Why did I chose a mastectomy over a lumpectomy? I had both options available to me. It was a tough decision to make. After speaking with my surgeons, I decided that a mastectomy was the best choice for me. There is a lot to consider before making this important decision.
Mastectomy vs. lumpectomy
A mastectomy is when they remove the entire breast. In my case, my left breast will be removed. I expect this to be a general mastectomy where they take just the breast. Sometimes a modified radical mastectomy is required; this is usually when lymph nodes need to be removed. A modified mastectomy takes more tissue extending from the breast to the underarm area. Both of these surgeries leave the chest wall and muscles intact.
A lumpectomy is when part of the breast containing the cancer is removed. The end result is that you are left with an intact breast which may or may not require reconstruction. It depends on how much breast tissue is taken during the lumpectomy.
Why I ruled out a lumpectomy
In my particular situation, a large amount of breast tissue was removed during my biopsy. The biopsy left me with my left breast being about a cup size smaller than my right breast. If I had chosen a lumpectomy, the left side would be even smaller.
Another disadvantage to a lumpectomy is that radiation treatment would be required. Radiation treatment has an impact on breast reconstruction. It can limit your choices. After speaking in-depth with my plastic surgeon about how radiation can impact breast reconstruction, I decided that I was better off with a mastectomy.
Why I chose a mastectomy
When I first found out I had cancer, I was sure I wanted to go with a lumpectomy. Then I got a second opinion about my treatment. I had the opportunity to meet with an amazing plastic surgeon. When I asked him which type of surgery will allow me to end up with the best cosmetic results, he replied "a mastectomy." He explained that in my case, there would be a significant size difference between my two breasts if I had a lumpectomy. Achieving symmetry between the two breasts with a lumpectomy would be very difficult. He felt that I would be unhappy with the end result.
My plastic surgeon will work with my general surgeon during the mastectomy. The two doctors will come up with a plan so that all incisions will be made to give me the best possible cosmetic outcome. My surgeon will remove the breast and then the plastic surgeon will start my reconstruction process.
Another reason I chose a mastectomy is that it removes all of the cancer in my left breast. I will not have to worry about a recurrence in the same breast. Most mastectomies do not require radiation treatment. This is important to me. I want to have as many choices for reconstruction that my cancer will allow.
It's all about body image
Body image is important. If you tell me that it is not, then you have never been faced with loosing a body part. For many women, myself included, our breasts define part of our persona and our sexuality. The decision to lose a breast was huge for me and it did not come easily. I have cried multiple times over this. It took weeks to come to a final decision. It was not until I met with a plastic surgeon that I was able to feel absolutely confident that a mastectomy was the right choice for me.
My biggest fear with mastectomy was having to wear a prosthesis until reconstruction is complete. I am still struggling with this part of my decision. The last thing I wanted is to end up with "franken-boob." I see this as the scarred remains where my left breast was. I view a prosthesis as part of this "franken-boob" image. In reality, most people will not be able to tell I am wearing one. Eventually, I will get my head on straight about this. It just has not happened yet.
I am comfortable with my decision to have a mastectomy. It is my body and I have to take control within the confines of what my cancer will allow. When it comes to cancer, choices can be limited. I was glad I had the ability to choose between the two types of surgery. A mastectomy will give me piece of mind that I would not have with a lumpectomy.
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