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  • Is a mastectomy really necessary? What do you think?

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    Old 01-18-2005, 03:59 AM   #1
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    Is a mastectomy really necessary? What do you think?

    I posted a few days ago concerning mastectomy with expander and nobody was able to reply so I was wondering if anyone could help me with this one.
    My surgeon has done 2 lumpectomies and now says he cant get clean margins and I am scheduled for a mastectomy next wednesday. I called my oncologist concerning chemo and he thinks I will need it but he said all thats left in my breast is pre-cancer. So, why cant they radiate the heck out of my breast and then give me chemotherapy to save my breast. I just cant understand why I have to go through this when my actual tumor was the side of a sesame seed..only 2 mm. There was a tiny bit of invasive (which has been removed) and another spot of non-invasive. The rest is precancer. My nodes checked clear. I need some thoughts from someone...please.

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    Old 01-18-2005, 06:16 AM   #2
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    Re: Is a mastectomy really necessary? What do you think?

    i'm not an expert but my mother is a breast cancer survivor. she had a double mastectomy. i remember her saying that even though she had the mastectomy she could still get cancer in the walls of her chest. my mother was 48 when she was diagnosed and her dr. felt that the mastectomy would help my mother beat cancer. she too had a small lump in her right breast. then they found something in her left. so just to be safe she went ahead and had the double mastectomy. if you have any other questions i could ask her for you.

    Old 01-20-2005, 11:09 PM   #3
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    Re: Is a mastectomy really necessary? What do you think?

    Joella, I'm no expert either but wanted to offer two thoughts. (I think I felt a lot like you on the eve of my mastectomy, thinking maybe this is simply not necessary at all, but after almost cancelling my surgery, I came to understand what was behind the mastectomy recommendation and realized it was really by far the safest, if not the only safe choice.)

    Anyhow my two thoughts I wanted to pass on are -- first, I noticed you've already had two lumpectomies. That's a pretty strong suggestion to me that your surgeon has most likely gone as far as possible to preserve the breast, and if he now finally believes it's time for a mastectomy, I at least get the feeling he has tried as long as medically possible to avoid it and still defeat the cancer, and now yes, it's time.

    I know in my case the initial plan was also for a lumpectomy (when I was first diagnosed with Paget's of the nipple), which would be followed by radiation of the breast. But a mammogram then showed a cluster of five tiny microcalcifications a little deeper in my breast, and then a biopsy showed them to be early cancer. (I'm not sure if there is always a clear line between pre-cancerous and early cancer, so that may be a consideration in your doctor's thinking too.) So, when the cancer was found in more than one spot, a lumpectomy was definitely no longer the treatment they could recommend, I HAD to have a mastectomy. In fact, in my case my surgeon did not want to even do two lumpectomies. (Although our comparisons are probably not exact because perhaps you had two lumpectomies in basically the same spot attempting to remove the same risky or cancerous tissue, if I understand you, whereas my cancer (cancers?) was in different spots.)

    Second, another factor my surgeon explained it to me was that radiation treatment is not like a sort of sweeping wide beam that just splashes over the whole breast but rather has to be aimed at a particular, single, specific target spot. But if they know the cancer has spread to more than one place, they don't know where to aim it anymore for the radiation to kill the cancer.

    Another factor against keeping the breast which my surgeon mentioned was that when they found some clearly cancerous changes in the breast tissue, that meant that other surrounding tissue also would have had changes that made it dangerous, that other cells would also be beginning to undergo changes that would continue to get worse and imperil my life, though they may not have been clearly visible as cancerous yet at that point.

    That was my understanding anyway.

    Just for your info about me (as I mentioned in another thread last week headed something like "nipple change" which you might want to check out, though I think I'm pretty much repeating most of it), my procedure, a simple left mastectomy, was about two and a half months ago and I have been amazed how much easier the surgery as well as the healing has been than I expected.

    Admittedly I'm still somewhat feeling my way through the aftermath myself, but it is really is by far NOT one of the worst things that could happen, as I had feared. Really it has been a somewhat unfortunate event, like life throws at us sometimes and we move on, that's how I'm experiencing it.

    Wish I could help you also realize it will work out and you will be fine!!! For me at least, my worries and fears were by far the biggest challenge.

    Also remember, luckily for you and me, many folks have unfortunately been through this experience before us and I'm sure you will see, as I did, that our treatment is so much safer, more effective and easier to handle than for those facing our situation the earlier days.

    Hope you will keep us posted if you have time.

    Old 01-24-2005, 09:04 PM   #4
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    Re: Is a mastectomy really necessary? What do you think?

    Let me first say how sorry I am that you are going through this.
    I too am not an expert, and I know every situation is different, but let me share with you my family's recent bout with breast cancer.
    My 33 yr old cousin was diagnosed with breast cancer in June 2003. She got opinions: one that wanted to remove the breast, chemo, and radiation, and the other doc who opted for a lumpectomy with chemo and radiation. Her cancer had not spread to nodes and she didn't want to remove the breast so she opted for the lumpectomy. After the lumpectomy, weeks of chemo and radiation, she was told last spring 2004, she was told that the cancer was gone and she could start looking to get the breast reconstructed (u know, not the whole breast but that missing part). Anyway, just a few months later, in July 2004, we found out that she had cancer in her lungs, spine, and 80% of her liver! She passed away in October.
    Like I said earlier, I know every case is different, so your situation may not be this, but please, think about the masectomy. We spoke to 2 or 3 other specialists towards the end, and they all agreed that her breast should have been removed to prevent this from happening. My cousin, being young, single, and vibrant, opted against having her breast removed.
    I know it's easy to give advice when it's not you. Frankly, I'm 29 and I too would be conflicted if faced with this. But just remember, you can live without your breasts.

    Old 01-28-2005, 10:33 PM   #5
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    Re: Is a mastectomy really necessary? What do you think?

    Sometimes yes, sometimes no -- that's where the trouble comes in. I had a mastectomy 2 yrs ago not b/c I had 2 tumors in my left breast, but b/c: 1) my age -- 27. The likelihood of my cancer recurring sometime during my life was very high. (Since then it has returned.) 2) Besides the tumors, I had tiny spots of residual cancer throughout the breast so it was impossible to clear a safe margin and remove all the cancer.

    Choosing a mastectomy was the hardest decision of my life, but I made the right choice based on my particular diagnosis. If I had a tumor that was easily removed, with no lymph node involvement, and an easily cleared margin I don't think I would have gone with the mastectomy b/c I don't think I would have felt it was necessary.

    My advice is to get a few opinions and definitely ask for an MRI. MRIs show cancer that mammograms and ultrasounds do not.

    Best wishes to you. I know exactly what you're going through and it's tough -- so ****** tough...

    Old 01-31-2005, 12:11 PM   #6
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    Re: Is a mastectomy really necessary? What do you think?

    I was diagnosed in 1999 with DCIS, so I opted for lumpectomy. Well, they didn't get clear margins, so I had to go back for more surgery, as well as a sentinal node biopsy. They came back negative and the second time around they got clear margins and upped my Dx to Stage One. I had radiation for the breast and lymph nodes just in case. After my swelling went down I realized to my utter disappointment that my breast had shrunk to 2 cup sizes less than the other. I am now a B on one side and a AA on the other. Not fun to shop for bras, let me tell you. If I had known this going in, and also that my nipple would remain so sensitive that I still can't bear-hug my husband after 6 years without pain, I would have gone for the mastectomy and reconstruction.

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