Surgical Options for Triple-Negative Breast Cancer


Aditya Bardia, M.D., MPH, and triple-negative breast cancer survivor, Latasha Jordan, discuss the importance of shared decision-making when considering mastectomy or lumpectomy and radiation for triple-negative breast cancer.

Aditya Bardia, M.D., MPH: Latasha, you had systemic treatment first. Tell us about your experience with surgery. In general, there are two options. One option is to undergo a lumpectomy plus radiation. Or, you can undergo a mastectomy. How did you navigate that choice? Tell us about your experience with surgery.

Latasha Jordan: My experience with the surgery, it was like I was like in and out. I thought I would be in there for three days. I thought it was going to be so painful. All of the images I had and everything I thought I would experience wasn’t true. It wasn’t painful. I healed well; I healed fast. I had to do some draining. I also had to give myself some injections after the surgery. I think I left the same day. I got it done and hours later I left. If I’m not mistaken, it was a one-day thing. It wasn’t as bad as I thought it was going to be.

Aditya Bardia, M.D., MPH: Any pain? How was the post-surgical period?

Latasha Jordan: No. I was expecting to be in so much pain. I thought I was going to have to take medicine because I was going to be in so much pain. I wasn’t. I was able to handle it. I felt nothing. They used some kind of blocker or something. Whatever they put, thank you. Thank you.

Aditya Bardia, M.D., MPH: Itworked like a charm, which is great.

Latasha Jordan: Yes. It did.

Aditya Bardia, M.D., MPH: I’m glad to hear you had a very good experience. It looks like the team was excellent.

Latasha Jordan: They were.

Aditya Bardia, M.D., MPH: Many times, part of the battle is having the right team. Latasha, you very nicely highlighted how you felt comfortable with the team, to the point that you were caring for the team. Also, you felt confident that the decision you made, be it the systemic treatment or surgery, was the right one. I think that’s really important. It’s important to feel that there’s a right match. You feel connected with the team and you’re confident in your team. I think that’s a very important point.

In terms of the surgical decision, was this discussed with you—mastectomy versus lumpectomy plus radiation? Up front, some patients decide, “No, for sure I’m going to get a mastectomy.” Some know for sure, “There’s no way I’m going to get a mastectomy. I want just the lump removed, and then I can do radiation.” Others tend to think about both options. Many times, it’s a difficult choice. What was your experience making this choice, in terms of deciding whether to get a mastectomy versus a lumpectomy plus radiation?

Latasha Jordan: It was difficult. I was all over the place. One minute I said one thing. The next minute I said, “I’ll just take it all off.” Then I was like, “No.” I wasn’t going to do any research. I trusted my team. I didn’t go to school to be a doctor or a surgeon or what have you, so I’m not going to go and do their job. That’s what they’re there for. I trust them. They’re my family. I honestly didn’t question a lot of things, because that’s how much trust I had. They trusted my thoughts, and I trusted theirs. I let them do what they were supposed to do. I didn’t give them a hard time. If they said, “You take this medicine at this time on this date,” that’s what I did. They know what to do. That’s what they went to school for. So for me to question that, I’m just not going to do that. I trusted them. And then from there, after the surgery part of it I even had a little break before the radiation.

Aditya Bardia, M.D., MPH: Thanks for bringing this up. I think it’s clear that you had tremendous trust in your team, and that helped you get through the systemic treatment as well as surgery. Surgical options for triple-negative breast cancer or breast cancer that’s localized in general include mastectomy or lumpectomy plus radiation. And in part, that’s driven by how many lumps there are and any history of a germline BRCA mutation or other hereditary mutation. If that’s present, the preference is to consider a mastectomy. Patient preference is considered. Some patients want everything out. Others prefer to have the lump removed and are willing to consider radiation. You had to consider the various options. You made your decision and the team was supportive.

Transcript edited for clarity.

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