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Post by *Shannon on Jun 17, 2019 18:41:09 GMT
The gist of it... I could 1) have a lumpectomy now, 2) treat tumor to shrink it and then have lumpectomy, or 3) have a unilateral mastectomy w/DIEP flap procedure, 4) have a bilateral mastectomy with DIEP flap reconstruction.
Part of me feels like I should choose option #1 or #2, do my 4 weeks of radiation and be done, cosmetics and major surgery be damned.
Part of me wants to do the mastectomy... get rid of the cancer and, hey, who doesn't want an improved bust line and a tummy tuck?
I am having such a hard time making a decision. Thing is, I feel bad for even considering the mastectomy. I don't NEED it, I mean to survive this. Some women have no choice and would love anything other than to have to have their breasts removed, and I'm considering doing it even though I don't have to? I know every woman is different and emotional outcome is important. I know that I am entitled to do what I think is best for me. My husband says it's obviously 100% up to me and that he supports whatever I want to do, but he also said, "I don't know why you wouldn't do the 6 month treatment and then remove the tumor." Even considering the mastectomy is nuts to him. I'm doubting myself and then him saying that... I feel like a heel.
A few more details about my options:
1) lumpectomy now: This would be an out-patient procedure, recovery would be one to two days of bed rest and then one week off work. It would result in a small, deformed breast. My plastic surgeon could try to make the other breast match more closely in size about 6 months after surgery and radiation. Plastic surgeon does not recommend this option due to amount of tissue that would have to be removed, he thinks it would have a bad cosmetic outcome. But, if I don't care about cosmetic outcome, this is the easiest and quickest option.
2) treat for six months, then lumpectomy: This option is the same as above except we would treat the tumor for six months with Tamoxifen, the do the lumpectomy. The tumor would be smaller meaning less deformed breast after lumpectomy.
3) single mastectomy w/ DIEP flap reconstruction: This requires a stand alone sentinel node biopsy to be done first. If biopsy is negative the mastectomy would be in mid-August with immediate reconstruction via DIEP flap procedure. Recovery would be 4-5 days in the hospital, then 4-6 weeks off work. If the biopsy comes back positive, I'd have the mastectomy and immediate placement of an expander. I'd then do radiation. About 6 months later the DIEP flap reconstruction would be performed. Recovery would be about the same time for each surgery, few days in the hospital, then 4-6 weeks recovery.
4) double mastectomy: This option is the same as #3 except the procedure would be done on both breasts. My breast surgeon brought this up because DIEP flap is a one time thing and if cancer shows up in the left breast at a later time and I need reconstruction a second DIEP flap cannot be done. Other sites are an option, but her thought is if you're going to do a mastectomy and are concerned about a recurrence down the road, go ahead and take advantage of the materials you have access to now and take care of everything.
A few extra tidbits... I am a medium B cup. I am a bit of a chubster and WILL be losing weight over the next year. I am going to start Tamoxifen this week regardless of what I choose to do. I am scheduled for a sentinel node biopsy on the 6/27. I figured I should go ahead and do the biopsy, it might help me decide. If it's negative I think I'd be more likely to choose the mastectomy. I have had genetic testing and the panels came back clear, no mutations.
The last time y'all offered opinions and support, it helped so much. Opinions on what you would choose and why would be awesome. I need perspective from those that have dealt with this. I'm sure there are things to consider that I don't even know about.
Thank you, thank you, thank you.
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Post by shevy on Jun 17, 2019 18:51:50 GMT
Don't worry about other people and their choices, they;re not you. What do you want to do, if you had to chose?
I had a biopsy that was DCIS 0 and because I also had 62% chance based on family history and my life choices, I chose BMX with DIEP. I wanted my own tissue, not an implant that may have to be switched out in 20 years. I've regretted it, thinking I was over treating myself, but then again my risk of breast cancer is 5%. No more mammograms. I got a hug mastectomy tattoo to help with my body image after scarring.
But this is me and my story. Yours is different and solely yours.
