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How do you choose between a lumpectomy or mastectomy?

A MyBCTeam Member asked a question 💭
Gilbert, AZ

Hello, recently diagnosed with DCIS/Comedo necrosis/Grade 3/ER/PR positive/Left Breast. The surgeon said is was a small area and could easily be removed and be treated with radiation and hormone blockers. I am really on the fence about the radiation side effects and really do not want hormone blocker's. I have the option of both surgery’s, but i am finding it hard to pick. I haven’t slept in 3 weeks and full of anxiety I will make the wrong choice and regret it. Part of me just wants to do the… read more

June 7
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MyBCTeam

First of all, a newly diagnosed DCIS that is small and caught early is genuinely good news, even though it doesn't feel that way right now. Three weeks without sleep and a head full of anxiety? That makes complete sense — this is a huge decision and it's okay to feel overwhelmed by it.

The most reassuring thing to know is Show Full Answer

First of all, a newly diagnosed DCIS that is small and caught early is genuinely good news, even though it doesn't feel that way right now. Three weeks without sleep and a head full of anxiety? That makes complete sense — this is a huge decision and it's okay to feel overwhelmed by it.

The most reassuring thing to know is that research consistently shows lumpectomy with radiation and mastectomy offer the same long-term survival rates. So there is no "wrong" choice here — just the right choice *for you*. Here are some key things to weigh when deciding:

Lumpectomy + Radiation:
- Shorter recovery (often around 2 weeks)
- Preserves most of your breast tissue
- Typically followed by radiation and possibly hormone therapy
- Some research suggests it may even offer slightly better survival odds for early-stage breast cancer
- May support better quality of life and sexual well-being long-term

Bilateral Mastectomy + DIEP Reconstruction:
- Removes more breast tissue, which can bring peace of mind
- Longer, more complex recovery
- Possible loss of sensation
- Reconstruction risks include infection, blood clots, scarring, and tissue complications
- Recurrence is still possible, though reduced Since your DCIS is small and localized, your surgeon's recommendation of lumpectomy makes clinical sense. However, waiting for your genetic testing results before deciding is a very smart move — those results could meaningfully influence which option is best for you.

It's also completely valid to ask your care team specifically about your concerns around radiation side effects and hormone therapy. There may be options or alternatives worth exploring together. Many MyBCTeam members have faced this exact crossroads. Some chose lumpectomy to preserve their body and avoid a longer recovery. Others chose mastectomy simply for the peace of mind — and felt it was the right call for *them*. Both groups found a way through.

You don't have to solve this tonight. Be gentle with yourself. 💙

June 7
A MyBCTeam Member

Hi, I am newly diagnosed also, just about the same as you except it’s my right breast. I am trying to decide on either lumpectomy with reduction/ lift (on good breast as well) which will require radiation & hormone blockers or bilateral mastectomy. I’m leaning more towards mastectomy for my peace of Mind. I am also waiting on genetic testing and mri (mri to see if anything else will be detected) my diagnosis is DCIS stage 0 grade 3 , estrogen and progesterone positive. I don’t have a tumor, I had calcifications in a linear distribution. I also have comedo necrosis (caused by the high grade). My calcifications were all removed with biopsy but surgeon said she was going to take an area of 3cm x 3 cm. I am worried about getting reduction then pathology coming back and not clear margins and having to go back in for masectomy in the end anyways. This is one of the hardest decisions I’ve ever had to make and I don’t want to do either of them, but if we want it gone we have to chose what we can live with after the surgery. I’m not sure I can mentally handle the follow scans, and going through this rollercoaster over and over. I’m not crazy about the radiation or hormone blockers either. I had a total hysterectomy last year that put me in medical menopause and had just started to feel good from my hrt (started 6 months ago) now; I can’t use my
Patch or vaginal estradiol cream so I’m nervous about the blockers. Unfortunately from what I understand that will
Most likely need to happen after either surgery for me. I know we will be ok, God is in control🥰 Just making the decision and stress of it all is so hard. I did get some anxiety medication from pcp two days ago, it seems to be helping some, maybe you could reach out to yours if needing a little help.

June 7

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