GG, I'm glad it hasn't spread.
We could all say what WE would do in your shoes, but only you can make the decision because only you really know how you feel about it all. It's not just your body image, it's how you feel about how your body IS vs how it looks. So many things. Plus your sense of safety and how important that is for you. Also, surgery like this is still major surgery, it has its risks and carries its own fallout on you emotionally as well as physically. ANY surgery where they cut into you, is a bosy assault. You feel emotionally and physically like an assault victim. And that's without the other emotional overtones of it being your womanly bits... a friend of mine who had her knee operated on, felt an emotional wreck as well as a physical one, for the first couple of weeks. her partner (also a health professional) reminded her that she had, in fact, been violated and this needed time to adjust to. of course the operation was essential to her and she is donig so well now, can move about better than in years. But it's important to be fully informed as to what to expect.
Go talk to your cancer specialist and also get a referral to a psychologist who specialises in counsellnig women going through the same wort of thing. You need to know what YOU feel, as well as have all the necessary information at your finger tips.
I wrote in another thread about a friend who had a diagnosis of breast cancer, a particularly aggressive one and how almost all her lymph nodes were also positive. Privately we all began saying our goodbyes. That must be nearly ten years ago now (I remember it was just before the Sydney Olympics). Amazingly, despite a family history of breast cancer (similarly aggressive) she changed her mind about having a total bilateral radical mastectomy and instead went for a lumpectomy on one side and a partial mastectomy on the other. She still has about half her original breast tissue but got reconstructed as soon as possible after the surgery/radiotherapy. We thought she wascrazy to not take the lot - with the lymph nodes positive, surely her breast tissue was likely to be harbouring cancer cells?
But she must have made her decision based on sound medical advice, because when we expected her to not last more than another couple of years, she's still with us AND is healthy and seemingly completely recovered.
An apparent digression - I was talking to my neurologist about the prednisone the rheumatologist put me on. The neurologist said, "We're increasingly realising that prednisone is bad for you. Even in patients where prednisone was originally considered to be life-saving. Even in most lupus cases, where prednisone seems to be all they can take to damp down the auto-immune attack on internal organs, longitudinal studies have shown that patients who never take prednisone are no worse off, long term, than those whose doctors give prednisone. The problems they have are different but the quality of life and long-term survival seems to be better, in the non-prednisone group."
Similarly, we as lay people might think initially, "That's it! Lop it all off!" but we need to KNOW that it's actually the best way to go.
My great-aunt found a lump in her breast when she was 80, but was too shy to tell her doctor. She figured at her age that she would die of other natural causes well before the cancer became a problem. But she was still hale and hearty at 99 when the cancer finally had grown to the point where it had ulcerated onto the skin. She HAD to have it removed. By then it was huge. Apparently on the operating table qwhen she lay on her back and a 99 year old woman's breasts should have sagged to the side, only one of them did. The other sat up bright and perky, like Mt Vesuvius, the doctor said. It ewas much worse tan they had feared - but they did a simple mastectomy, removed the tumour and didn't bother with any lymph nodes. No chermo, no radiation therapy. At her age cancers generally grow too slowly to worry about. it had taken 20 years to get to that stage.
She was out of hospital three days later and just strolled back in to her unit as if she had been for a Sunday drive. She died two years later, not of anything cancerous. Her heart finally began to give out and I think she told the doctors to stop fiddlnig with medications and let her go, God said it was time. She'd spent a total of maybe two weeks in hospital, over her entire life. Half of it was her final week. The rest of her life she had dedicated happily to helping other people, in a very active and fulfilled life. Cancer? It barely made an impact on her life, onlyfor a couple of months while they discussed what to do about it. And maybe worrying quietly for 20 years until she had the courage to 'fess up.
A simple mastectomy like my great aunt had is not that big a deal. A radical, where they take pectoral muscles too, is drastic. Find out what you would be in for afterwards (in terms of limited mobility - can't raise your arms, for example) and maybe talk about a compromise option that will give you the peace of mind you need without too severe a body invasion.
Maybe while your nodes are clear, something less radical may be the way to go.
It's just too complex for us to advise you any deeper, I think.
But as Trinity said - whatever you decide, nobody here could judge you or be critical. it's your body, your concerns and fears you need to address. You are entitled to do what you feel safest with. We're here for you regardless.
Marg
