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Single Mastectomy vs double Mastectomy

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I am 37 years old and have been diagnosed with DCIS high grade in my right breast.

I decided to do Mastectomy but not sure what to do with left breast as I want to keep it.
I have a family history of breast cancer.

any suggestions?

Comments

  • exbrnxgrl
    exbrnxgrl Member Posts: 4,747
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    Is your family history confirmed by genetic testing? With the currently known genetic mutations (far more than BRCA genes), only a minority test positive, about 15%. I think knowing your genetic risks would be helpful in the decision making process. Take care

  • al0225
    al0225 Member Posts: 5
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    thank you for your suggestion exbrnxgrl.
    I am waiting to hear my gene test results.

    I am new to this community and not following what does it meant by - Stage IV Bone met upper femur

  • exbrnxgrl
    exbrnxgrl Member Posts: 4,747
    edited August 2023
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    Stage IV means metastatic breast cancer. This is bc that has spread beyond the breast, typically to liver, bone, brain or lungs. Stage IV is not curable. Met is short for metastasis, so a bone met to the upper femur simply means there is bc growing on the femur (large thigh bone). Those of us who are stage IV often list the areas of mets in the diagnosis line.

    There was a page that explained commonly used abbreviations in the bc world but since the site upgrade 🙄, I am not sure where it is or if it still exists. You can try to search for it or just ask if an unfamiliar abbreviation comes up.

    I hope you get your genetic testing results soon as that can play an important role in decision making. Take care

  • mavericksmom
    mavericksmom Member Posts: 1,121
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    If your doctor recommended mastectomy, I would definitely go with a bilateral. My reasoning is from experience after three diagnoses of breast cancer.

    I was denied a bilateral mastectomy in 2019 because my doctor lied to me and refused to remove my "healthy breast!" Low and behold, less than 4 years later, I was diagnosed in the opposite breast! I had a second mastectomy but had to have an implant which I hate.

    I would also highly recommend DIEP reconstruction! If you have DIEP for a single mastectomy, know that if you are diagnosed in the other breast in the years to come, you can't have the same reconstruction. DIEP is once and done! You can have it done for both breasts but it has to be done at the same time in one very long surgery!

  • moderators
    moderators Posts: 7,907
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    @al0225 and @exbrnxgrl, here is the Guide to common abbreviations, where you can find definitions for all the medical terms and abbreviations. 😊

    The Mods

  • moderators
    moderators Posts: 7,907
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    @al0225 Choosing between a single and double (bilateral) mastectomy can be challenging, and the right decision is different for each woman. Medical concerns to weigh include your risk of developing a second breast cancer, as well as the surgical risk of the procedure. You'll know more, as you've mentioned, after you receive your genetic testing.

    Personal concerns may include anxiety about lifelong monitoring for another cancer on one side or reduced sensation on the other. There are also financial, emotional, social, and practical issues to consider.

    Ultimately, the choice is a personal decision that should be made after carefully considering the best information you currently have.

  • miriandra
    miriandra Member Posts: 2,043
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    If you decide to go flat, be sure you discuss Aesthetic Flat Closure with your doctor. It's a specific style of reconstruction that leaves a smooth chest wall where the breast was with a minimum of excess skin or lumps. I don't wear a foob, but I have heard that they are much more comfortable over a flat chest than over dogears and folds.

  • momur62
    momur62 Member Posts: 3
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    I will be getting a right breast mastectomy in under 2 weeks for 1 Ductal in situ, and 2 lobular invasive tumors.

    I am over 60 and have large breasts.

    I told my surgeon I didn't want reconstruction due to my other health problems, but she didn't really "consult" with me about it.

    I read about dog ears, etc and have no idea what to expect or even ask. But I wonder about having both breasts removed.

  • miriandra
    miriandra Member Posts: 2,043
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    I had a unilateral mastectomy and am a borderline B/C cup. My surgeon said that larger women may develop back pain because of the uneven weight on the torso. However, there is a lady on one of my Facebook BC groups who is larger chested and openly uni-breasted. She posts lovely selfies and seems to be thriving.

    Ask about "Aesthetic Flat Closure". A great resource for AFC is https://notputtingonashirt.org . They have a list of vetted, flat-friendly surgeons, galleries of successful flat closures that you can show your doctor, and other resources. Dog ears can be fairly common, especially if your treatment plan includes radiation after surgery. (The idea being that skin can sometimes shrink unpredicably.) Fortunately, these can often be corrected with follow up surgery after the radiation burns have healed.

    More concerning is "flat denial", which is flat closure with no care to the appearance of the chest: excess skin flaps, keloid scars, etc. You can also ask if your surgeon has any images of their post-mastectomy flat closures to get an idea of their skill and abilities.

  • moderators
    moderators Posts: 7,907
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    Welcome, @momur62! We're so sorry you find yourself here, but we're glad you've joined our community and hope this place can be a source of support and guidance for you! The link @miriandra posted has a lot of really great info - if you'd like to read more about going flat, we have some information HERE you might find helpful!

    The Mods

  • herb
    herb Member Posts: 58
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    I would do a double. I had lumpectomy and radiation in 2015. 8 years later my family cancer saga showed I was brca positive. On February 27th I had a double BMX. What I have come to realize that I should have opted for the double 8 years ago. If you don't do the other side ,the unaltered boob gets pendulous and looks ridiculous next to the other breast.

  • exbrnxgrl
    exbrnxgrl Member Posts: 4,747
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    herb,

    We have more than a few members who have chosen a uni mx, with and without recon, and are content with their decision. It might not be what you would choose but I am sure that they don’t feel like they look ridiculous in any way. We all make different choices for different reasons.

  • miriandra
    miriandra Member Posts: 2,043
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    "What I have come to realize that I should have opted for the double 8 years ago. If you don't do the other side ,the unaltered boob gets pendulous and looks ridiculous next to the other breast."

    Fortunately, at least in the US, insurance is obligated to cover any surgical procedure that promotes symmetry. So if you opt for a unilateral, and later change your mind for a bilateral, the option is always on the table for you.

    Breasts become pendulous and look ridiculous over time regardless. My boobs looked very different than they did in my 20's, even before my diagnosis. That's part of what fed into my decision to go with a mastectomy rather than a lumpectomy - that and not having to do rads after a mastectomy.

  • herb
    herb Member Posts: 58
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    Your dead on they get ridiculous as you get older. I had great boobs at 55 when I was 1st diagnosed but by 64 and facing brca, I had to do a masectomy. I was not even upset because my current breast line looked ridiculous. One boob was 21 inches long from top to nipple with a dd cup and pendulous. The other was 7 inches and a c cup. The the radiation and lumpectomy affected my breast tissue that much. Had I known this at 55 it would have been so much better had I passed on the radiation and had a total masectomy, not only would my reconstruction been easier, I would have a more uniform outcome. Post radiation my ps said that my not be possible due to the effect of radiation on my tissue

  • miriandra
    miriandra Member Posts: 2,043
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    That's something that many people don't really think about when they are offered rads. Radiation doesn't just kill cancer cells - it literally cooks your tissues. Think about the textural difference between a raw steak and medium well. That's your skin and pec muscle. I know they have gotten much, much better with precision and aiming of the radiation, but I was very worried about this in particular. My bc was on my left side, and I really didn't want my heart anywhere near a radiation stream if it could be avoided.