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craftykitten
Pearl Clutcher
Posts: 4,304
Jun 26, 2014 7:39:32 GMT
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Post by craftykitten on Jun 17, 2019 18:58:55 GMT
We all have to do what's best for ourselves. I've had a double mastectomy and no reconstruction yet (they wouldn't do it before any radiotherapy, although as it turned out I didnt have rads) and I certainly don't begrudge your choices. My story is my own.
Have you had any genetic testing done? I only had cancer in one breast but had them both removed. I have a genetic fault that puts me at higher risk of cancer. I didnt know this when I had the surgery, but it has made things a lot clearer in my mind.
Hugs because even if you "only" have a lumpectomy, cancer sucks.
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Post by tentoes on Jun 17, 2019 19:15:57 GMT
Sending prayers for you. Like others have said, you have to do what is best for you. One of my friends is currently considering the same options as you are. Very hard. ((HUGS))
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Post by Zee on Jun 17, 2019 19:22:38 GMT
You owe no one anything. This is YOUR BODY YOUR CHOICE. Don't worry about what other women feel about their breasts.
I had no choice other than to have a mastectomy. I chose bilateral to have a matching set, and because I had already had biopsies done on the non-cancerous breast and I didn't want to do any more ever.
I did not have the flap, I can't remember why my plastic surgeon felt that wasn't the best option in my case but he came highly recommended and I had faith that he knew what would give me the best outcome.
I don't regret the bilateral mastectomy one bit. I think even if lumpectomy had been an option, I still would have opted for the bilateral mastectomy because of all the mammograms, ultrasounds, and biopsies I'd been having for four years before developing cancer. I felt like a ticking time bomb.
But if your case is much simpler and you can do a lumpectomy and feel better about that than mastectomy, then that's what you should do! I should add I was never very attached to my breasts in the first place (other than literally, har har) so I don't miss them much. I went up a cup size and I feel like my body is more balanced now. I'm very happy with my choice.
Best of luck to you--it's almost harder having those options, isn't it, because you're not sure what to do? Look at lots of photos of what you can expect and be sure you'll be comfortable with the end result.
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Post by *Shannon on Jun 17, 2019 20:22:05 GMT
Don't worry about other people and their choices, they;re not you. What do you want to do, if you had to chose? I had a biopsy that was DCIS 0 and because I also had 62% chance based on family history and my life choices, I chose BMX with DIEP. I wanted my own tissue, not an implant that may have to be switched out in 20 years. I've regretted it, thinking I was over treating myself, but then again my risk of breast cancer is 5%. No more mammograms. I got a hug mastectomy tattoo to help with my body image after scarring. But this is me and my story. Yours is different and solely yours. Thank you, shevy. I'm not so much worried about what others would choose, it's that I like to know other people's thought processes. I want to make sure I'm considering every thing when making this decision. I find that when I hear people discuss why they chose what they chose it opens me up to thinking about different approaches, considering things I wouldn't have considered otherwise. etc. You stated. "I've regretted it." What do/did you regret? Thank you for telling me about your tattoo. I've started looking at them and wow, some of them are so wonderful - visually beautiful and what a way to be you - to claim back some of what cancer took. I love them. Would you mind sharing what yours looks like? Floral, gothic, armour, vines? If you'd rather not share, please tell me to take a hike.  |
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Post by *Shannon on Jun 17, 2019 20:27:26 GMT
We all have to do what's best for ourselves. I've had a double mastectomy and no reconstruction yet (they wouldn't do it before any radiotherapy, although as it turned out I didnt have rads) and I certainly don't begrudge your choices. My story is my own. Have you had any genetic testing done? I only had cancer in one breast but had them both removed. I have a genetic fault that puts me at higher risk of cancer. I didnt know this when I had the surgery, but it has made things a lot clearer in my mind. Hugs because even if you "only" have a lumpectomy, cancer sucks. craftykitten - I'm sorry for what you've gone through. I have had genetic testing done and both panels came back with no mutations. Thank you for your input. |
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Post by shevy on Jun 17, 2019 20:29:55 GMT
