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Lumpectomy vs. mastectomy

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JenIrene11 View Drop Down
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    Posted: Jan 12 2022 at 2:25pm
looking for personal experience stories when choosing lumpectomy vs. mastectomy. Iím stage 3b TNBC with internal mammary node and axillary lymph node involvement. After 6 rounds of taxol/carboplatin w/ Keytruda, the tumor and lymph nodes have shrunk significantly and scans show no evidence of metabolic activity. My original thought was to do double mastectomy and just been done with it for peace of mind ( since there are atypical calcifications on the non cancer side). After talking to my oncologist, she feels my risk of recurrence is the same whether I do double mastectomy or double lumpectomy (recurrence risk do due node involvement. Now Iím confused and donít know what to do. Interested if anyone else has been in this position. Also I am BRCA negative as well so no risk there. Thank you!
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cookie54 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cookie54 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 12 2022 at 7:01pm
JenIrene I'm so glad to hear that you had a good response to chemo! Yes it is true that a mastectomy vs lumpectomy doesn't appear to affect the risk of recurrence. It truly is a personal choice, for me I knew mastectomy was it. Prior to being diagnosed with breast cancer I had a biopsy every year for 7-8 years. So I had enough of mammo's and biopsies ,it was a fairly easy choice for me. There is no wrong choice you just have to do what feels right to you. Think about the pro's and cons of each, invasiveness, recovery time, risks, reconstruction or flat closure, future mammo's or no mammo needed etc. 
As you said whatever will give you more peace of mind which is so important!
Best wishes with your decision, be well.

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HelenC View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote HelenC Quote  Post ReplyReply Direct Link To This Post Posted: Jun 01 2023 at 11:34pm
Hello, it is so glad to hear the chemo works for you. In my case, I have no nodes involved and reached radiology total response before surgery (verified by MRI). However, I still optioned double mastectomy just for ease of my mind. I reached PCR. Also, I do not need to do radiation. I want to return to norm life asap.  I am happy with my decision. For your case, since you have nodes involved, you will need to do radiation regardless lumpectomy or Mastectomy. Anyway, it is totally a personal choice based on what I talked to my surgeon and medical oncologist. Good luck! 

Edited by HelenC - Jun 02 2023 at 12:01am
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Maddsgran View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Maddsgran Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2023 at 6:03pm
Hello, I'm curious which surgical option you chose and why.  I was diagnosed in August 2023 with Grade 3, Stage I, MRI and PET neg for lymph node involvement or spread. I'm finishing chemo soon and will have surgery in March and I'm just trying to get others' experiences because for me this decision is really hard and confusing.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Clarise Quote  Post ReplyReply Direct Link To This Post Posted: Jan 09 2024 at 12:20pm
Hi Maddsgran,
I am having the same struggle.  I was diagnosed in June 2023 with Grade 3 Stage II, Ultra sound negative for lymph node involvement. I finished chemo and am scheduled for lumpectomy with radiation.  I met with a plastic surgeon on Friday who discussed the skin and nipple sparing mastectomy with me.  Now I am confused as to which option I should choose.
Any input from would be welcome!
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Melk View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Melk Quote  Post ReplyReply Direct Link To This Post Posted: Jan 10 2024 at 9:15am
Iím laying the hospital now post lumpectomy and reconstruction. I chose this route because Iím not eligible for implants. I developed a severe reaction to Keytruda after my first dose with taxol and carboplatin in September. It hospitalized me. After that I did 4 rounds of AC. On the 3rd round, I had an allergic reaction to emend, the premed nausea med. I was able to get the chemo dose in. However, I went back to taxol, on a slow drip and went into anaphylactic shock. After the tumor board met about my case, they recommended I get surgery in and then continue treatment. They recommended the lumpectomy and an allergist said no implants for me. I was very torn about the lumpectomy which would be a breast reduction as well or the mastectomy with the diep flap reconstruction. Radiation with the lumpectomy scares me. But I still chose this route because I didnít want the longer surgery and longer recovery time with diep flap reconstruction. It was such a tough choice and I felt so much pressure since I had to make a decision around the holidays after all my other issues. 


They kept me in the hospital with the lumpectomy because of all my allergies. Iím sore but the pain meds. 

The choice is hard and so personal. Itís not easy at all.

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