Lumpectomy or Mastectomy? It's Your Decision to Make
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- Опубликовано: 11 июн 2024
- We teach you about the surgical options available for treating breast cancer. There are distinct advantages and disadvantages with lumpectomy and mastectomy surgeries.
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Questions for your Breast Surgeon:
1. What are my surgical options?
2. What surgery do you recommend for me?
3. What is the difference in recovery?
4. How do the “local recurrence” rates differ?
5. Can you outline the possible complications of both surgeries?
6. Should I do “Genetic Testing” before surgery?
7. Lumpectomy vs. Mastectomy surgery options
A Lumpectomy (followed by radiation) for early stage breast cancer is generally considered the optimal choice because it is less invasive and has the same cure rates as a mastectomy. At surgery, the breast cancer “lump” is removed with a margin of normal tissue around it. You are able to keep your breast with a lumpectomy, but you will likely benefit from a course of radiation to that breast to lessen the risk of developing a recurrence of cancer in the lumpectomy area of the breast in the future. It is important to note that some may not be good candidates for a lumpectomy.
A Mastectomy (usually without radiation) for early stage breast cancer is a more involved surgery especially if breast reconstruction is performed. It is important to understand that multiple surgeries are often needed by a plastic surgeon to ultimately achieve a symmetric, cosmetic outcome. “Nipple-sparing” and “skin-sparing” mastectomy techniques can now achieve better cosmetic outcomes than in the past. One advantage is that you can generally avoid radiation for early stage breast cancer. A mastectomy does not generally improve survival rates compared to lumpectomy for early stage breast cancer.
Why is breast surgery a complex decision?
Every patient presents with a unique breast cancer situation. Your breast surgeon is the key person to understand what surgical options will serve you the best. Multiple cancer factors play into these options. This is a complex decision and recommendations may differ amongst surgeons. Most importantly, it is up to you to make a well-informed decision that suits you as a person and a patient.
Do I have time to decide what surgery is best?
This is a difficult time and one of information overload. You have plenty of time to learn more about your breast cancer and discuss your options with your breast surgeon. Taking a few weeks to make a decision has not been shown to have an effect on your cancer outcome. Early stage breast cancer usually can be managed with either a lumpectomy followed by radiation or a mastectomy alone. There are distinct advantages and disadvantages to both approaches. When you are well educated about your options, you will be better prepared to work with your breast surgeon to decide what surgery is best for you.
Myths and Facts about surgery and early stage cancer:
A mastectomy does not reduce the need for chemotherapy
Lumpectomy is an outpatient surgery
It generally takes 3 to 6 weeks to schedule a mastectomy with reconstruction
Genetic testing before surgery can sometimes alter your decisions
Breast radiation after a lumpectomy usually takes 4 to 6 weeks
Does a mastectomy increase my odds of survival?
A mastectomy does not increase your odds of survival for early stage breast cancer. This question has been studied in detail. If you have a lumpectomy and radiation, your chance of being alive ten years later is exactly the same as if you had a mastectomy without radiation. “Survival” is the most important cancer outcome we measure. It is the same for both treatment approaches for early stage cancer.
Why do some choose a mastectomy over a lumpectomy?
Most of the time this choice is a personal one for a variety of reasons. There are legitimate differences between the two surgical approaches involving recovery, side effects, complications, and costs. It is important to realize that everyone has different goals, unique personal situations, and their own reasons as to how they manage their health issues. “Patient autonomy” is essential to a great “doctor-patient” relationship. The more informed you become, the better decisions you will make for your own cancer situation.
Ask about BRCA Genetic testing before surgery.
You need to ask yourself this question, “If I have cancer and carry the BRCA mutation, would I change my mind about surgery and have both breasts removed to reduce my risks of having another new breast cancer in the future?” If the answer is yes or maybe, you should consider undergoing genetic testing before your recommended surgery. If the answer is no, then you can undergo testing after surgery.