Thank you, shevy. I'm not so much worried about what others would choose, it's that I like to know other people's thought processes. I want to make sure I'm considering every thing when making this decision. I find that when I hear people discuss why they chose what they chose it opens me up to thinking about different approaches, considering things I wouldn't have considered otherwise. etc. You stated. "I've regretted it." What do/did you regret? Thank you for telling me about your tattoo. I've started looking at them and wow, some of them are so wonderful - visually beautiful and what a way to be you - to claim back some of what cancer took. I love them. Would you mind sharing what yours looks like? Floral, gothic, armour, vines? If you'd rather not share, please tell me to take a hike.  Shannon, I'd never tell you to take a hike. I didn't go through a cancer center so I had no advocate who walked me through things and I'd never want anyone to go through this alone like I did. Ask me any question you want and I'll gladly answer. my cell is 612-819-9132, please text me anytime. HOnestly. I regret that there are people who tell me all the time that I over treated my DCIS. However, I have to remember that these were cancer cells, waiting to bloom and I would have been going through the whole mastectomy process at some point in my life. My Mom, maternal grandma and maternal great grandma all had breast cancer. I regret that it too me off my awesome 100 pound weight loss and that I became depressed without the support I really needed. However, I think that there are big ways to combat these things. Counseling and advocacy right away to help support you, means less feelings/emotions to settle and bog you down. And never ever let anyone tell you that what you're feeling isn't valid. A smile never cured cancer, there is no reason to hold back angry hot tears over the process that is changing you forever. Have a surgeon who will show you pics of things that don't always go right and how he/she would fix it. Have that person give you the name of someone to call to verify work. I've shown most of my tattoo on here before, let me send you a message.... |
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Post by *Shannon on Jun 17, 2019 20:30:04 GMT
Sending prayers for you. Like others have said, you have to do what is best for you. One of my friends is currently considering the same options as you are. Very hard. ((HUGS)) tentoes - I hope your friend comes to a decision she is peaceful with soon. Thank you for your support. |
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Post by *Shannon on Jun 17, 2019 20:38:10 GMT
You owe no one anything. This is YOUR BODY YOUR CHOICE. Don't worry about what other women feel about their breasts. I had no choice other than to have a mastectomy. I chose bilateral to have a matching set, and because I had already had biopsies done on the non-cancerous breast and I didn't want to do any more ever. I did not have the flap, I can't remember why my plastic surgeon felt that wasn't the best option in my case but he came highly recommended and I had faith that he knew what would give me the best outcome. I don't regret the bilateral mastectomy one bit. I think even if lumpectomy had been an option, I still would have opted for the bilateral mastectomy because of all the mammograms, ultrasounds, and biopsies I'd been having for four years before developing cancer. I felt like a ticking time bomb. But if your case is much simpler and you can do a lumpectomy and feel better about that than mastectomy, then that's what you should do! I should add I was never very attached to my breasts in the first place (other than literally, har har) so I don't miss them much. I went up a cup size and I feel like my body is more balanced now. I'm very happy with my choice. Best of luck to you--it's almost harder having those options, isn't it, because you're not sure what to do? Look at lots of photos of what you can expect and be sure you'll be comfortable with the end result. Thank you ZeeEffingGee, having that peace of mind of not really having to worry about the other breast is not something to be ignored. It's something that is weighing heavily on me. Having options is a blessing... and a PITA!  |
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Post by shevy on Jun 17, 2019 20:41:42 GMT
having that peace of mind of not really having to worry about the other breast is not something to be ignored. It's something that is weighing heavily on me. You have to try to let this go. I know it's hard because I watched my Mom and I sometimes feel like a 'failure' for lack of a better term because I had DCIS and not full blown cancer cells all over me. But mine and yours was caught early. That is to be thanked. BUt you can't take on the world of those who had no choice. It will eat you alive in this process. |
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Deleted
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Aug 18, 2025 21:08:32 GMT
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Post by Deleted on Jun 17, 2019 20:43:04 GMT
I just want to stop in and tell you Peas that I am in awe of your strength and support and I just have such admiration for the way you support each other in times like this. You just cannot know how much I wish for healing and health for all of your bodies. TPS can be a crazy place, but at times like this....like a rainbow of gold!  |
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Post by colleen on Jun 17, 2019 20:52:32 GMT
I had bilateral mastectomy with Diep Flap reconstruction. I didn't have cancer. I am BRCA2 positive and my mother, my sister, my grandmother, three aunts, and two cousins have had breast cancer. It was a no brainer for me. My sister had the same surgery (and cancer) 6 months before me. Same surgeons, etc. She had a beautiful result. I had some complications (not life threatening) that kept me in the hospital for nine days and my result is not quite as picture perfect as hers, but pretty swell. I did not find the recovery difficult at all once out of the hospital.
