Owning My Lumpectomy Decision, Again

After choosing a lumpectomy in 2019, I hoped I made the “right choice.” But is there really a “right choice” if we are given a choice between surgeries for cancer treatment? Both surgeries are valid options for removing breast cancer. So perhaps the question is better asked, “How can we make the right decision for us right now?”

Decision-making isn’t easy, even in low-stress situations. When we make choices that impact the rest of our lives, the stakes get even higher. I had an opportunity to re-evaluate my decisions as I faced another lumpectomy in 2022. I needed to own my choice in 2019 once again.

After undergoing another lumpectomy in the summer of 2022, do I regret my surgical choice in 2019?

Surgery Choices- 2019

In 2019 I was faced with a difficult decision.  Which surgery would I choose to remove my DCIS-  A lumpectomy plus radiation or a mastectomy?  It was a tumultuous and challenging time to walk through.  I didn’t want to make either of those choices, yet there I was, a newly diagnosed cancer patient the day before my 42nd birthday.  

Eventually, after getting all the imaging and genetic testing done, I decided to choose a lumpectomy plus radiation.  

As I wrote in my previous surgical choices post, these were my main reasons for choosing this option:  

1. DCIS in one location
2. No genetic variants
3. No Lymph node involvement
4. Quicker recovery time
5. Keep my breasts

I’m grateful that my surgeon was able to clear my margins during my first lumpectomy so that I didn’t need to have multiple lumpectomies in 2019.  

As with any choice, there are consequences.  Because I chose to keep my breasts, I would still need to undergo regular follow-up imaging.  My surgeon has me on an every 6-month imaging cycle for the breast that had DCIS and an annual imaging cycle for my left (non-cancer) breast.  

For two and a half years, the imaging didn’t reveal anything concerning.  There were a few times I needed follow-up ultrasounds to examine some findings in my left breast, but nothing that would warrant any further medical intervention.  

I certainly didn’t enjoy the scanxiety that came every time my imaging rolled around, but I knew it was a part of the path I needed to walk.

The summer of 2022 changed all of that.

Summer 2022- Another Lumpectomy

As I’ve written before, my imaging turned into an inconclusive biopsy that led to another lumpectomy.  The suspicious mass was one that the medical team had been watching since 2019. It appeared to be a benign fibroadenoma. 

I have a history of these benign masses, and most of the time, they remain stable and are observed.  In my case, their sizes are notated via ultrasound, but generally, they don’t need to be biopsied or removed.  In 2019, several fibroadenomas were notated on my chart, and during my lumpectomy, my surgeon removed the largest one since I was already having surgery for the DCIS.

Between June 2021 and June 2022, one of my fibroadenomas grew significantly. It increased in size by almost 266%.  That warranted a biopsy- which ended up being inconclusive.  The pathology team recommended removal via a lumpectomy to get a complete pathology.

Thankfully, the mass ended up being a benign fibroadenoma.  It was certainly the most adventurous and troublesome fibroadenoma I’ve had to date.  

This latest time of in-between has allowed me to reflect on my decision in 2019 and explore if I would have made a different choice.  Would I have chosen a mastectomy to avoid this latest surgical adventure?

Do I regret my 2019 choice?

Short Answer: No!

Longer Answer: Complicated. See below!

After going through the ups and downs of another biopsy and surgery, I was struck by how different it felt this time.  

In 2019, I entered an entirely new world.  In a flash, I was transported into cancer land, and I was full of fear, anxiety, and shock.  I was faced with procedures that I’d never been through before.  I watched my loved ones struggle to cope with their emotions and care for me during my times of need.  Our family was thrown into turmoil as I was out of commission for most of the fall of 2019 with diagnosis, treatment, and radiation. 

 Our virtual school year had just begun, and the boys needed a learning coach to provide consistent supervision, especially as our younger son had just entered high school.

My primary goal was to get back to being the learning coach as quickly as possible.  A lumpectomy plus radiation meant a much quicker overall treatment time.  

I was aware that I would need to continue regular imaging, which I was committed to doing.  

Impact of Choosing a Lumpectomy

I’m really happy with my choice to do a lumpectomy.  My breasts look normal- except for a few small scars.  My sensation has been preserved, as have my nipples.  My scars have faded nicely over time; in fact, the stretch marks I have from my two pregnancies are more prominent than my scars.  With a single surgery, the cancer was removed, and I could begin the road to recovery after radiation treatment.  

With that being said, because I had a lumpectomy, there was breast tissue left to image and, in my case, mysterious fibroadenomas to explore.

If I had had a mastectomy in 2019, that tissue wouldn’t have been there, and I would have been spared this latest surgical experience.  

However, I would have had a very different recovery pathway in 2019.  In all likelihood, I would have had expanders placed at the time of mastectomy, had 4-6 weeks of recovery, and many weeks of fills for the expanders, followed by an exchange surgery.  It’s quite likely that my exchange could have been delayed due to the 2020 pandemic.  

How would I have felt in 2022 with my reconstructed breasts?  I probably would have been happy with my decision as well.

So how can I write that I’m happy with my lumpectomy decision, but I think I would have been happy if I had decided to do a mastectomy instead?

Truthfully, I made the best choice I could at the time.  I listened to my medical team and then made the decision I wanted to.  I had people encourage me to get a mastectomy and “be done with it.” But they weren’t the ones who would be living with that decision.

Honing in on my “why”

It was such a challenge to hone in on what I really wanted- especially because I didn’t want to make that decision in the first place. However, when I finally got to the decision-making, I was ready.  I had all the pieces of information I needed, and I trusted myself. I also had faith in the things I couldn’t control. In the back of my mind, I knew that I might need another surgery in the future.  But I wasn’t living in the future. I was living in my life right now.

I decided that a lumpectomy was the best decision I could make at that time.  And I live every day reinforcing that confident choice in my head.  I don’t entertain thoughts of regret or doubt because I didn’t make someone else’s decision.  I made MY decision.  Not my husband’s, my mom’s, or my friend’s.  It was MY decision.  

I also know that if I had come to the conclusion to have a mastectomy, that would have been MY decision as well.  I would have sorted through the information differently and found a way to make peace with that decision as well.

If my surgeon hadn’t gotten clear margins the first time, I would have needed to make another, more difficult decision.  That wasn’t the path I had in 2019, though since then, I’ve connected with many who have had more challenging surgical pathways than I have.  

Owning my 2019 surgical choice, with the information I had at the time, has enabled me to move forward in 2022 with one more scar on my breast.

I made the right decision for myself in 2019 and again in 2022.  I know I made MY decision, and that confidence helps me move forward daily.

As you are walking through decision-making, I encourage you to find a way to own your decisions. Know why you’re choosing what you’re choosing.  Whether that is a surgery, a treatment plan, or a schooling option for your child. Knowing why you picked something is helpful whenever you need to revisit a decision. 

Important Note: I am not a medical professional. Please take any medical questions you have to your care team. For more information, please see my disclaimer. All information on the page should be considered general advice only.