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Painful lumps in the breasts. Lumpectomy or mastectomy preferred?

My Wife has a large painfull lump in her left breast , after a phyical exam by a Breast Surgeon, she suspects cancer , we scheduled a biopsy with ultra sound with contrast, during the biopsy the needle hit a vain and bleeding stopped the procedure. However the ultra sound spotted a smaller lump in the same breast and another lump in the right breast. After a consultation with the Surgeon, she wants to do a wire guided lumpectomy of the large lump. Then said depending on the finding of the removed lump, we can formulate a treatment plan. The lumpectomy will be scheduled in about two weeks. My Wife is now having second thoughts, for example: all the reading she had been doing on the internet is saying more than likely she will end up having to have a Mastectomy in the end, so why go through multiple proceedures. So we know it comes down to trust, but in this day and age how do you really know the intentions of someone you don t really know. Our Family Doctor just recently moved away so we really don t know a trusted source for guidance. I m sure we can go back one more time and discuss these new areas of concern, before locking in on this surgery, but if this Surgeon suggested the proceedure that I just outlined, we feel we would really not trust her if she changed her recommendation based on what we are thinking? We can go for a second opinion, however it s already been over a month and my Wife is getting tired of all the testing, and would just like to get it over with. So thats where we are now. James and Sharon Kille
Asked On : Mon, 28 Jan 2013
Answers:  2 Views:  144
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Oncologist, Surgical 's  Response
Dear Sir,

I can see that you and your wife are concerned with the current problem and are searching for the correct treatment.
If the lump is palpable, then core needle biopsy is the best method to know the nature of the lump. It is surprising that the surgeon is not opting for that even if it was not possible the first time. It can be done under ultrasound guidance to improve its yield.
Needle localisation is only indicated in cases where the lump is not palpable - usually seen when a lump or calcification is detected on a mammogram.
Once the biopsy report is out, then the further management would be decided. The management can vary from breast conservation surgery (which is cosmetically better) to a mastectomy.

I hope I have answered your query. Please feel free to clarify any further query if you want.
Answered: Tue, 5 Feb 2013
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Oncologist, Radiation Dr. Dipanjan Majumder's  Response
this is very simple problem, breast lump if on core needle biopsy came out to be malignant then only there is a chance of mastectomy. but as your lump is small. lumpectomy may be an option , based on pathology report further treatment can be planned. even it comes out to be malignant then also mastectomy will not be mandatory. several approaches are there. do not worry follow your surgeon's advice.
Answered: Wed, 30 Jan 2013
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