Initial treatment plan... when to have mastectomy?

Hi all,

Last week I was diagnosed with grade 3, breast cancer - Her2 positive.  Overall, everyone that I have spoken to has been positive about how small the cancer is so we’re very hopeful for a great outcome.

Having met with the oncologist today, I just have a few things that I would like some advice on as although we asked as many questions as we could, I had an appointment to get a small metal clip put on the cancer soon after (and as my appointment was 3 hours late, we didn’t have much time inbetween) so we were a bit pressed for time.

Being Her2 positive, from what I understand I need to have the Herceptin injection which is fine but as explained, being Her2 positive means the cancer is aggressive and they have suggested starting this after chemo but my concern is, if it is aggressive, why do we not start as soon as possible?

Does anyone have any advice regarding a lumpectomy or a mastectomy? I was initially going to go for a lumpectomy as the oncologist said they are both going to be effective, there isn’t much difference in terms of that but the only difference would be I would have to have radiotherapy if I opted for a lumpectomy. I have implants currently so radiotherapy may affect these so would prefer to avoid it to be honest.

If I opt for a mastectomy, I have been told that I can have it before or after chemo but the reconstruction would have to be after chemo. Is there a reason why I couldn’t have my mastectomy and reconstruction before chemo?

Sorry for all the questions! Just trying to get my head around everything… It is a minefield! 

Thanks in advance!

  • Hello,

    i was grade 2 her2 pos....as my lump was small I had lumpectomy first....then chemo then rads...now on herceptin and tablets....

    if you opted for surgery first you would need time to heal before chemo starts , my op was jan 3 rd chemo began Feb 14 th....but I'm guessing a full mastectomy would take longer to heal? 

    There seems to be a protocol where treatments are concerned....and your treatment plan will be individually catered to you, so put your trust in your team and write as many questions as you can in the meantime.....

    I hope it all goes well xxx

  • Hi Kim

    I got diagnosed with grade 3 invasive ductal carcinoma and Her2 positive on 26th June. Originally they said as the lump was small that I would have surgery within 4 weeks. When I went back the following week to see the surgeon, it had been decided that actually as I was her2 positive chemo with herceptin first would be better. I’m having my markers put in on Monday and a heart scan, see the chemo nurse Wednesday and have my first chemo session next Friday. You should have been allocated a breat nurse and given a phone number to call. If you give them a call with any questions you have, they should be able to answer them for you. Don’t feel that you’re pestering them. They understand that you don’t take in all the info at once. They have all of your notes. Everybody’s treatment plan is different. Take care.

    Amanda xx

  • Hi,

    Thanks for your message and your good wishes.  Yes, have a great team looking after me and know they will do the best for me.  Just trying to understand everything and how it all works.

    Hope all goes well with you too. Xxx

  • Hi Amand

     Thank you for your message, it is really helpful.  I think one of the things that’s confusing me is that my surgeon also said that my best option was to have chemo with Herceptin and then surgery. But when I saw the oncologist she said I have four different options and I’m just working out which is the best.

    i have a called the breast cancer nurse and just waiting for a call back so hope to be able to talk things through with her.

    Thanks and I wish you all the best with your treatment.

    Kim. Xx 

  • You’re welcome Kim

    Hope you get the answers you want. All the best and take care

    Amanda xx