Iam a breast cancer survivor. Within 6 months my mamogram has abnormality there. They want to do more imaging and ultrasound. I have been praying and talking it over. Iam really leaning on having my breasts removed. I have had radiation 30 treatments. I did take the genetic test and I do not cary the Brac 1 and 2 genes. I go on monday to see my surgeon for follow up and explain the findings of this new abnormal test.
Iam praying for all of us to make the right decisions and that we all stay cancer free and change our diets. Bless everyone from my heart💕💕
I chose a mastectomy with no reconstruction because I didnt have time to go to radiation everyday for 4-5 weeks and my skin being burned. I also didnt want to worry if the cancer would jump over to the healthy remaining breast in 5-10 years. I also didnt want additional surgeries to reconstruct ,which would take more time out of my life. I am fine being flat,with the option of wearing my bra with silicone forms when I feel like it.
Hi tracey,how r u?
Same!
I did the same. Double mastectomy, no reconstruction. I am very happy with my decision.
Thank you all for posting! Very hard decision I have to make this week!
My sister is planning for mastectomy, how was your postop recovery?
I really wish my surgeon had suggested I watch your videos. I felt rushed and uninformed about my choices. Surgeons and the other “care team” members should point patients to resources that discuss options available. I went into this experience completely ignorant and without ANY knowledgeable support. I felt very isolated and powerless. Maybe that is why my care team didn’t suggest I take more time and refer me to the world of resources available - knowledge is power. And, it appears, patient ignorance allows the care team to have all the power.
This is so detailed.. I was able to share this with my family to give them a understanding. Lord knows I couldn't remember half of it!!!
This Dr. sounds very Positive I would Trust him Had early breast cancer and I also had a very good Sugeron thank God for these Drs.
Thank you for saying that it’s okay to choose mastectomy. Means a lot to someone contemplating this option mass media constantly seems to create an the notion that choosing mastectomy is abnormal.
Exactly! I had a lumpectomy 25 years ago, it was about 1/3 of my breast tissue. Now the same breast has a recurrence. I don’t want a third time and would rather just take it all now. They can take both. I’m not as attached to my breasts as I am to rising from this, like a Phoenix. I have my team meeting 2 days from now. It’s really good to know this is my decision and watching this has been helpful.
Yes im happy to choose mastectomy flat yes i feel now swlling numbness in my armpit i got and surgery on January 22,2024🙏🏻🙏🏻🙏🏻i pray to heal god fast recovery 🙏🏻
@@janealcoseba1453 How are you now?
I worship this doctor! His demeanor and detailed explanations are incredible. I’d give anything to have him as my doctor! Thank you so very much for this very informative video! 💯👌🏽
This was very helpful, thank you!
Thank you soooooo much for this information. You were great
Thank you for educating.
Thank you for breaking this down. I was so overwhelming and cloudy about my diagnosis it was scary.
So informative! It helpep me decide.
Thank you for your teaching
this is very helpful thank u i will be looking through this daily
A very reassuring and greatful video. Thx u so kindly
Thanks. Doc very helpful
Thank you.
Great info Doctor
Thanks 🙏
I had non-invasive ductal carcinoma in situ stage 1 in 2002..and BRCA1 positive..My surgeon suggests to have a breast saving surgery, lumpectomy chemo/radiation..21 yrs. Ca. free..
You are the best. I wish you were my breast surgeon. Could I get a second opinion from you. How can I contact you. God bless you and give you a healthy and long life.
Good day i just found out that i have breast cancer and the doctor said it have to remove,it is invasive ductal carcinoma, iam a was a fried but lesson to you giving me more strength with my sister
I just found out I have the same thing
My surgeon always put me on pressure about lumpectomy. I have phyllodes tumor
For men with low and internediate grade DCIS is it enough to have a lumpectomy surgery? Is it neccessary to have a surgery with DCIS?
I have a 10mm DCIS and do not have the gene but am being pushed to have a double masectomy due to family history. Also they are saying I have a nonmass mass so I go tomorrow for a MRI guided biopsy. I have had two different docs push for a double masectomy even if it all comes back negative. I was also told that even with a double masectomy I will have to have a mamogram every year even though there is no breast there and I don't understand that part at all.
