Large Lumpectomy vs. Mastectomy: Experiences with Oncoplastic Reconstruction?

I had invasive ductual carcinoma-I had a lumpectomy 4.5 mm-and lymph nodes removed with reconstructive breast surgery-just 20 rounds of radiation

Thanks Allison. Hope you are doing okay. Did they do reconstructive in same surgery as lumpectomy or was it several weeks later?

Hey Wendy, Ok so I was diagnosed on April 25th, 2024 that I had the breast cancer, after the annual mammogram and biopsy , I was like WTF, so meet with the breast surgeon, plastic surgeon, radiation oncologist and medical oncologist. I had the dream team, had my surgery on June 7, 2024, lumpectomy on left breast also removed 4 lymph nodes from the left underarm, then I had the reconstructive breast surgery during the breast surgery, I didn’t need implants because I had very large breasts, make a long story a hard ache, the plastic surgeon did a great job and I don’t have to wear a bra if I don’t want to. Btw I love your name, that is my cousins name and she was the first person to know about my cancer, she works in the medical field. Keep in touch. I love to help. Best, Allison ❤️

Thanks for sharing your story. Very helpful! Take care!

Good luck with everything, if you want to reach out to me I will definitely be here. Allison

I had invasive ductal carcinoma in my right breast approximately 1cm, very small. Had lumpectomy and reconstructive surgery the same time not aware that the reconstructive surgeon did not perform the surgery, but only looked on to two other practicing physicians. I was very large breasted and asked to have a major reduction due to the fair of cancer coming back. He told me he would reduce my breasts enough so that they were proportionate with my body and also told me that he would leave my right breast slightly larger due to the possible shrinking from radiation. After surgery, I noticed that my breast were exactly the same size and looked fine other than a bit of a sloppy stitch in the crack of my breast. About a month after my radiation I noticed my right breast shrinking and now two years later I have a significantly smaller right breast than I do my left breast. Had I known it was going to be this way I would have asked the surgeon to perform the surgery himself, and I wouldn’t have had my breasts reduced as much. I’m left with a hard mass of, I’m assuming would be dead tissue from the radiation in my right breast and a significantly smaller right breast than my left breast.

I have Stage 1 ILC and had lumpectomy with oncoplasty during the same surgery. My plastic surgeon left the left size larger to accommodate for shrinking during radiation.

I had what your asking. Double right lumpectomy and left breast reduction at the same time. In my opinion, reduction Dr did not remove enough of the cancer free breast, but after 6 months they are sisters, one only minimally bigger, not twins as my cancer Dr so eloquently told me. The boobs seem to have dropped also, so I'm a little disappointed especially since I had a lot of problems due to not taking my RA meds to have the surgery. I had 18 rounds of radiation and 4 lymph nodes removed. My boobs are still too big to go braless.

Thanks for sharing Cynthia. Sorry that happened.

For those with smaller masses wondering why they did oncoplasty?

Wendy, I chose oncoplasty because it allowed the surgeon the freedom to take more tissue to insure that we got clear margins.

Thanks. I have 2 sites and they want to also take tissue in between so around 10+ cm. They gave me option lumpectomy with oncoplasty or mastectomy. I’m pretty overwhelmed by both.

Where are you being offered this procedure? I never heard of… but I wonder if this onocoplasic might work for me. Is it relatively new? I have Stage 1, ILC, but the doctor is favoring a masectomy because all sort of in one area which means cutting out all on one side. Asked if a partial rebuild could be done & was told no. Is this oncoplastic done with fat transfer? Our hospital does not offer either of these procedures.

My understanding is they rearrange the tissues in your breast after lumpectomy if you have enough left over tissue- to make it more symmetric and fill the hole. I am in Boston and it’s done by plastic surgeon here after breast surgeon removes tumor.

Hi Wendy. I had a very large tumor and DD/E breasts so had lumpectomy and reduction on the other side at the same time. Plastics did the contra side after oncology was done so as to match the size in case they need to remove more than anticipated. I did not want to entertain the thought of another surgery for reconstruction later. I had radiation about 3 months after surgery and am overall happy with my decision.

Wendy, My tumors were very small and I was opting for a simple lumpectomy until my pre op Oncologist highly recommended double mastectomies because of the very aggressive cell type with triple negative and Ki score 95%. Pre op one tiny tumor less than a quarter of an inch, but in surgery a second tumor already appeared. I had skin and nipple sparing saline reconstructions at the time of the mastectomies that were and are well appearing and tolerable. I couldn’t have flap reconstruction because of Autoimmune problems.

Hi Julie and Irene. Thanks for sharing. Glad you are both doing okay.

Hi Wendy. I had early stage ILC and chose to do the lumpectomy with oncoplasty surgery. The breast surgeon removed the 2 tumors I had and the lymph nodes. Immediately following the plastic surgeon came in and rearranged the tissue and did a lift on my cancerous breast and then did a reduction and lift on my noncancerous breast. He did leave my cancerous breast a bit larger to account for shrinkage following radiation. I had 20 radiation sessions. I am 8 months out of surgery and am very happy with the results. My breasts are very perky and match pretty well. The only complaint I would have is my scar on the noncancerous side overgrew and the plastic surgeon has had to give me a steroid shot in the scar twice now to stop the growth. But that is just my skin and have had this with several other surgeries so I wasn’t surprised. The radiation took care of the scar on the other side. Doing the surgery this way allowed my breast surgeon to remove more tissue allowing for a higher chance of getting clean margins. Good luck with your decision and treatment.

Hi Brenda. Thanks very much. Glad it all went well. Hmmm sounds like a good option for me.

Allison K… where is this dream team that did so well with your surgery?

Suzy Q, The dream team is in Riverhead, NY

Irene, You mentioned that you couldn't undergo a tumectomy due to having an aggressive form of cancer, unlike mine which is slow-growing in my left breast only. The doctors here also advise on a double mastectomy even though it is not hereditary. Additionally, your doctor advised against flap reconstruction because of your autoimmune disease, so it seems you may opt for going flat. In contrast, my doctors haven't discussed how my PMR or Hashimoto's diagnosis might impact my treatment. The oncologist even seemed surprised when I mentioned these conditions after the contrast dye did me so much harm. I emphasized the need for caution when introducing toxins into my body. Is there no way for you to have any rebuild & reshaping of your breast? How does your autoimmune condition stand in the way? Must you opt to go flat which is better than leaving hanging skin.

Brenda … where did you go? Who is this great surgeon? I need to find a place? Looking for options.

Wendy L Same as my situation. Please where did you go? Surgeon? I need to have my records sent electronically to find out if I am a candidate. Would require traveling from Mid Wisconsin to

I had a lumpectomy in my left breast. My surgeon said, how would you like a breast reduction? Insurance will pay for it. Excited, I asked him to reduce my cup size to a B. He smiled but said nothing. He did surgery and when I was in recovery (instead of seeing me) he went to talk to my husband. That was so confusing as I wanted to ask the doctor questions. Long story short, throughout my treatment, I saw the PA on two separate occasions and not the surgeon. I am very disappointed and to date have never seen him again. As an aside, I did not get a B cup. I have a D cup. It appears he took out the tumors with margins in the left breast and matched the right breast to it. I had radiation treatment afterwards. Never saw the surgeon again. I figure he avoided seeing me afterward the surgery because he did not do what I asked.:(