Oncology (General Cancer)/Surgery decision

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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 radiation.
Thank you

Answer
Well, I will put it this way. If I happened to be female and found myself in your exact situation my choice would definitely be lumpectomy followed by radiation. If that is possible depends among other things on the size of you tumor of which I know nothing. But the fact that you are given a choice seems to me to indicate that your tumor can not be considered as too big for a lumpectomy. If your tumor truly is a stage 1 I can not understand why chemotherapy is considered necessary unless your tumor is HER 2 positive. You have not mentioned that - which is important - so I suppose it is not. Yes radiation may have side effects. So does surgery! Side effects of mastectomy including lymph node removal from the arm pit on the affected side can even have quite dramatic side effects. Lymph edema in the arm on that side for example. The risks of radiation injuries to your heart and lung are quite small. There is in the USA quite a scare for anything and everything connected with "radiation". That scare is quite exaggerated! If my mother or my big sister were alive and in your situation I would give them exactly the same advice!. Around 6 years ago I was diagnosed with prostate cancer. I frustrated my urologist by refusing any kind of surgery. The reason was that it would almost certainly make me completely impotent and there was also a rather big risk of urine incontinence - my prostate was also quite enlarged so more refined kinds of surgery were not possible. My choice was radiation therapy. With a higher end dose than you will get and with both my bladder and my rectum in the radiation field. I only had bladder problems during treatment - and I would have had them anyway after surgery at least for a time. Hardly any bowel problems at all. So I was satisfied and today it seems I am cured - at least so far. And no other problems! I have treated lots of breast cancer patients with radiation. Based on that experience my advice stands! Good luck!
By the way, by just giving you the choice I think your surgeon has abdicated from his/her duty of also giving you advice. Yes it is your choice, that is your right, but unless you yourself have a medical education you can hardly excute that right in a rational way without advice!








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Oncology (General Cancer)

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Claes-Gustaf Nordquist, M.D.

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Questions concerning Cancer, Oncology, radiation Therapy, Tumours, Chemotherapy, Cytotoxic Drugs, Hormonal Therapy, Radiation Protection.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions in the number of questions there. I also answer questions in these other categories: General History, Military History, Brain Tumors, Breast Cancer, Colon Cancer

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I'm a medical doctor and specialist in medical oncology and radiation therapy

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