Recurrence After Mastectomy vs. Lumpectomy

I have had a whirlwind  diagnosis of a trip-neg recurrence after only 7 months of being disease free. The doctors think this cancer was in the breast at the time of my lumpectomy, but was quiet/dormant until recently.

I'm wondering... (hind sight is always 20-20) -- If I had had the mastectomy in the first place, would the cancer have come back at all (a mastectomy would have theoretically removed all of the cancer, active or dormant)? Or, would I have had a recurrence anyway -- just somewhere else, more foreboding than in my breast?

Please understand... I am only fact finding. Not second guessing my initial treatment decision (I was not mentally ready for a mastectomy at the time) or my doctor (he has sent my slides to Harvard for second opinion; is treating me aggressively now).  I am at peace with my situation. Grateful for the treatment I've had, and that cancer has only been found in my breast so far.

I'm just wondering out loud...  Do you think trip-neg ladies should always be advised to have a mastectomy at the initial diagnosis?  We have such a high rate of recurrence. The odds are really against us. Does a mastectomy give us better prognosis? 

In my case, an initial mastectomy could have (theoretically) saved me the radiation treatments and the involved reconstruction treatment (latissimus dorsi flap) that was needed b/c of the radiated skin. 

Okay Joan2844,

Dear dear Pam,

You know, I so DREADED my mastetomy, but once it was over (and I had physically recovered), I was really okay with it. The breast that was removed always felt so bad -- I thought it was left over side affect of my radiation; now I believe that breast was just DISEASED. Every day the breast ached and bothered (worried) me in one way or another. Now, it is gone and I don't have the physical aching (or the worry) anymore. It is a blessing.   

And... this will sound corny, but I am a strong Christian -- lots of prayer, Bible study and honestly trying to give my situation to God. Before the surgery I cried and worried about not being a "whole" woman. One day (before the surgery) I was praying and the thought came to my mind, "You are whole in the Holy Spirit." I believe in my heart that that was God talking to me, and I felt such peace in that realization. I am still a vibrant, useful person in this world without my breast. The only limitations that exist for me are the ones I put upon myself!

I hate what cancer has done to me -- with a back flap and all my lymph nodes removed, I really do feel handicapped on my left side. But, I'm determined to make it through. Thanks for your responses ladies.... And yes, please do vote. The poll is mine, and I'm really interested in the results....     

OK, looking at this poll, so there are NO persons out there that have had a recurrence/mets that had a Mastectomy??? That's quite a statistic don't ya think?

Edited by Wendy2 - Jun 30 2008 at 1:40pm

My vote was the " I had a single mastecomy; cancer came back in other breast," but it was a new primary, 369 days later.  I've now had two mastectomies, failed TRAM recon, genetic testing to find out I am BRCA 2+ and had my hysterectomy/oophorectomy last Friday. Talk about a whirlwind 15 months. It's been a crash course on Cancer, treatments, tests, 5 surgeries. genetics and more medical terms than I ever wanted to know. But....I am alive. Next year I WILL celebrate my 50th Birthday!

Joan,

Just found this post.  My husband and I were just talking about this this morning.  In hindsight I would have had the mastectomy first.  I would also advise anyone newly diagnosed tpn to consider this.  I wonder all the time if I wouldn't be where I'm at now if I would have just gotten rid of them both at the beginning.  The oncologists/surgeons are doing a disservice to us by not telling us the challanges of being TPN.  I thought this was a good thing when I was first diagnosed.  Now, I know the truth.

When first diagnosed I was not told I had triple negative. I was only told that my cancer was very aggressive. The doctors told me it was my decision, but because of my implants a lumpectomy would be tricky. I decided to have a mastectomy (on my left side). I had a tumor about 1.5cm and just wanted it off. I had reconstruction at the same time. I didn't have a recurrence till 3 yrs out in my left arm pit.Never a problem in the other breast, knock on wood. And by my signature you can figure the rest out.

I hadn't seen this survey before tonight. I agree with Chaya. Shouldn't this include those that haven't had reccurance? Also most on this site are fairly newly dx. It would be nice to see #'s and comparisons of those beyond 3 years.