Because I’m so small chested, that was the main reason I chose double mastectomy. If u mess up the one w the cancer in it - u have to make the other one match. So figured the only option was double mastectomy w reconstruction.
Are you happy with your decision still? I am debating, but had the same thoughts.
Thanks Dr.❤ but the back ground music is disturbing!
Thak you much doc
ThankU so Much fr such a comprehensive lec.
Allah Bless U Always
Ameen
I had an MRI it didn’t show any cancer but my breast surgeon still wants me to have surgery she said my biopsy showed 5% that I might have cancer and I might not. I feel pressured by her to have surgery. Please respond
Why in DCIS readiation instead of remove the bearst first?
Excellent information about the choices. I had dcis twice, in each breast 6 yrs apart. I chose lumpectomy, radiation and medication. I’m brc negative on the genetics. I wish I would of asked more questions. If it returns a 3rd time I will have double mastectomy with no reconstruction.
Curious ... in 5 years has anything changed to make BRCA2 ER+ Stage 0 less necessary for a double mastectomy for best outcomes ? (42 year old who has also been treated for cervical stage 2 ) Lots of family history of BRCA2 types of cancers...
Thanks sir.. I have a question.. What is difference between operable and large operable breast cancer..?
I believe it is if you opt for a lumpectomy, you have to have enough breast material present for them to be able to take a certain margin of tissue with the tumor in the middle.
If the choice is no different then why if it’s Barca they want you to do mastectomy.. They tell you to why if both treatments are the same ? And why you don’t have to have radiation if you have breast mastectomy but have to with a lumpectomy ? What if I have radiation after a breast mastectomy..
You Just Easy My Mind Thank You, My Doctor, Did Say Lumpectomy You Voice Is So Calming
what about malignant invasive papillary carcinoma mass 1 cm with multiple suspicious 3-5 mm masses?
Let's say you are positive for the BRCA gene and have a mastectomy, can the cancer come back elsewhere in your body?
I had 3 mm - had lumpectomy. I am NOT going to have radiation
I got a lumpactomy. With stage 2.
How are u doing
Can you have radiation if you take blood thinners
Recovering from lumpectomy 2 weeks ago still sore. Waiting for further test on cancer to see if I will need chemo plus radiation
Did they say you have to do both?
@@melissaweaver6689 went to oncologist on yesterday 11/12 yes I have to have both 😬
I hope you're doing well!
I got a lumpectomy for a Fibroadenoma she was going for a semi node biospy and opened me up took the tumor out said it looked benign and closed me back up and had it tested all this is super scary I couldn’t even feel the tumor I had a bruise for 5 months and they found it. My oncologist couldn’t even feel the tumor.
Does having multiple lesions increase your risk for cancer coming back & would a mastectomy be more helpful in that case?
I am a cancer patients, Dr. They found out that out of 18 nodes 3 cancer cells are positive. I had a mastectomy. How long shd I take make chemo therapy. I had been taking 8th session of chemotherapy. What is ERPt means.?
Are there foods that trigger breast cancer while treating it?
I’m going in next month for a double mastectomy!!🙏🏽🙏🏽🙏🏽🙏🏽🙏🏽🙏🏽😢
I have a family history having lost my sister and mother Also have triple positive ER+PR+HER2+ HER2 is a very rare aggressive form of breast cancer only 20% get it I have a 27mm tumour and also the MRI picked up a 8mm one So I'm leaning towards a Mastectomy (with a reconstruction maybe) still thinking weather or not to put myself through a reconstruction or not afterwards 🤔Also hoping to avoid radiation if possible I am blessed it is still Early Stage and is contained and hasnt spread Also feel blessed they have a new drug that targets the Her2+ they didnt have years ago!Having 6 rounds of chemo before surgery Then have to 11 rounds of Targeted therapy after the operation and hopefully I can skip the radiation (not sure yet)
Question: (from a doctor please) If you have a mastectomy, I know that you said it has the same survival rate for that tumor that had formed, but to me, the mastectomy would remove more cells that could possibly form a NEW cancer from those cells that malfunctioned just like the original tumor malfunctioned. Yes, the original tumor could send “sick cancerous cells” to other places in your body and you have that risk, but the remaining breast material could also form more tumors from the cells that were normal and had their own malfunction in the DNA. To me it would be better to remove the breasts to remove the extra cells that could also fall into a cancerous state of their own. You could get a lumpectomy and do the radiation and it fix that tumor, maybe because it had all the cancer cells it had created still localized within that breast or removed by the surgeon and none escaped; and then you still had all the “clean” normal cells in your body that could “malfunction” into cancer. I know it would never make the risk zero, but to me less breast cells = less risk of malfunction whether by this first tumor or new ones that arise.
