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Topic: Unilateral vs. bilateral mastectomy?

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Feb 28, 2008 06:58AM

LorenaB wrote:

Hello everyone, I've been posting occasionally on this board for the past few weeks but this is the first time I'm starting a conversation.  I got some news this week and I'm trying to decide what to do - -I thought I might get some good advice from those of you who have already had a mastectomy or have made a similar decision.  (If this conversation would fit better on another section please redirect me!)

I had a lumpectomy with SNB in January (microscopic cancer cells in sentinal node), and then a re-excision and axillary dissection last week.  The good news from the second surgery is that all the lymph nodes were clean.  The bad news is that the found "DCIS in all margins" and the surgeon is recommending a mastectomy.  I will be going through chemo first (starting in a few weeks) so I have some time to consider my options, consult with the oncologist, find a plastic surgeon, etc.  I do plan to have immediate reconstruction.

I am trying to decide whether it makes sense to do a bilateral mastectomy or just do the one side.  There is no indication now of cancer in the other breast (bone scan, CT scan all normal, too) and my genetic testing came back negative.  The doctor said that removing the other breast is not medically necessary.  But I am wondering about chances for recurrence over my lifetime -- I am 41. 

Then I'm wondering about the aesthetic aspect.  I am now a DDD cup, so if I get a uni-lateral mast, I would definitely get a reduction on the other side as well, so I can have two matching, medium-sized breasts.  But will they really match?  I haven't even begun to explore the various options for recon, but I would imagine that the two sides would look different, age differently, etc.

I'm also wondering about how it feels to have a uni-  vs bilateral.  Does it feel weird/uneven to have one natural and one reconstructed, or do you get used to it?

I would appreciate any thoughts, feedback, experience w/ any of this.  Thanks!!!

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Feb 28, 2008 07:04AM AnneW wrote:

I think the underlying issue becomes what sort of reconstruction you want. Personally, I would only do implants as a bilateral. They are just so different from the natural breast.

If you want to keep a sensory-intact breast, then maybe a unilateral mastectomy with a TRAM or lat flap or DIEP. They are more extensive surgeries, but use your own tissue so the breast is more natural.

My first bc was at age 44. I found another one in the other breast at age 50. Fortunately, they were both stage 1. After this second bout, I had both removed. I have no regrets about NOT having them both removed 6 years ago.

My thoughts. I know others will chime in, too.

Good luck deciding. The choice is not always an easy one.

Anne

2002 IDC stage 1, grade 1, rads & AI

Dx 9/18/2007, ILC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2-
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Feb 28, 2008 08:37AM mradf wrote:

Lorena,

I believe that my genetic counseling sessions(my test was negative, too) and the consult with the plastic surgeon before making my decision both had a great impact on my decsion.  I opted for the bi-lateral mastectomy, one side cancerous and one side prophylactic and, two weeks out, have no regrets.  I was also given the best possible pathology report this week, as they got it all, clean margins, no invasion to the lymph nodes, and I do not need chemo or radiation.  To my surprise, I was not the best candidate for the reconstruction using my own abdominal or back tissue.  Honestly, although I would have loved having my own tissue and the happy side effect of the tummy tuck, I am happy I do not have the additional challenge of healing from that on top of the bi-lateral mastectomies.  I had expanders placed during surgery and my PS and BS anticipate an excellent outcome.  My PS said that the bi-lateral gives him the best chance   to provide me with the most uniform result. Although neither doctor pressured me to have bi-lateral, both told me afterward that I had made the best decision based on all the factors including family history, peace of mind, size of cancer, etc.     

Ultimately, you need to make the best decision for you using all the information you can gather.  And you will.  Once I made my decision, I felt calm and never looked back.  Please let us know what you decide.

Maria

ALL WILL BE WELL. - Julian of Norwich

Dx 11/19/2007, DCIS, 4cm, Stage 0, Grade 3, 0/7 nodes, ER+/PR+
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Feb 28, 2008 10:20AM Noni wrote:

I had DCIS in my right breast and an area of calcification in my left.  My genetic testing came back negative and I had the option of a simple lumpectomy in the right breast.   However, I didn't want to constantly worry about what was happening in my left breast so I decided on a bilateral with a DIEP. 

