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Mastectomy over Lumpectomy Does not mean Zero % Chance of Breast Cancer

By Peglove Tuesday, December 06, 2011

Today on Dr. Drew they had a panel of doctors talking about Guiliana Rancic's choice to get a double mastectomy to avoid "looking over my shoulder for the rest of my life". It is also on the heels of Wanda Sikes, the  Black comedian having the same procedure for her micro-cancer, or stage zero breast cancer, for the same reason; she did not want to have breast cancer. She says she has a "Zero % chance of getting it again".

 

The trend in the media has been to report these procedures as "preventative" measures. But what they have not said is that there is no such thing as 0% chance of getting breast cancer, even without breasts. Your breast tissue extends to your collar bone and across the pectoral and lat muscles. There is really no way to remove every breast tissue cell from the body. Of course, with less area of breast tissue, there are less chances of recurrence--but not zero %  chance, which is what these women keep saying. It bugs me because it is inaccurate and wrong information. There is always breast cell tissue left after a mastectomy. And as some of us know from experience, it only takes one cell to go nuts and grow and make a tumor. It is a hard pill to swallow.

 

These stories are not reporting about the nerve damage that mastectomy causes. They expounded the "advances in reconstructive surgery", which of course is better than it was. But they forget to mention the scars, and scar tissue, implant rejection, and lymphadema that may occur after mastectomy and reconstruction. However, they do mention how radiation thickens the skin. Somehow, the message that mastectomy is better is being conveyed in these stories. I am here to say that if you get the choice, and you choose one or the other, feel that your choice is yours and yours alone--that no matter which celebrity gets breast cancer and opts for a radical procedure for her own "peace of mind", that one road is not better than the other in terms of survival--unless your genes say so- and your own doctors say so.

 

I was also faced with the "choice" of double mastectomy or lumpectomy with radiation. They give only some people this choice depending on your type and stage of cancer. I feel like it was a no brainer for me. I had the lumpectomy with radiation and chemotherapy. This was my path and I took it. After comparing survival rates and no real better chances at avoiding recurrence without breasts, I chose to keep mine. Some friends thought a chance to have "free" breast implants was a great possibility! "Wow! Why not! Go BIG and get something out of this ridiculous cancer crap", and at first seemed like an even deal. But then, I did my research.  

 

A big part of making my choice was learning about the mastectomy procedure, recovery time, and how much nerve damage and chronic pain some people have across the chest and back area. Also, no one really tells you that implants (saline or silicone) do not warm at the same rate as the body, and do not weight the same as real tissue. Some people that have chosen larger implants have more problems with this body temperature issue, and others feel the weight of implants makes them feel uneven. Some mastectomies can be "nipple sparring" but then become necrotic. Others are followed by several procedures because the scar tissue may pucker and pull the breast in the wrong direction, changing the shape of the breast, requiring corrective surgeries. Some times the body just rejects the implant for unknown reasons. These little details are left out of the story. The story goes, "I had breast cancer, I had a mastectomy, and got new breasts." No one tells you that there are complications that can go on and on for many months after and sometimes years. It seems like too much to go through if you have the choice of keeping your breasts and having the same survival rate. 

Phyllis Johnson, Health Guide
12/ 7/11 6:35am

Peg, you have done a fabulous job of explaining the issues around this decision.  I am also often appalled at the way the media spins cancer news.  I'm glad you did your research to find the procedure that was right for you.  Both ways leave you at risk for later complications.  My lymphedema therapist says she sees women who did not realize that the lumpectomy/radiation route has a risk of lymphedema from the underarm radiation.  Since the overall survival rate is the same, it is crucial that women ask plenty of questions about which later side effects or complications are most likely for them personally and then weigh it all.  Ultimately, there is no one right aswer for everyone.

Anonymous
Norma
1/ 5/12 11:41am

I absolutely agree with you. I've heard celebrities quote some contradicting information.  I was diagnosed 3 years ago with Ductal carcinoma stage I. I had a lumpectomy, chemo and radiation. After my treatment I spoke to my Oncologist about getting a bilateral mastectomy to reduce my percentage of a cancer re occurance. I got separate opinions from two Oncologist's who said cancer does not always necessarily re occur in the same area. If it's gonna happen it can reoccur anywhere else in the body.  So, having a bilateral mastectomy does not put us at zero percent of a reoccurrance. We will always have to proceed with caution and having faith in God that we will remain cancer free.

 

 

PJ Hamel, Health Guide
1/ 5/12 11:59am

Very true, Norma - while a mastectomy reduces (but doesn't eliminate) the risk of recurrence or a new cancer in your breasts, the original cancer could have traveled elsewhere in your body, despite all the treatment. So - we just go forward with hope and faith, and take it one step at a time. Be well - PJH

1/ 5/12 3:57pm

I just wanted to clarify that we all have the BRACA 1 and 2 genes. These are tumor suppressing genes, a good thing.  They become a problem when the genes mutate and can no longer suppress tumors which puts a person at a higher risk for breast cancer and ovarian cancer.  For more evidence based information on these and other cancer related issuses check out the National Cancer Institute(NCI) website.

Phyllis Johnson, Health Guide
1/ 5/12 7:50pm

You are absolutely right.  We should be more careful with our language and include the word "mutation" when discussing genetic risk for breast cancer.  Like many language terms, it is all too easy to shorten an expression and lead to confusion.

PJ Hamel, Health Guide
1/ 5/12 8:15pm

Yes, Phyllis is right - I was sloppy early this morning in my answer... Thanks for the correction, much appreciated. PJH

3/ 1/13 4:03am

I added this into my post. Thanks!

PJ Hamel, Health Guide
3/ 1/13 3:43pm

And thank YOU for paying such close attention, Peg - cheers! PJH

By Peglove— Last Modified: 03/01/13, First Published: 12/06/11