Oncology (General Cancer)/Breast cancer

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Question
I was just diagnosed with stage 1 or 2 breast cancer.  4 o'clock invasive mod. Dif ductal with also pre cancer cells. I need to make a decision on what route of surgery to take.  An oncologist will not be assigned to speak with me until after surgery.
If I choose a lumpectomy I will need to have chemo and radiation. If mastectomy no radiation. either one i choose my percentage of survival is the same.
Since radiation is in my body forever the side effects  might be rare scare me.
My cancer is on my left side.  I am concern about future heart problems and bone problems among other
Problems that might occur.  Your thoughts on radiation therapy complications with lumpectomy vs masectomy with chemo and no radion for side effects.
Thank you

Answer
I don't know how old you are.  The younger you are, the more the risk of radiation.  But even very young women who get radiation for breast cancer don't really have much increased risk of heart disease, etc, if the radiation is done properly.  Most radiologists do "tangential" radiation, so that very little radiation gets past the rib cage, and only tiny amounts get to the heart.  If the cancer is very deep in the breast, though, they may have to modify things.  Patients with hodgkin's disease, where the disease is often in the lymph nodes around the heart, are the ones who seem to have a higher incidence of heart disease.  In my career, I've seen almost no serious complications of radiation and chemotherapy, associated with lumpectomy.  On the other hand, there are complications of mastectomy.  If you have large breasts, you are going to notice a difference related to the loss of a breast in your posture and muscle tone.  If you have any kind of plastic procedure (tram flap, saline implants, etc) things can go wrong early or late.  The bottom line is that if a woman has a cancer that can be treated either way, I almost always advise lumpectomy with chemotherapy and radiation.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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