I thought I had my mind made up. I called the surgeon today to schedule the lumpectomy. She called me back and wanted to confirm that that is truly what I wanted to do. She said that after talking to the plastic surgeon, they feel the best "cosmetic" option would be to do a mastectomy. She said that she wanted to make sure I understood that scar will be visible, and that I may not be happy with the final result, considering how high up on my chest it will be and how long the scar will be since it needs to cover the length of the tumor (about 1.5 inches) as well as enough of a "negative margin" on each side of the tumor (so greater than 1.5 inches long). Contour wise - they will leave the "dead space" and not fill up the divet (for lack of a better word). My body will fill up the space with fluid on it's own, so the curviness will be maintained, but asthetically - it will be a noticable scar.
So what. I can wear a scar. I'm not scared of that.
To me, if I have a mastectomy on one side, it doesn't make sense to not do the other side. So there's not really a "middle" type decision. It's either a lumpectomy or a double mastectomy ... in my mind anyhow.
The issue is - they can't tell me what my risk is until they see my tumor out and under the microscope. BUT -- the only way they can get the tumor out, is to do surgery. And choosing WHAT surgery to do is such a BIG decision. It's so FRUSTRATING!! It would be a more informed decision of what type of surgery I wanted to have if I knew my risk. I basically have to make a blind decision on how to remove it before I even know my risk of it coming back. I wish I just knew.
Conservative. My instincts are telling me to go conservatively. Start with the lumpectomy - dissect the tumor, tell me my risk. If I need to do a double mastectomy after we get it out and figure out my risk, then I can -- but if I decide to do the double from the starting gate, there's no way to put it all back if it wasn't necessary.
Radiation. I'm told radiation is "married" to lumpectomy. But my instincts are telling me that radiation might be too aggressive of a treatment. I'm willing to do chemo and hormonal therapies -- those treatments are sitting peacefully with me. But radiation - for whatever reason - is not. So I told the surgeon that - that I'm not sure I'm going to accept radiation. She said that if that's what I want then I should just to the mastectomy.
It's all so confusing! And frustrating. It would be so much easier if I didn't have so many options, at least it feels like that. I just don't want to be overly aggressive in treatment with a tumor that they're telling me isn't that aggressive.
I thought I knew what I wanted to do. We're going in the morning to talk to the surgeon again. To review just the surgery portion of it -- to focus on what the outcomes are. I can wear a scar across my chest. It's just a scar.