UMX or BMX at stage 3 ....any regrets? Advice?

dancingdiva

UMX or BMX at stage 3 ....any regrets? Advice?

dancingdiva

I need advice...I'm 42, had huge tumor taken out in lumpectomy but had positive margins so going back for mastectomy. I don't know whether I should just get a reduction on right side or get rid of it all together since its I have dense breasts and a couple of "normal" lesions already. I'm scared to leave it when it might have soemthings growing in there or take it out for nothing. Being stage 3 scares me in this position . I can only have implants ....not enough tissues for others.

I'd like to hear some advice . Any regrets u ladies have had?

Anonymous

I don't think being Stage III matters at all in the decision. A bilateral is really about localized disease or preventing 2nd cancers. Your relatively young age and having had benign breast lumps would be reasons to consider a bilateral. But even with that you are pretty low risk to develop a 2nd cancer. What's your family history like? Have you had all the imaging available (mammo+ultrasound+MRI) to make sure there's nothing lurking in there?

So far I've only had a unilateral. But I don't think I'll be keeping the healthy breast long-term. Something whacked out in my genes caused me to get cancer so young - we just don't know what it is yet. The reason I didn't go for a bilateral in the first place is because my surgeon didn't recommend it and I needed more time to get comfortable with cutting off (quite literally) the option of never breastfeeding.

Kicks

I'm IBC and had UMX 5+ yrs ago with no regrets at all. I did not do recon - again no regrets at all

Kay_G

I did a umx and DIEP reconstruction, with a lift on the other side. Like you, I had no choice. Mine was because I had multi centric tumors in different quadrants of the breast. I don't regret not getting a BMX. I am glad I have sensation in at least one breast. My bs and onc advised against a BMX because they said that is just not the way breast cancer acts. It does not migrate to the other breast, it would have to be a completely new cancer. My onc told me the only reason for me to get a BMX was if I would just be too nervous and anxious about getting cancer in the other breast. I was a few years older than you (47) at diagnosis. I am happy with my decision, but so are lots of other women who chose BMX. There is no right or wrong answer, it's whatever feels right to you. Best of luck

Momine

Dancing, I had lobular cancer and it is notorious for not showing up on mammos and scans. In my case, the follow-up on the good breast would have been intense and would most likely have involved many biopsies. Also, I like symmetry. So I chose BMX and found a surgeon willing to oblige (some won't, because medically/statistically it is not warranted unless you are BRCA+). In my case, it was a good thing too, since lefty was full of LCIS and other pre-cancer that had evaded mammo, U/S, MRI and CT. However, that is how lobular often behaves and if your cancer is ductal, please disregard that bit.

I did not have recon. Initially the idea was that I would have delayed recon, but the more time passes, the less likely I am ever to do it. It is a bit weird being flat and it is an adjustment, but it really doesn't bother me in any deep way. I am not interested in having lumps of silicone wedged under my pecs. Like you, I do not have enough tissue for a flap. After much research, I decided that I would not be happy with the look of reconstructed breasts and I am SOOO not interested in any more surgery, especially not a surgery with a very high complication and failure rate.

sbelizabeth

Mine was sneaky...a 1.2 cm lump, close to the skin, with a 3" umbrella of dermal lymphatic invasion, popped up just 3 months after an "all clear" mammogram.  The path report after the lumpectomy, including the skin involvement, made a mastectomy unavoidable.  My radiation onc didn't want a tissue expander placed (and it probably would have failed anyway, with all the zaps I got), and I went uni for a year.  I really didn't like the one-sided lifestyle. 

I had a bilateral DIEP because I also wasn't interested in having silicone in my chest, because with as much radiation damage as I had implants would be problematic, because I wanted the "healthy" breast gone for symmetry and peace of mind, and because I didn't want to strap on heavy, hot breast forms every day.  I love my DIEP "breasts."  They have helped move me from scarred and damaged to whole and recovered. 

Anonymous

Momine, I could have written your post.  Same here.  ILC in the right breast, chose a bilateral and the left breast had LCIS that never showed on mammograms.  I have never had any reconstruction and after ten years I am completely happy with that decision.

Dancingdiva (love your screen name), this is such a personal decision.  I wish you peace and clarity in making your decision.

dancingdiva

selizabeth, I am meeting my rad Onc this Friday for the first time. How come urs did not want. You to have TEs placed? I have extensive skin involvement too.

sbelizabeth

Dancingdiva, I was aware that many rad oncs will allow placement of expanders before rads.  Mine was just super-cautious.  He wanted the targeting of the rads to be exact, to the millimeter, and had had some incidents where the rads-damaged skin just didn't hold up to expansion, got infected, and the expander had to come out. 

I'd had other rad onc opinions that an expander would be fine, though.  For my own situation I wanted as much skin GONE as they could get, which would have made an expander even more challenging.

caaclark

I had a single mast 9 years ago-no recon and no regrets, although I hate that I still get a mammo on the remaining side each year. Initially I wanted a double mast. but my doc said they only do that for risk reduction and not for anxiety reduction. I was 40 at the time and am now 49.

Spookiesmom

I had bmx 3 years ago this month. I told BS from the get go I wanted both gone. He gave me a little argument but did what I wanted.

My RO was pleased I chose no recon, made it easier for him to target where he wanted.

I'm still flat, have no regrets.

dancingdiva

thank u for sharing ur stories. Everytime I see something strange on the other boob..Im like "that's it, it's coming off"....then I get scared and just want a reduction and deal with recon only on one breast.

lkc

Hi Dancin, This is a really personal decision. For me,as her 2 pos, and older, almost 50 I pushed for an prophylactive mastecomy on my good side.( From the point of discovery of my lump to my 2 weeks later surgery on my bad boob, I was loaded with BC and had 12 pos nodes). Once I was over all my chemo and rad tx I demanded the other one off.Path report on that one showed alot of atypia and hyperplasia, a ticking time bomb. No regrets and no more mamos!

sbelizabeth

It really is a personal decision.  I miss the "healthy breast," in that it had normal sensation, a real nipple, and was just...real.

On the other hand, I had a 100% normal mammo in June 2011, and found a Stage III cancer in September 2011.  I don't want anything sneaking up like that again.  I know there's always some residual breast tissue left behind, but I sleep better, knowing my risk of another nasty shock has been decreased.

bride

I wanted a BM but my SO didn't want to do that. Finally convinced her, then started to fight with insurance co. Unfortunately, because of chemo related problems, I wasn't strong enough to have a BM. Yes, I regret that. I didn't elect reconstruction which I don't regret. But each of us have different needs and desires. Were I younger or my relationship status different, I may not have made the same choices. My only advice is to go with what you're most comfortable with.

Best,

bride

Momine

Jillian777, good to hear that you are doing so well. You and I have very similar DXs.