My surgery was 10 years ago. My sister (a nurse anesthetist) often works on similar surgeries and says the results now are even better than ours and the surgeries are shorter. I think my complications scared other family members who have had mastectomies from having Diep flaps, but I would do it again. My breasts look so much better than theirs, although my sister says the implant surgeries have much better results now too.
Go with your gut. You know what you can live with. If you have any reconstruction get the best surgeon you can find and travel if you have to, it's worth it.
Please feel free to reach out if I can help in any way. I wish you all the best.
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Post by Zee on Jun 17, 2019 22:30:59 GMT
Also just wanted to say that I hope your DH will be supportive if you do opt for the bilateral mastectomy. I'm very grateful for my DH's supportive attitude and that he was never fazed by my incisions and drains and scars. Having someone in your corner during recovery is such a help, mentally and physically. I don't feel at all bad about my appearance now. It is what it is. I feel rather fierce actually. I keep considering tattoos but I just can't decide what to get, so I still have Barbie boobs for now.  Hugs to you. |
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inkedup
Pearl Clutcher
Posts: 4,837
Jun 26, 2014 5:00:26 GMT
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Post by inkedup on Jun 17, 2019 23:55:32 GMT
I don't have advice, but I wanted to wish you the best possible outcome, no matter what you decide.
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Post by PNWMom on Jun 18, 2019 5:06:53 GMT
Also just wanted to say that I hope your DH will be supportive if you do opt for the bilateral mastectomy. I'm very grateful for my DH's supportive attitude and that he was never fazed by my incisions and drains and scars. Having someone in your corner during recovery is such a help, mentally and physically. I don't feel at all bad about my appearance now. It is what it is. I feel rather fierce actually. I keep considering tattoos but I just can't decide what to get, so I still have Barbie boobs for now.  Hugs to you. Yay for Barbie boobs! I had bilateral mastectomies/tissue expanders/silicone implants, then went back and did nipple reconstruction. The nipple surgery was on February 28th, and my diagnosis had been March 1 of the previous year, so it was exactly one year of cancer crappiness. Anyway--the nipple reconstruction. I very much regret doing it. My boobs don't move much, and I don't need or wear a bra at all, even though I'm a D cup. Yay for no bra! However, the nipple reconstruction means that I have small erect looking nipples (well, one is pretty scarred down flat, and one is a bit erect), and that is visible through thinner materials and I end up wearing tank tops under my clothes a lot. Which kind of sucks. I wish I'd just left things at the Barbie stage and could go braless now without needing a tank top. Totally my two cents... I never went back for nipple tattoos because I have never seen any examples of them that looked great, but I wanted to have something to symbolize my closure, so I got a tattoo on my side/ribs/around the right boob (the one that had cancer) that is just swirls and looks cool and helped me have closure for this whole cancery saga. No one sees it but me and my husband (I lie. My toddler sees me naked all the time, as does my baby). I suppose the top is visible if I'm in just a tank top. |
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Post by KelleeM on Jun 18, 2019 8:10:17 GMT
Iâm almost 6 years out from diagnosis. I had a lumpectomy, chemo (2/2 positive nodes), and radiation. In hindsight I wish I had gone with a double mastectomy just to get rid of more of the worry. I know itâs not a 100% guarantee of no recurrence but itâs low.
