Have you ever broken a bone?

The treatment’s fairly simple. You go to the hospital. Have an X-ray. Get the break set, have a cast put on, go home.

There’s not a single decision you have to make along the way.

But get breast cancer, and what’s the first thing that happens? The surgeon asks you to make a decision: lumpectomy, or mastectomy?

Choose a lumpectomy, you get to choose option A (standard radiation), or option B (brachytherapy).

Having a mastectomy? “Do you want reconstruction with that, Ma’am?”

And let’s not even get started with chemo. Now THERE’S a decision fraught with angst, if ever there was one. Go for it, and endure what may be lifelong side effects? Or skip it – and take a chance on the cancer spreading.

Strange, isn’t it? At that vulnerable time when you’re barely able to assimilate the fact you have cancer – let alone deal with the emotional fallout – you’re asked to make decisions that could impact whether you live or die.

Is it no wonder so many of us kind of mentally stand around going “Whaaaa….?”

Meanwhile, the clock is ticking. The surgeon needs to make a surgery date; you need to get slotted into the radiation or chemo schedule.

Come on, what’s it gonna be?

While it’s tempting to MAKE A DECISION NOW in order to please the doctor, keep to the schedule, or simply to get the whole process moving, please do yourself a favor: slow down. You’re making major decisions, ones that will affect your body for the rest of your life. It’s worth taking the time to think things through.

If your hospital has a facility that helps patients make health-care decisions, use it. There may actually be a department called “shared decision-making;” it’s becoming one of the hot new models in the field of medical medical. Or ask a hospital social worker; if anyone knows the facility’s resources in this area, it’ll be a social worker.

If there’s no one at the hospital to help you, take a look at the following posts on this site. 

Lumpectomy vs. mastectomy
If your tumor is very small, or very large, you’ll probably get a recommendation from the surgeon as to which route to go: lumpectomy or mastectomy. However, for smallish to mid-size tumors, the surgeon may very well give you your choice. How do you decide?

It boils down to how much of a risk-taker you are. A mastectomy removes almost all of your breast tissue, thus almost all of your risk for a recurrence in that breast. But you also lose your breast.

A lumpectomy removes just part of your breast, often a small, unnoticeable part. You keep your breast – but you leave yourself more open to a possible recurrence.

What to do?

One breast, or both?

Often, if the cancer is aggressive, the surgeon may ask if you’d like to consider a prophylactic mastectomy: that is, removing both the breast with the tumor, and your other, healthy breast. This definitely cuts your risk for both a recurrence in the same breast, and a new cancer in the other breast.