Honestly, even if there was nothing in my left breast I would have opted for the bilateral.  I was also a DDD before surgery and had been talking about a reduction prior to my diagnosis.  Large breasts can be a curse and I am loving having something more managable.   It's like a whole new world.  I am only 5 weeks past surgery but I think my chest looks so much better now than it did before.

bilateral mastectomy with immediate diep on 1/21/08

Dx 12/5/2007, DCIS, <1cm, Stage 0, Grade 3, 0/6 nodes
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Feb 28, 2008 02:29PM, edited Feb 28, 2008 04:09PM by Sassa

I was also over endowed before my diagnosis.  I opted for a mastectomy (no reconstruction at the time). 

It was horrible being so uneven.  I thought I had back, shoulder and neck pain before the mastectomy.  Believe me, it was much worse after the surgery.

I thought about having a reduction of the other side.  My oncologist recommended that I have a simple mastectomy as it is much easier to recover from than a reduction.  She also pointed out that if I decided to have reconstruction, I would be starting out even.

When I had a funky mammogram on the other breast, I went ahead and had the simple mastectomy (turned out everything in the breast was benign).

At this point, I have not had reconstruction.  My prostheses are about an A cup size.  There are days that I go without them.

I love being flat chested.  My back, shoulders and neck don't hurt.  I can finally find tops that fit across my bust and on my shoulders.  I can exercise without discomfit.

I don't think I will ever have reconstruction.

Dx 11/6/2006, IDC, 1cm, Stage I, Grade 3, 0/9 nodes, ER-/PR-, HER2+
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Feb 28, 2008 03:14PM catbert4209 wrote:

Lorena:

This is a very personal decision.  I had a similar experience--two areas of suspicious calcification in my left breast that turned out to be Stage 1.  I had a lumpectomy, followed by an MRI that showed residual disease, a second lumpectomy that got all the residual disease but showed DCIS in the margins.  The MRI showed a fibrous adenoma in the right breast that was also removed, but my radio-oncologist and BS said there was every possibility that DCIS would show up in the right.  For myself, I wanted to get off the surgical merry-go-round and start healing.  I opted to have a bilateral mastectomy with immediate reconstruction on January 30.  Right now I'm sore, but healing, and my PS thinks I will  have a good outcome.

Get all  the information you can, and decide what you think you can tolerate. Above all, do what is best to give you a healthy life!  All the best to you!

Cat 

Catbert--A positive attitude may not solve all your problems, but it will irritate enough people to make it worth the effort! (^..^)

Dx 8/20/2007, DCIS, 2cm, Stage I, Grade 1, 0/17 nodes, ER+/PR+, HER2+
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Mar 3, 2008 04:24AM 1965sally wrote:

Glad to read about all your experiences.  I would have liked to have a support group to discuss the challenges of being DDD (me too!) even before I had cancer.  I hope more people who've experienced lopsidedness will post here.  I'm weighing up everything now, trying to decide whether to have a prophylactic on the other breast.  But I know cancer can still recur after mastectomy, but it would be nice to get off the surgery merry-go-round, as you said!

One factor I'm keeping in mind is my 2 year old daughter.  I would like to have the least arduous recovery possible, for now.  Is recovering from bilateral much worse than from unilateral?  Or is it better than two separate unilateral recoveries - like a two-for-one special??

Mastectomy and reduction 4-30-08; unilateral lat flap + TE for recon 11-17-10

Dx 12/20/2007, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER+/PR+
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Mar 4, 2008 05:02AM hopefor30 wrote:

I agonized over this decision -- it is a tough one -- but finally opted for a unilateral.   My BS did not recommend a bilateral, but I know I will some have risk for my other side.

Another thing to consider is based on what type of recon you want.  A DIEP can only be done once, so if you want that, it is worth considering a bilateral.   In my case, due to previous surgery, I only had the veins/arteries for a unilateral DIEP and that clinched my decision.   If I had been able to do a bilateral DIEP, I might have.

Recovery from DIEP is tough, but doable.   It does take a good 2 months before you feel normal.   The first 2 weeks you definitely need someone with you to help with meals, kids, etc.

Good luck with your decision.

M.

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Mar 4, 2008 04:25PM LorenaB wrote:

"My oncologist recommended that I have a simple mastectomy as it is much easier to recover from than a reduction. " 

Hmm, if this is always the case, then it will definitely influence my decision in favor of the mastectomy.

