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Unilateral vs Bilateral Mastectomy and Recovery



I was diagnosed in June of 2017 at age 42 with DCIS in my right breast. It was high grade and estrogen and progesterone negative. I do not have a history of breast cancer in my family or the BRCA genes. I had a lumpectomy and 7 weeks of radiation.

I was just diagnosed last month with a local recurrence. I’ve met with my oncologist and have an appt with the surgeon this Friday. My oncologist says the surgeon will recommend a mastectomy, because the same breast cannot be radiated twice. She said insurance companies have been less supportive of removing healthy breasts and that I may not be able to have a bilateral mastectomy, something the women I know that have had breast cancer recommend. She also said that due to having radiated breast tissue, my only option for reconstruction is a DIEP flap reconstruction, because an implant won’t take to radiated tissue.

This is all happening right before I’m suppose to start internship in the fall and I’m having difficulty knowing what decisions to make, and feeling like I’m only being offered one.

Is a unilateral mastectomy much different from a bilateral mastecimy, when choosing a DIEP flap reconstruction, in its appearance, recovery time and future possibilities for complications?

Thank you for any and all information!


  • mavericksmom
    mavericksmom Member Posts: 1,200

    Zen girl, I had a mastectomy after my second cancer diagnosis. I asked for but was denied a bilateral mastectomy. I had DIEP reconstruction which was hard to go through as it is like having three surgeries at once, but results were amazing!

    Make sure to check with insurance before having a DIEP reconstruction as coding has changed and insurance might not cover this.

    Three years later I was diagnosed with breast cancer in my right breast. DIEP is a one and done surgery, so I needed to have an implant reconstruction after my second mastectomy. I hate the way my breasts look now.

    I do have strong family history but I wish I had a bilateral mastectomy. I should have gotten a second opinion as it was my BS that denied me, not insurance.

    My second mastectomy and all the circumstances around it forced me to retire early and I gained back all the weight I worked so hard to lose. I am coming up on my one year third diagnosis date and I am trying to put back the pieces of my life so I can move forward.

    I was 49 with my first diagnosis, 65 with my second and 68 with my third.

    Having breast cancer three times is like having it for the first time, three times!

    Wishing you the best. I won’t tell you what to do but will share my experiences and reasons for my treatments. Feel free to ask me anything!

  • zengirl
    zengirl Member Posts: 3

    Thank you for your kind response @mavericksmom! I appreciate you sharing your story in so much detail. I’ve met with the surgeon, and now need to meet with the plastic surgeon and have an MRI. Hopefully both will happen this week.

    One thing I’m really struggling with is the prospect of losing feeling in my nipples and/or my nipples themselves. It seems trivial, but it breaks my heart.

  • mavericksmom
    mavericksmom Member Posts: 1,200

    Zengirl, definitely ask the PS about feeling in your nipples. If that is important to you, it's important!!!!! I don't have nipples so I can't say, but I was surprised that I have sensation in both my fake breasts, more so in the DIEP side, and occasionally I get phantom nipple pain in the DIEP side.

    I miss my breasts, and I totally understand why nipple sensation is important to you! I don't know of anyone on the reconstruction topics I have participated in, who said they miss their real breasts. Everyone is focused on being glad their cancer is gone. I get that, I am too, but I still miss my real breasts! They were the only body part I had that I really liked!

    Crossing my fingers that you see your PS and get your MRI this week! I will be thinking of you so please update here!