following surgery, I had six doses of taxotere and cytoxan chemo. My reconstruction went very smoothly, although going through it and chemo simultaneously was challenging some days. I believe, by law, insurance must cover reconstruction following mastectomy; your doctors get asked this question every day, so don't be shy about talking to them--or their office managers--about it.
I had a bilateral mastectomy and was really fortunate to have reconstruction at the same time. I was very lucky to wake up from the surgery with implants already. The recuperation was quite easy for me. Two of my four drains were out within 3 days and the remaining two were out within 5 days. I had 27 lymph nodes removed with no sign of cancer. It was great not to have to go through the process of two surgeries nor the process of the expanders. I am the only one that I know who has breast cancer that was able to have immediate reconstruction. I went down a size in my cup size and had plenty of skin to accommodate the implants.All of my friends whom have had breast cancer have chosen a bilateral so that their breasts will match and to hopefully not have any future surgeries. Talk to both your surgeon and a plastic surgeon for whats best for your type of cancer and your stage of cancer. Good Luck!
I would go with the recommendation of your surgeon and oncologist, they will have your best interest and longevity in mind (and if you ever feel that they don't - change doctors). Both of mine recommended either a lumpectomy or mastectomy and stated that my survival rate was identical with both. As a result, I chose the less invasive choice, the lumpectomy. I've questioned my decision since and my surgeon (who specializes in diseasess of the breast) told me that surgery will never be the answer for breast cancer. It is used to remove cancer, but that treatment for on-going survival from breast cancer, will always be chemo and/or radiation. I believe her from everything I've read and researched. Even having your breasts removed does not eliminate the risk of re-occurrence. Each case should be looked at individually - there is not 1 answer that fits all cases. Please talk with your doctors - many blessings!
When I was diagnosed with stage 1 trip negative in my left breast in Sept '10, I wanted to have a double mastectomy. This was not an option as I was being treated for advanced renal cell carcinoma. I had a lumpectomey with an extra large margin as well as 6 weeks of radiation, no chemo, because they did not want to take me off my renal cell chemo.
If it were my call I would go with the double, a trip neg lesion was found on my liver in late April (my scans were clear in Jan/Feb).
It's my understanding that insurance has to cover any surgeries related to breast cancer done now or in the future. Talk to your doctors about your options and risks and outcome for each. My breast surgeon, oncologist, plastic surgeon, and radiation oncologist each discussed options and left the final decisions up to me and my husband. I did ask a couple of times "If it were your wife, what would you do?" They were very honest and straightforward each time. Also pray for wisdom and for peace about your decision. God bless you whatever you decide. Each case is so different, so there's no right or wrong decision. It can be overwhelming. Take a deep breath. You will get through this:)
I had a small lump but it after a dye mammogram they found a lot more cancer. I opted for a
double mastectomy with silicone and full recon - pretty happy with them.
I was very glad I didn't wake up every morning worrying about more cancer. They will never look like "real" bobs but in clothes they are fine and my husband is happy with them LOL ( I think because they have nipples.) If your surgeon and oncologist agree, insurance will pay for them and full recon. I did not have to get chemo or radiation after mine because my margins were clear. Frankly the tamoxifen made me far more emotional and crazy then loosing my breasts!
read some of the other information on a post we started recently.
i went with the bilateral mastectomy for loads of reasons - including just the thought that there would probably be only one major surgery and that i would be symmetrical afterwards. turns out, i did have to have a minor revision to flatten things up a bit. i decided against recon. i did not want to have multiple surgeries. honestly, i'm happy flat.
it's a hugely personal decision, but i do believe that detailed discussions with your surgeon(s) are key. make sure that you have all of your questions answered.
i like the peace of mind that i have because i have as little breast tissue as possible after the bilateral mx. i like that i'm symmetrical. i like that i won't have to have scans (MRI, mammograms) of breasts. and... i actually like being flat.
i miss my nipples. no, it's not exactly ... well... a topic for polite conversation, but it's true. i miss my nipples. so, i guess i would consider a single mastectomy if i were opting for reconstruction and had a good shot at symmetry. but, symmetry can be difficult to achieve depending upon your shape and size. but for me, reconstruction was not a good choice.
so, those are my major thoughts... i hope you are able to make a decision with which you can find peace. and congrats on the effective chemo - that's got to feel good - that it seemed to have been worthwhile! i also had surgery AFTER chemo, and the peace of mind knowing that the chemo was effective was HUGE!!!!
Don't just assume reconstruction is best for you since it has to be covered by insurance. I am so glad to have avoided addtional surgeries, complications and feelings of "foreign boobs." It's not something I'm comfortable with for myself. But I know women who have been made to feel reconstruction is necessary in order to "feel like a woman" or "feel whole" and I am one of a number of women here to say that simply isn't so. Foam prostheses work just great for me!
Cancer showed up in my second breast just in time for me to say remove them both at the same time. I'm with others in that I wanted all the potentially suspect tissue removed. Having been diagnosed with breast cancer, I had the opportunity to have it all cut off my body, even though I was told I could go with lumpectomies and radiation if I chose. I'm extremely glad about the decisions I made. I did not make them because of my doctors; I made the decisions I did based on doctors' input, pathology and my own intuition. In the end, I have excellent range-of-motion and potential physically, shortest recovery and best long-term prognosis. I would think that a double mastectomy instead of a single would not increase recovery time needed. But a single would limit your options a bit regarding size choices, symmetry, etc.
Regarding insurance and a mastectomy for a second breast that "is not indicated," I do know of some women who have had insurance deny coverage to remove a breast that still tests out healthy. If I were you, I would get answers about that directly from your insurance company in writing.
Good luck! I hope your research in advance really pays off for you. :-)
I had bilateral with expanders which made room for the silicone implants. Given your young age, you might consider the possibility that your cancer has a genetic component, which would make your risk of getting cancer again much higher than the average woman. FORCE is an organization which I found to be extremely helpful as I was gathering information. Even if you do not have a genetic predisposition, the information on reconstruction will be valuable to you.
Due to the size of my tumor, I was originally told I would need chemo before a lumpectomy to shrink it and then need radiation after surgery. Because I needed chemo either way, I was more leaning towards a mastectomy to just get it all out. I had an apt on a Friday morning to go over all the options and was going to spend the weekend making my final decision.
That afternoon I got the results of my BRCA testing. Positive for BRCA-2. I didn't need to think anymore... bilateral mastectomy with immediate reconstruction. Surgery is scheduled in 5 days and chemo will start up in early February.
Whatever you decide is a completely personal choice for what is best for you. No one else can make that decision for you.
My surgical oncologist said she had a patient in her 60's who had her 2 daughters, both in their 30's, with her for her appointment. After the oncologist explained the 2 options to the family, the 2 daughters said what they would do if it was them. Each choose the opposite. Same appointment, same info, same family, 2 choices. VERY personal.
Best of luck to you!!