A few more questions: is DIEP the surgery where they take muscle from the abdomen?  or is that TRAM?  I'm still no good at keeping all procedures straight. 

For those of you who elected to have a double mastectomy, did your health insurance cover it completely (including reconstruction) even if only one side was cancerous?

Right now I am leaning toward the bilateral but I still haven't seen a plastic surgeon, so I have a ways to go before making a final decision.  Thanks so much for the input, it is really helpful!

Dx 12/20/2007, IDC, 1cm, Stage II, Grade 3, 1/11 nodes, ER+/PR+, HER2-
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Mar 4, 2008 05:00PM AnnNYC wrote:

Hi Lorena,

DIEP takes no muscle, TRAM takes some of the transverse rectus abdominus muscle (a component of your "abs") -- a procedure called the "free TRAM" takes only a little bit of muscle.

I had a unilateral mast with silicone implant reconstruction, and I'm quite happy with it.  I'm 55 (54 at the time of surgery) and a C cup, so the factors going into my decision are clearly different from yours. 

But I will say that my implant breast doesn't feel terribly alien (I notice I didn't put quotation marks around "breast" so I'm getting to feel more and more like it's mine!) -- I have quite a bit of sensation in the skin (and muscle) covering the implant, and the texture of the silicone feels very similar to my real breast.  For me, retaining one breast with nipple/sexual sensation was an important consideration and has been very nice (I also declined lift/reduction in "good" breast for this reason).  I also felt very strongly that I wanted to minimize  incisions -- I didn't want surgery on my abdomen, back or backside, or unaffected breast -- for me that was a huge priority and contributes to being happy with my recon decision.

Dx 3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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Mar 4, 2008 08:15PM Kathy_K wrote:

In the muscle sparing free tram, the doctor uses a postage stamp size piece of muscle.  In DIEP the doctor dissects the muscle to remove the blood vessels that run through it.

And, yes, the insurance companies will pay for the surgery to the other side for symmetry.  At Kaiser, I had a unilateral MS free tram.   The Stage 2 included the reduction on the other side was considered a follow-up and only cost me $15.00 !!  Insane!  Anyway, I understand that the insurance companies must pay until you are satisfied as long as you do it with one of their providers.  Go outside the network and you may have a fight on your hands.

Anyway, I ended up having an unfavorable pathology report after my reduction and ended up having another mastectomy.  This time I needed to go for an implant.  I got the one-step procedure and that recovery was a piece of cake.  Whatever you decide  I will tell you that having bilateral surgery will give you the opportunity to have matching reconstructions.  If you think that if you go unilateral, you will be second guessing yourself and waiting for the other shoe to drop, bilateral may be the right thing for you.  Some women can just do one side and then forget about it and worry about the other side when and if they need to.  Which woman you are will determine your choice.

Good luck with it.  No matter which you choose, there will be others that will tell you that you are wrong.  You have to do whatever feels right to you and for you. 

When a woman tells the truth she is creating the possibility for more truth around her. Adrienne Rich

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Mar 4, 2008 08:55PM iodine wrote:

Having a bilat is no guarantee of better symmentry/match.  Just thought I'd add that tidbit.

I agree with the above, you will know what kind of attitude you have and make your decision from there.

I chose a uni with a lift on the good one.  Am happy now, even if I did have to do it twice cause the first ps did a poor job.

Dotti---BE NOT AFRAID, Pope John Paul

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Mar 5, 2008 03:57AM 1965sally wrote:

This is a really helpful thread - thank you all. 

I asked my breast surgeon yesterday about getting a reduction on the good breast at the same time as the mastectomy, and he thought it was a good idea due to my large breast size (plus, the tissue from the reduction can be sent to the lab for a pathology report, which could help my peace of mind).  But the one plastic surgeon I'd consulted before said he wouldn't do that - insisted that you have to do any reduction at the time of reconstruction.  But I'm not so concerned about having a matched pair.  I may have to have radiation after the mast., delaying reconstruction for months, and I don't want to be carrying around a watermelon on one side with nothing on the other!  It sounds like bad back city.  So I'm shopping for other PS opinions this week. 

Do any of you have advice on this?

Mastectomy and reduction 4-30-08; unilateral lat flap + TE for recon 11-17-10

Dx 12/20/2007, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER+/PR+
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Mar 5, 2008 06:43PM moonie wrote:

Hi -

The decision to go unilateral vs bilateral is very personal.....only YOU can make the right decision for you....and whatever decision you come to...know that it is 'right'.