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Post by mikklynn on Jun 18, 2019 11:38:08 GMT
I am praying for you to arrive at a decision that gives you peace.
Whatever you decide is right for you.
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Tearisci
Pearl Clutcher
Posts: 4,965
Member is Online
Nov 6, 2018 16:34:30 GMT
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Post by Tearisci on Jun 18, 2019 14:03:27 GMT
You have to do what you feel the most comfortable with and it's really hard when faced with all of the decisions. I opted for a mastectomy on the affected breast with a DIEP flap based on my type of cancer (slow growing, non aggressive etc). i'm glad I did it because I like that it is my own tissue. After the surgery, they found small amounts of cancer in my lymph nodes so I also ended up with radiation which shrunk the new breast quite a bit. I'll have another reconstruction soon to even them up.
I am also getting a full hysterectomy because my cancer was highly made up of estrogen and at 52, I want it all out!
Best of luck to you and peace with your decisions
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Post by kelbel827 on Jun 20, 2019 18:41:12 GMT
Iâm so sorry you have this decision. If it were me, without a doubt I would pick 4. My mom died of breast cancer. She was 42 at her first diagnosis and 51 for her second. Two different kinds, not a spread. If she had done the mastectomy the first time, itâs possible there wouldnât have been a second time. Just my 2 cents.
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Post by kernriver on Jun 20, 2019 23:51:14 GMT
I had a lumpectomy 22 years ago. I wish I had a mastectomy.
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Post by elaine on Jun 21, 2019 0:57:42 GMT
Hi everyone! This is a timely question as I am writing this from a hospital bed having had bilateral reconstruction surgery for the second time this morning. When I was first diagnosed in March 2018, I thought I had 1 tumor about 1 inch in diameter. My surgeon favored a lumpectomy even though it was large, but I was waffling between that and a mastectomy. When my tumor board found more suspicious looking areas when reviewing my mammogram pictures, they had me go for another biopsy and more small tumors were found. That did it for me - with multi-focal cancer in one breast, I opted for a bilateral mastectomy. There was a hint of âyou may be over-treating thisâ from my oncologist, especially when my lymph nodes werenât found to contain cancer. And then my oncotype came back from the lab 2 weeks after surgery with my cancer cells having a 30% chance of coming back without chemo. So, 8 grueling rounds of chemo it was. And so, I donât regret for one moment choosing a bilateral mastectomy. Because you donât/wonât know your cancerâs oncotype until after surgery and there are no guarantees- even if it âlooks goodâ to your oncologist and oncology surgeon at the beginning. Your lymph nodes may have cancer cells - you wonât know that until surgery. Your oncotype may be high risk - you wonât know until after surgery. Even though chemo supposedly has dropped my risk down to under 10% of a recurrence, if I had my other breast, I would worry for the rest of my life. I never want to face chemotherapy again and my anxiety would be through the roof at every mammogram. I never have to have a mammogram again. The only thing I would have done differently, if I could do it again, is to go craftykitten âs route and not had reconstruction. The first plastic surgeon who worked on me at the time of the mastectomy screwed things up so badly that I have now had two 5-hour reconstruction surgeries to fix things. He was a reservist who was called to short-term duty at Walter Reed because their plastic surgeon who does breasts was called to temporary duty elsewhere. You, however, wonât face that situation and it sounds like have a skilled surgeon at the helm! I wish you the best with whatever you decide. Iâll echo what others have said, however: make your decision based on YOU and what you think and what you can live with, not what others think. And, not to be a doomsayer, I gently encourage you to consider what your response would be if your case isnât as simple and positive as it seems now. How will you feel about each of your decisions if it turns out that your cancer is in your nodes and you need radiation and maybe chemo? Or if your oncotype indicates your cancer cells have a high likelihood of recurring? I will pray that those arenât the case, but I am thankful that my tumor board found those other tumors which changed my mind, because I would have regretted not having a bilateral mastectomy when my oncotype came back. Your responses and anxiety levels might be very different from mine, however, but it doesnât hurt to consider what they would be in possible scenarios. (((Hugs))) |
