Chance of recurrence if only single mastectomy?

Bubu

I got the news last Friday. It was a tough weekend, but I am at a better place today after talking to friends, doing research, and having a loving husband. My goal is to get rid this cancer with as little suffering as possible. (Don't we all?)  Two cancer cells found on the left breast with one in the mass at max 1cm and the other in the duct at max 0.5cm.  Grade II. Invasive Ductal Carcinoma, moderately differentiated. Hormone receptors are good at positive 97% and 80%, Her-2/neu Negative, Ki-67 at Low 6%, P53 is negative.  No lymph node removed for testing because it was a biopsy thinking it was 99% benigh at that time. (Surprise!)  So with that report, my surgeon said my prognosis is good and he advised mastectomy on the left breast only, follow with chemo.  Being a cancer dummy, I naturally asked "what about the right? How do we know it is ok?"   He basically said cancer does not travel that way, he thinks that there is no reason to remove a completely healthy breast and my chance of getting cancer on the right breast is low. He is ordering additional mammograms and ultrasounds for both breast to ensure.  I read that many women opted for double mastectomy for peace of mind. I am unsure what is best to combat recurrence.    I am waiting for my second opinion appointment with another doctor hoping to hear different perspective.   What have been your experience with deciding on single or double?  Is there a statistic out there that gives a percentage of recurrence if only one breast is removed vs two?    I'm glad to find this board and I thank you all in advance for your help.  

mcgis

I opted for a double mastectomy because I did not want to end up doing "it" all over again in a few years. I wanted to be proactive. I don't have a family history.  My surgeon told me the same thing that cancer doesn't travel across breasts that way but if it can show up in 1 what's it to stop from showing up in the other. It's all a personal preference though.  On a side note my plastic surgeon was glad I opted for a double because it made his job easier to match the girls rather than trying to match a new one to the old one.

voraciousreader

Before you begin the discussion of whether or not a bmx is wise, you should first request the Oncotype DX test to see if you would benefit from chemo. For early stages ER +, hER 2 negative tumors, with up to 3 positive nodes, you may qualify for the RxPonder clinical trial which is helping patients decide if chemo is beneficial.

Furthermore, there was a recent study suggesting BMX is becoming a far more frequent procedure that has physicians concerned.  It would be wise to understand all the pros and cons of the procedure before embarking on it.  Despite knowing that BMX rarely improves individuals survival unless they are BRCA +, remember it is a serious operation for many that choose to have it.  I wish you well.  Lucky for you that you have many choices!

JohnSmith

It's really a personal choice. I think many women believe they will get a better cosmetic result by doing a BMX. Surely, one natural breast and one "rebuilt" will probably appear very different without clothes. With clothes on, you may not notice the difference at all.

Certainly having them both removed reduces the likelihood of LOCAL recurrence to roughly 1-3%, at least that's the number we were told for Lobular Carcinoma. In terms of Ductal Carcinoma, it might be a slightly different percentage, but it will be low.

Renee51

I chose bilateral mastectomy because I have had several "issues" with my left breast, never the right. However, on screening mammogram, low and behold I had cancer. I figured with all the lumps and cysts I had had on the left, I didn't want to live with the constant fear of waiting for the next problem. I don't regret my decision. 

Kay_G

I had a much larger tumor (multi focal) and multiple lymph nodes when I was diagnosed.  I was 47.  It was all in the right breast and nothing suspicious in the left.  My initial gut reaction was to get a BMX.  Both my surgeon and oncologist recommended a single mastectomy.  I am glad I listened to them.  I have no feeling in the reconstructed breast.  I am very grateful that is not the case in the left breast.  But you have to make your own decision.  

Mommato3

I decided to just have my right breast removed.  For me, I didn't see a reason to remove a healthy breast.  I'm going smaller on that side so I'll have a reduction on the left so they match better.  

Getting BC in the other breast means it is a new DX not a recurrence.  A local recurrence is in the left over breast tissue or lymph nodes.  A distant recurrence is in another part of your body (bones, liver, lung, etc.).  

It really is a personal choice.  Yes, many have a BMX so they match.  Others do it so they have less worry about getting it again down the road.  Especially if they are BRCA 1/2 positive.

mmtagirl

sorry you have to join us!  It is still so fresh and new for you and getting a plan in place is the hardest part.  