I had a unilateral skin-sparing mast and 9 months later had a Tram Flap and reduction of the other side for symmetry.  I went from having large droopy Ds to nice perky Cs and I am very happy with the new ones!!  I think the surgeon who said a reduction is worse than a mast was just looking for more $$$$$ since he would do the mast and a ps would do the reduction.  The reduction was DEFINITELY the EASIEST of the 3 procedures for me!  My ps even said that the reduction was 'nothing' since it is just tissue removal.  There have been studies that show breast reduction lowers your risk of bc, apparently since there is less tissue.

It was annoying to be lopsided for 9 months, but maybe that made me appreciate my recon even more!  I just used a soft fake boob since it was a short time.  I actually did have the 'original' pedicle tram and have had no issue with loss of muscle.  I can do everything i could do prior to my recon.  THE MOST IMPORTANT thing about any recon, regardless of type is to be sure and find a ps who has done many of that particular type successfully and has pics to show you and hopefully happy patients with whom you can chat.  With any type of abdominal recon, the other important thing is NO LIFTING for 6-8 weeks.  The nice thing with these types of recons is they do change as your body changes with weight loss and gain---pretty amazing.  However, it is definitely a BIG surgery and you do need to know that going in....for me it was totally worth it.

Good luck to everyone trying to make these decisions!

Dxd 12/03, DCIS, Mast, ILC, ooph, unilateral pedicle tram 2004

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Mar 6, 2008 03:39AM 1965sally wrote:

Thank you for the advice moonie, glad to know it worked out so well.

Mastectomy and reduction 4-30-08; unilateral lat flap + TE for recon 11-17-10

Dx 12/20/2007, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER+/PR+
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Mar 8, 2008 03:04PM nurse1breastcancer2 wrote:

I would really appreciate some advice.  I had a lumpectomy (plus chemo and rad) in 1999 and was just diagnosed with a new breast cancer in the same breast.  Staging is not finished yet but I am not sure what to do.  One mastectomy for sure, but what about the other side.  I am fifty and not sure about reconstruction and possible complications.  I will need chemotherapy and am really struggling withis decision.  My husband is cool either way and very supportive. 

Dx 3/6/2008, IDC, Grade 3, ER-/PR-, HER2-
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Mar 8, 2008 03:19PM mradf wrote:

nurse1brastcancer2

I can tell you that my sister who was diagnosed at age 46 and is now 51 opted for the lumpectomy , followed by chemo, radiation and a subsequent brain tumor (cured).    When I was diagnosed in November, I took a lot more time to decide than she did, and opted for the bi-lateral mastectomy.  Now granted, our cancers and lives are different.  She had a palpable lump that she found, I had microcalcifications found by mammogram.  She never had children, and I have two ages 11 & 14.  She does say now, however, that if she were to have another breast cancer, she will not hesitate to have a bi-lateral.  It's cool that your husband is cool.  That helps a lot.  My husband of 24 years was okay with whatever I decided, and, more importantly, he was able to look at me after surgery, help with the drains, showers, dressings, etc.  THAT is what in sickness and in health really means!  I am still healing from Feb 14th surgery and in the reconstruction process and have no regrets at all.

You will make a decision that is right for you. 

Good luck.

Maria 

ALL WILL BE WELL. - Julian of Norwich

Dx 11/19/2007, DCIS, 4cm, Stage 0, Grade 3, 0/7 nodes, ER+/PR+
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Mar 8, 2008 03:50PM Laura-Vic wrote:

As everyone has said - completely an individual decision. I will just share my experience. I was also a DDD (a G-H) if I could get one. I had a 4.1 cm tumour in my right breast. I elected to have a bilateral mastectomy. My surgeon too discussed the issue of infection in the "non-cancerous" breast and the risk that brought. I could not however imagine looking down and being constantly reminded of the size difference, the natural breast would always be a time bomb in my view, the weight difference, the discomfort when not wearing a "balance" .... all those things. My surgeon too would not do it as a "reduction" because of the potential for recon dissatisfaction in equity as others have said.

I cannot say how totally totally and absolutely calm I am about my decision. Recovery was simple. There was surprisingly little pain in any area of the chest.

