Roxy Jacenko ignored doctors' advice to have a mastectomy. Was that dangerous?

Roxy Jacenko‘s interview with 60 Minutes last night has certainly got people talking.

The PR firm founder spoke about life with her husband in prison, looking after her two young children singlehandedly and put to bed any rumours that she “lied” about having cancer by filming her surgery to remove the very real breast cancer.

The 36-year-old also revealed that despite recommendations from surgeons from Sydney’s St Vincent Hospitals that she undergo a full mastectomy, she decided against it.

“I suppose unlike everything else in my life where I go full pelt, this was one thing I wanted to do in what I guess you could call a ‘phased’ approach rather than going ‘OK, we’ll chop off my boobs’,” she said during the interview.

“I also think we need to have a look at what has transpired in the last six weeks of my life and making such rash and big decisions right now, I don’t think I’m in the head space to do it.”

A mastectomy required the removal of the breast, nipple, areola and sentinel lymph nodes.

Image: Channel 9/Screenshot

Jacenko underwent surgery to remove the cancer, surrounding tissues and affected lymph nodes at Melbourne's Epworth Freemasons hospital, with the 60 Minute crew filming the whole process.

Specialist Breast Surgeon and Surgical Oncologist Professor Bruce Mann conducted the surgery and maintained  Jacenko's decision to remove only the lump in a lumpectomy was just as safe in her case as it would be to remove the whole breast.

Jacenko's decision surprised a number of viewers, but breast surgeon and Pink Hope Medical and Professional Advisory Committee member Dr Jane O'Brien believes there's nothing to be concerned about.

"There is no evidence that the survival or treatment of breast cancer is in any way altered by being more or less radical with respect to surgery. There will be a proportion of women who a lumpectomy is not appropriate for a few reasons, the most common being the amount of tissue that needs to be removed versus the size of a woman's breast," she told Mamamia.

Image: Channel 9/Screenshot

Around 35 per cent of Australian breast cancer sufferers opt for the mastectomy, although not all actually require it.

Family history of the disease, concern for the aesthetic appearance of the breast and getting rid of the need for subsequent surveillance which can be very anxiety-provoking are often reasons people oft for the more radical option of mastectomy rather than the lumpectomy.

"Patients who are suitable for lumpectomy are almost always given the choice of the two. While it depends on individual cases, if a subsequent surgeon felt it was safe to conserve the breast, it is unlikely she has taken a significant risk with her cancer treatment," she says.

When questioned about whether it was due to a fear of losing her breasts, which she had augmented from an A cup when she was 24 years old, Jacenko denied she was taking her health lightly.

"Oh thanks! Now the world knows [about my augmentation] instead of thinking I have this lovely set," she joked, before continuing, "It's not that. I just want to go slow in the first time in my life." (Post continues after gallery.)

Dr O'Brien says Jacenko goes against the common trend she sees in her patients.

"The trend these days of all patients, particularly the younger ones, are wanting to go more radical than is necessary," she says.

"There is no reason not to do what she's done as a first stage and say, 'Let's do a lumpectomy, see what's done and have chemo and buy myself time to make decisions in a more timely fashion'.

"You can do stages and buy yourself time to consider. If in doubt, there's nothing wrong with going minimal and then you can work up to do more later. What she's done, assuming that was the game plan, is perfectly fine."

It took Dr Mann than 20 minutes to locate and extract the cancer, which was about the size of a small mandarin.

The cancer. Image: Channel 9/Screenshot

"It felt good. The cancer was localised, the lymph node felt negative. In that situation, chances are it will be good, but let's wait and see," he said.

While Dr Mann agreed the prognosis was good, Jacenko still has a long road ahead, needing radiation and possibly chemotherapy. There's also no guarantee that she won't lose the affected breast in the future.

According to breastcancer.org, certain circumstances will allow breast cancer sufferers to choose between a mastectomy and a lumpectomy.

The latter followed by radiation is likely to be equally as effective as a mastectomy if the person has only one site of cancer in the breast and the tumour measures under four centimetres.

Listen: Rosie Waterland and Laura Brodnik discuss Roxy on The Binge podcast:

When making your decision there are a number of factors to be taken into consideration, including whether you want to keep your breasts, are concerned about how they will look, surgery downtime, or whether cancer will return.

While a lumpectomy is a less invasive surgery and preserves the appearance of the breast, several weeks of radiation therapy are required post-surgery. Further surgery may be required if the cancer is found to have spread, and the radiation limits your treatment options should cancer return.

A mastectomy can often provide greater peace of mind by removing the whole breast, but is a much more extensive surgery with a longer recuperation time and post-surgery side effects. Further reconstructive surgery is often also required.

Watch: The trailer for Roxy Jacenko's 60 Minute interview. (Post continues after video.)

Obviously both options have advantages and disadvantages and the best option will vary from individual to individual. The decision between the two will be based on a preference sensitive system discussed between the patient and their healthcare professional.

"Most breast surgeons would work in a team that would include a breast care nurse and both routinely provide enormous amount of reputable information in electronic and written form to help with decision making," says Dr O'Brien.

"Most surgeons would also have a bank of past patients who you can connect with. The individual decision is based on many things including cosmetic aspirations, the size of cancer compared to size of breast, the stage and grade of the cancer and family history. There is no shortage of support."

Image: Channel 9/Screenshot