I opted for the BMX for very personal reasons.  My grandmother and mother both had BC at different times in both breasts. Both new cancers.  Even though BRCA testing came back negative I did not have faith they genetic testing had caught up with familial relationships and did not want to be the third generation dealing with it two times.  If I am honest with myself I also was vain enough to think about symmetry and with my very large and droopy natural breasts I didn't think that symmetry would ever be possible with reconstruction.

I asked for oncotype dx testing before surgery but was told it wasn't protocol but would be considered after.  I was 1 node positive with an oncotype score of 16.  I did enroll in the RxPonder trial and am in the chemo arm.  

Was not hoping to do chemo but am here to tell you that we all rise to the occasion and get through it.  6 more treatments and I am done!  If nothing else, we learn a lot about ourselves through this process and I believe come out the other side much stronger and compassionate.  Hang in there! You have come to the right place!

tlj030

I had a single mastectomy based on my surgen's recommendation. I was planning on double when my husband and I went in to discuss our options. We both felt this was the right decision for me. 

Moderators

Welcome to BCO Forums. It is a very stressful
time but often talking with others can help. You'e already had a flood of feedback, that will help with deciding to go single or double. Statistics are generally that you should have no more chance of recurrence than you did of your first Dx, however there are psychological and physical considerations as well to consider - are your breasts large or small, how will you cope with your mammo after the first surgery (it can be very stressful). 

Are you considering recon or going flat?

You
could read the Reconstruction stories and options on BCO and
ask questions.

You may
consider not reconstructing and going flat, so read Living
Without Reconstruction After a Mastectomy

There
are many issues to consider and many variables in all treatments depending upon
location, surgeon, your body's responses and your Dx.

We understand
that it is confusing, often overwhelming and there is so much information to
read and consider but there is no easy way as YOU have to make the decision as
to what is done to YOUR BODY.

Sorry
we can't help more. You are best talking with the other members. Waiting is a
hard time but can be well spent in educating yourself on the options for
treatment.

All the
best

The Mods

juneping

i would say you seek a second opinion if lumpectomy is an option. no need to remove the whole breast if the tumor is small. have you done a MRI yet? get all the things checked out before jumping into surgery.

jessica749

Any good surgeon will recommend single mastectomy over double if you don't have either of the BRCA. But perhaps you want to ask about the 'third gene' and any others yet to be discovered  )   http://www.nytimes.com/2014/08/07/health/gene-indi…

I did bmx over single very aware as the mods said that it was my body and I needed to live with it, and in it, no one else, for the rest of what I hoped would be a long, long life.  It's true though, NO sensation in the fake breasts which is a big drawback.  Also, living with a certain chest tightness you get used to. My size is also smaller, not out of choice but PS said that's the way it was/would be.  But I am happy for the choice I made. I save money, time, and angst by not having any breasts to screen and biopsy.  I also reduced whatever the risk was of a local recurrence of X%- some said 5%, others said 10 %,  who knows, but now we do and it's basically down to 1%.  That was why I did it. 

PS my happy end is that the 'healthy' side had DCIS which no one noticed from the ultrasound or the MRI or the mammogram.  

msphil

hello sweetie for Inspiration to you I had L mast(20yr SURVIVOR) Praise GOD,mstill have my right breast, continue to come here with us for support.msphil(idc stage 2, 0/3 nodes, 3 months of chemo before surgery and 3 months after, got married, then had 7 wks of rads and 5 yrs on tamoxifen)

Meow13

Re-occurance risk you are usually worried about to a distance part outside the breast. I was told removing health breast didnt help me. But if you have brca1/2 you may want to think about it.  Being er/pr positive means you can get tamoxifen or ai for treatment.

Bubu

Thank you everyone for responding. I am truly grateful for the support from total strangers.  Love and peace to all. 

efeuer777

I had a single mastectomy 8 years ago last month.  I just had a 2nd mastectomy 10 days ago.  No recurrence.  This was a 2nd separate cancer. I wanted the doctor to perform a double eight years ago but he really didn't want to take the perfectly healthy breast, and the insurance would not pay for the double at the time.  You make the best decision you can based on the best information you have at the time.  I hope all goes well for you!!