I now have prosthetics that are about an A-B cup and am thrilled, absolutely thrilled. I can wear almost anything I want. My shoulders and back do not hurt at all. I can sit at any table without feeling like I'm laying my boobs on the table or in the food. There is no sweat building up underneath my boobs and I'm not constantly adjusting elastic - ever. I'll be able to go au naturelle in the summer. I'll be able to wear those nice tops and/or summer cotton dresses without a bra. I do not regret it all.

And just think - I can buy normal, hussy or va va voom prosthetics .... leave them in the dresser and decide !!!

And yes, my medical paid for the bilateral ... and, because it was done as a result of a cancer diagnosis, should I decide in the future to have reconstruction (not likely at this point) they will cover that as well.

Good luck with your decision - I just wanted to step in and share my experience.

Laura in Victoria

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Mar 8, 2008 03:53PM otter wrote:

nurse1breastcancer2,

I don't like the looks of that score.  Hopefully, it's only the first inning of the game, and you have 8 more innings and a lot of at-bats to turn things around! 

If you are really considering a bilateral mast. as the solution to your newest tumor, I think these issues are the most important:

1) Is there a strong history of BC in your family?  Were you (or were others in your immediate family) tested for BCRA1 and/or BCRA2 and found to be positive?  That would increase your risk, for sure.

2) Have you had a breast MRI in association with this most recent dx?  That will tell you whether there is anything of concern in the "good" breast. If there is evidence of another malignancy there, that would strengthen the argument for a bilateral (for some women).

3) How hard is it (or how hard has it been) to check your breasts for recurrence or new tumors?  If you have very dense breast tissue or fibrocystic breasts (like mine), you've had a devil of a time sorting out the normal from the suspicious, and mammograms haven't helped very much.  How was your newest tumor discovered (mammography?  self-exam?  annual CBE?)?

4) You said this was a "new breast cancer" in the same breast.  Are you sure it's an entirely new tumor (new primary), or is it recurrence of the original one that was treated in 1999?  The rate of same-side recurrence after removal by lumpectomy/rads is around 10% over a 12-yr period.  The same-side recurrence rate after mastectomy is only 5%.  So, maybe your new tumor is actually due to cells left over from your old tumor.

I don't know how your previous chemo fits into the recurrence picture.  And, I can certainly understand how frustrating and saddening this must be. Hang on to that dh--he sounds like he will be your rock through all of this!

Big hugs!!! 

otter 

Dx IDC, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2-
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Mar 9, 2008 11:07AM jdg1 wrote:

I had no problem when I met with the first surgeon after getting my diagnosis telling her I wanted both removed.  She was floored.  My mother is the only child and she had BC around 17 years ago, there were a few of my mothers first cousins with BC and my Grandmother so I opted for a bilateral.  My BRAC1 and 2 came back negative, but I didn't want to chance another BC in the other breast.  I also was only 42 when I was diagnosed.  Breast fed 3 out of 4 kids and decided they served there purpose.  I don't have any regrets at all.  But it is a very personal decision that only you can make because you have to be comfortable with them and unfortuanately once they are gone that is it.  I also had the tissue expanders done at the same time and just had my exchange about a month ago.

Infiltrating Ductal In-Situ Stage IIB Grade 1 No node involvment, ER/PR + HER 2 -, Oncotype DX 17

Dx 5/30/2007, IDC, 0/2 nodes
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Mar 25, 2008 03:18PM, edited Mar 25, 2008 03:19PM by kswdy

It's time for me to make the big decision. I had a bilateral lumpectomy 8 years ago, no cancer. I went from a near B to a near A. This past August I was diagnosied with HER+ bc in my right breast (2.8 cm). I've had 24 weeks of chemo(tumor now drastically reduced) I will have Herceptin and Avastin for the next year. I can have a lumpectomy but I would need recon after so a mastectomy sounds better. I'm leaning toward bilateral because I'm HER2+ and I want to do whatever I can to further reduce the chances of this happening again. I'm afraid of how it would feel to only have one side done. Do you feel an imbalance? I'm 43 and there is no bc history in my family. I will have immediate recon with expanders....I am on the thin side of things. Does anyone have any advice? I am so confused.