Is this correct thinking?
the surgeon told me it isn't cancer but calcification, they want to do a lumpectomy regardless to check the area out. I am hoping they can reconstruct what they take out, Breast cancer does not run in our family ?
sue zaple how are doing? I wish you the best
not doing to bad, they went back in and took two 2cm areas out after the first surgery, again he said not CA but may turn to it in 2 to 5 years or maybe more . they cant predict when that may have happened . It was done by a surgeon out of Toronto general hospital who now works at a hospital in London , Ontario . so glad i had this done, still have the breast and he did a wonderful job at keeping the shape . I have a follow up this month to see if i need radiation . if it isnt CA why the radiation maybe .
I wish I found this 6 months ago when my journey started. Thank you! I have passed your program onto my primary doc and others starting their journey.
I’m having wire guided breast biopsy in 2 weeks for 5mm mass I’ve had issues with calcifications only in the left breast since 2014 this is a new area not the original area found 2014 I’m 56 wondering if I should just have lumpectomy left upper outer section
@@suezaple4950 can you share the name of the doctor?
I am a man but If I had to choose it would be a mastectomy. They say that the survival chances are the same but that is certainly not true under the women that I know . But it could be coincidence. The latest is a dochter of my niece that had lumpectomy and chemo and radiation but it still spread . Wile the ones I know that took the mastectomy and had the lymph removed at the same time are all still alive .
THANK YOU I WILL DO a mastectomy I have Triple Negative stage 2 breast size 38DD I was thinking about Lumpectomy I have cancer in the right breast I'm afraid if I get the Lumpectomy it will spread to the life breast can any of your neices help me
This is my first cancer journey
I have triple Negative breast cancer, my BRCA1 came back negative. The hardest decision was what kind of surgery to have. At the end I had a bilateral mastectomy with reconstruction. Still had radiation 30 sessions.
It is a difficult decision and very different for every woman. The right choice is ultimately a very personal one.
Losing my breast was the hardest decision ever, I still cry very much. But I know it was the right choice. Love this channel
Breast Cancer School for Patients I have canser I ready went to chemo and my doctor said a lumpectomy is good for me but I don’t know what to do
My surgery is 3 weeks away and I am still having difficult time making a decision. I am 29 years old and was offered the options of lumpectomy or mastectomy. No history of breast cancer in my family and genetics revealed inconclusive results. I just don't know what to do.
My wife was just diagnosed with triple negative. If you dont mind me asking did you have chemo? I wish you well.
More and more women are choosing to not reconstruct. I am a Physician and I chose a BMX without reconstruction. Non reconstruction should be mentioned to women and offered as an option.
Area 51 Farms with Dr Beth it was offered to me as an option.
👍
Can one breast feed with the other breast?
Cancer cells can travel anywhere in your body.
🙏💜
I had 3 lumpectomys.
They still couldn't get all the cancer so I had a mastectomy.
What stage were u when u found out
I have two different opinions. One doctor decided on a mastectomy just because I have an extremely dense breast. So confused. Honestly, I do not want to have a mastectomy and feel too much pressure from this doctor, especially since she suggested breast construction, even though I’m not interested.
I choose mastectomy in flat and axilla surgery in January 22 2024
The background music is irritating and unnecessary.
Thank you.
I had 3 mm - had lumpectomy. I am NOT going to have radiation
Did they do a needle biopsy? I would think that alone would cause some of the cells to be able to travel.