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Post by malibou on Jun 21, 2019 1:12:43 GMT
I will continue to keep you in my thoughts as you make these really hard decisions. elaine nice to see you. Got you tucked up safely in my thoughts too. |
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ModChick
Drama Llama
True North Strong and Free
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Post by ModChick on Jun 21, 2019 2:45:25 GMT
I just want to stop in and tell you Peas that I am in awe of your strength and support and I just have such admiration for the way you support each other in times like this. You just cannot know how much I wish for healing and health for all of your bodies. TPS can be a crazy place, but at times like this....like a rainbow of gold! Exactly what I was thinking reading this thread đ„° |
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Post by scrapmaven on Jun 21, 2019 2:45:41 GMT
Do what will best for you and get your surgical oncologist's advice. Praying that this is a quick battle and that you never have to deal w/this, again.
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Doxiemom
Junior Member
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Post by Doxiemom on Jun 21, 2019 4:48:10 GMT
I had a preventative double mastectomy 11 years ago due to pre-cancer cells and a strong family history. So I didnât have cancer but I can share what Iâve learned from the mastectomy and reconstruction.
First, I donât regret my decision as it is wonderful to not have to go for mammograms, ultrasounds and biopsies anymore. I had implant reconstruction and the recovery was pretty easy. However, I âve had a few complications with the implants and had two replacement surgeries.
So I see the benefit of a flap reconstruction using your own tissue. The benefits of having a double mastectomy and DIEP reconstruction is that the breasts will feel the same, look the same and you wonât have to get mammograms on the remaining breast like you would if you just did one. My mother had a mastectomy and flap reconstruction on only one side and has her natural breast on the other side. They look very very different.
I wish you the best in your decision.
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PLurker
Prolific Pea
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Location: Behind the Cheddar Curtain
Jun 28, 2014 3:48:49 GMT
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Post by PLurker on Jun 21, 2019 7:34:33 GMT
No experience so I have no advise for you @*Shannon but best wishes and hugs sent your way. elaine đ hello! Good to "see" you! |
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mnscrapper
Junior Member
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Post by mnscrapper on Jun 21, 2019 13:28:06 GMT
Three years ago I was diagnosed with stage 1 breast cancer. My tumor was 8mm and wasnât picked up by my yearly mammogram. I happened to have an MRI that picked up the tumor. I did the double mastectomy and have not once regretted my decision. I did reconstruction with implants and am extremely happy with the results.
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Post by grammadee on Jun 21, 2019 14:51:48 GMT
Your decision has to made according to how you feel. I wanted to know the cancer was "out of me" and opted for the lumpectomy first and treatment (chemo and radiation) afterward. That gave the doctors a chance to look at the tumor and assess its spread (lumpectomy also included a biopsy of lymph nodes).
The difference in size of my breasts was not very dramatic after the procedure, but today--25 years later--the radiated breast is about half the size of the unradiated one. I am not concerned about how it looks, (and let's face it, at my age no one else cares to "check me out") but finding a bra or swim suit to fit properly is sometimes frustrating. If I had to make the choice again, I would do the same thing I did.
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Post by shevy on Jun 21, 2019 16:15:11 GMT
elaine I'm so sorry you're going through this. mY Mom had an absolute horror of a plastic surgeon when she was diagnosed. She had to have her's redone due to issues and has ongoing lymphedema. I always hear, 'stay positive', but in reality you need to be your own best advocate and look at the big picture. More and more women aren't having reconstruction and I support that what a woman does is her own journey. @*shannon I keep thinking of you and your decision.
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