Dx IDC, Stage II, HER2+
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Apr 12, 2008 07:14AM muttnut wrote:

I have had a single mastectomy, with reconstruction later.  I am waiting for genetic test results to come back to see if I have BRCA gene.  If so, I will have another mastectomy with double reconstruction at the same time.  My surgeon said that if I have the gene, there is a 66% chance of getting breast cancer in the intact breast.  If not, it is about 12%.

Life is uncertain - eat dessert first!

Dx 2/19/2008, IDC, 2cm, Stage IIa, Grade 2, 3/13 nodes, ER-/PR-, HER2-
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Apr 12, 2008 07:37AM kimbly wrote:

I am going for the unilateral with immediate reconstruction/ left breast.  At this time it is all I can handle.  I have thought about it alot, it is a very personal decision.  I did consider having the gene test but then decided at this time not to. There is no history of breast  cancer on my moms side at all but I am unsure of my dads side.  MY surgeon said that considering that and that I am 46 she would not try to talk me into the genetic testing.  I may decided to do it later and then go from there. 

Dx 11/21/2007, IDC, 1cm, Stage I, 0/3 nodes, ER+/PR+, HER2+
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Apr 14, 2008 03:20AM 1965sally wrote:

I am 42 and had genetic testing - negative.  So I decided to do unilateral mastectomy with reduction on the "good" side at the same time.  I'm delaying reconstruction since they think there's a chance I'd need radiation too, also I just wanted to try out being lopsided and wearing a prosthesis - maybe I'll decide not to reconstruct after all.  The reduction will provide the added peace-of-mind bonus of having the removed tissue looked at by a pathologist, and it's something I've long thought about having done anyway (trying to go back to a C cup).  I'm scheduled for April 30th.

Mastectomy and reduction 4-30-08; unilateral lat flap + TE for recon 11-17-10

Dx 12/20/2007, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER+/PR+
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Apr 14, 2008 05:11PM VBG wrote:

I have opted for bi lat as I was diagnosed with ILC in June '06 and again in Jan '08 in my left breast.  I did have genetic testing and was negative.  I had rads and tamox and neither worked to stop the recurrence of cancer.  I am now 48 and my only concern is being cancer free from this point forward.  All the docs agreed that I needed a mast on the left side and most thought that the bi lat was a good idea given my age and the likelyhood of another cancer over the course of my lifetime.  My cancer journey has been challenging since the recurrence was a major surprsie to all my docs given that I had such a low grade cancer.

I did decide that I wanted a more uniform look as well so that was a factor too.  I keep telling myself that I will have young/perky boobs when this is all over!

I am scheduled on April 29th and hoping that the outcome will be good.  No matter the outcome I will be on my way to cancer free!

recurrence 12/07 IDC/ILC stage 1 grade 1 6mm; 4/29/08 bilat/recon/ooph chemo starts 6/11/08

Dx 5/21/2006, ILC, 1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Apr 14, 2008 05:20PM danix5 wrote:

I opted for bilateral I just wanted to deal with this surgery one time.  I did have tumors in "good" breast that were concerning.  I felt the match up would be better with both gone and I could stop the "never ending worry!"

It depends on how comfortable you are with monitoring.  I had done that for 11 years.  I had had enough!!!  I wanted the safety of the bilateral.  After I made my decision my onco stated that I needed a bilateral so that just confirmed my choice. 

It is a tough one!  Think about your future and going through this surgery twice- VS- leaving a feeling "boob" in place! 

I am not so into gambling when it comes to cancer!  I was BRAC1 and 2 negative.  but there are so many genes they have not identified and I did not know what started my DCIS and was not willing to think it would not start in the other one too.

Good luck with your very difficult decision!

Dani

Dani DCIS, two areas rgt breast, grade 3 high comedo with necrosis

Dx 10/23/2007, DCIS, 2cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR+
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Apr 14, 2008 06:07PM ehkonline wrote:

I also went for the bilateral mastectomy when I was diagnosed with ILC last fall (skin-sparing with expanders). I am only 36, with a strong family history and mom to 2 kids, so I had no desire to repeat this process.  In addition, I really felt like my outcome would look better with both being the same, and I thought it would feel strange to have one real and one fake.  I am very happy with my reconstruction and would not change a thing about my surgeries! 

