Unilateral or bilateral???

BrandyB

I had a stage IIb tnbc which was threated with neoadjuvant therapy which resulted in a complete pathological remission. I'm not a brac1 or 2 gene carrier. I originally wanted to have a bilateral mastectomy so that it could be put behind me, but my dr thinks that I should reconsider. What are my odds of getting a new primary??? I'm so confused!!!



Can you please share your thoughts on the matter and the decision you ultimately made (uni or bi?)



Thanks!

Brandy

Luah

First of all, Brandy, congratulations on achieving a 100% pCR with neoadjuvent; that is often not the case with trip negatives, and it bodes well for the future!  I can't comment on your odds of a new primary. I do know that rates of local recurrence in trip neg are generally lower than in other BCs, and rates of distant recurrence (mets) are higher. Your surgical choice impacts local disease only. I hope your onc can give you the answers you're seeking.

jenn3

Brandy - it sounds like you responded well to the chemo.  The decision to remove one or both breasts is such a personal decision.  Have you talked to the PS?  S/He may be able to help you with the decision after you discuss what kind of recon you would be having and the options that are available to you.  Good luck with such a difficult decision.

anonymice

Brandi, congrats on the response!

I am having neoadjuvant treatment and have chosen to bliateral mx.  My reasons are better chance at good symmetry, I have large breasts and do not and never have liked it, do not want all the mammos and ultrasounds and possibly biopsies again, but the most important is that it DOES decrease your chance for ever dealing with breast cancer again.  Stats vary but here is what important to me - they are finally learning how to keep the vast majority of breast cancer patients alive for a very long time.  We don't really *have* good stats on, say, what will happen to us in 20 yrs.  For some treatments we don't even have a year of research on the general cancer population.  So, I would rather not be the surprise group who gets a new primary because, say, Taxol causes a new primary in a small subset of people 20 yrs down the road.  

Breast tissue of any kind is very sensitive to cancer, and that no one but a fool would argue.  Obviously, it is a no-brainer for me, personally.