Dx 10/19/2007, ILC, 2cm, Stage II, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Apr 15, 2008 12:45AM Viktoria wrote:

I'ts so good to have somewhere to learn how others are dealing with all the decisions and treatments needed.Smile

   I had posted before about large breasted mastectomy and when I learned how many were happy with getting bilateral Mastectomies I knew that was for me, I hated the thought of being lopsided but now more then that the possibility of having to go through breast cancer later in life, right now my boys are young(3 &6) and I couldn't handle finding out I have cancer again during important times in their lives. 

     I've had problems after each lumpectomy (3 of them), and was so happy that I found a different surgeon (head of the breast care center) and was loving the ideal of being totally flat chested for awhile, but now I'm feeling like this is never going to end. The new surgeon doesn't want to do a prophylactic mastectomy, and my breast is infected again so now after another round of antibiotics I'll be starting chemo (A,C,T) in April. Knowing I still have cancer in my breast and that its very aggressive (grade 3 with necrosis) scares me, where else is it going to show up.

    How did you get your surgeon to agree to a bilateral mastectomy??? I have a strong family history of breast cancer. I was going to go for genetic  testing but the surgeon says if it's negative there won't be any reason to do a bilateral. Yell uurgh!!

    Has any one else worried about getting Chemo before all the cancer is out? I know chemo is suppose to kill the cancer cells but I don't even know how much cancer is left in that huge cancerous breast of mine and now I just want it gone. 

    

Dx 1/31/2008, IDC, 6cm+, Stage IIIa, Grade 3, 3/19 nodes, ER+/PR-, HER2-
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Apr 15, 2008 05:26AM Dejaboo wrote:

Im wondering too how you get your Surgeon & I also have an Oncologist who Is agaisnt a Bilateral Mastectomy.  My Surgeon says he wont argue with me, But he doesnt think its necessary to treat this current cancer (Hello-thats not my Only goal!! & I have told him that)

I see a Different Onco next week.

 I had a Lumpectomy already...Mainly because I had to do something & No one was listing to me saying I wanted a PBM.

So what Problems may I also encounter with Insurance...Does anyone know?  Will my Surgeon Be able to word it right so I can go ahead with my Plans?

I will get my Genetic testing back in early May- Im sure that would help with the insurance end.  I am hoping it will be Negative for my Daughters Sakes. (Would be nicer for me too Smile)

Dx 3/7/2008,DCIS, IDC-1.2mm, Stage tIA, Grade 1, 0/1 nodes, ER+/PR-,HER2+,Lump/SNB-4/1/08, Bilat 5/22/08, EX 9/22/08, PFO & ASA heart Closure 12/29/08, 7/09-RAVH, 11/09-NOLA-SGAP-to fix Symmastia! Stage2 4/2010, Stage2B 11/2010, Truncal & Arm LE

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Apr 15, 2008 06:18AM LorenaB wrote:

I guess it must depend on your insurance, and also your surgeon.  When I  mentioned the possibility of doing a prophylactic mast on the other side, my doctor just nodded and said, "that is up to you."  She was not advocating for it but she acknowledged that many women feel more comfortable having it done, and she would have no problem moving forward if that is what I choose.  If your surgeon is refusing -- check w/ your insurance, and then go find another doctor!  I'm sure there are others who know more about this than I do....

Dx 12/20/2007, IDC, 1cm, Stage II, Grade 3, 1/11 nodes, ER+/PR+, HER2-
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Apr 15, 2008 06:21AM Noni wrote:

My story and thinking is the same as Dani.  I had DCIS in one breast and decided to go with a bilateral.  

Honestly, if you want a bilateral your surgeon has no say. I had a mild cancer in one breast and could have easily gotten away with a lumpectomy and radiation but I decided to be more aggressive and just get it over with at once.   My surgeon was supportive but even if he weren't he couldn't override my decision with the insurance company.

The insurance company will pay for a bilateral and full reconstruction no questions asked.  They would much rather pay for one surgery than several other down the line, if it came to that.   Not to mention they are legally required to pay for it.

For what it's worth, I got the genetic testing done and decided on the bilateral before I even got the results.   I knew that regardless of the outcome I was going to go thru with the bilateral.  When they finally called to say that the results were in I seriously considered not getting them until after surgery.  In the end I learned my results (negative) on Friday and had the surgery on Monday.   I have no regrets.

bilateral mastectomy with immediate diep on 1/21/08

Dx 12/5/2007, DCIS, <1cm, Stage 0, Grade 3, 0/6 nodes

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