Bilateral vs unilateral madtectomies

jlstacey

I'm curious how everyone else came to the their decisions. I had a possible another tumor in my opposite Breast which came back benign. I also did genetic testing and that came back negative. This leaves me with a great internal debate.

Do I prophylactically remove my right Breast for ease of mind? I just read an article on BCO that women with hormone receptor negative BC are ten times as likely to have a new cancer in the other breast than our hormone receptor positive sisters!

Curious- have you read anything like this?

How did you make your personal choice?

muska

Hi jlstacey, I think in addition to medical considerations there are a few factors that many of us take into account, including age. In my case, I was diagnosed at 54 after a dozen years of regular mammography that showed only benign changes until 2013 when I got an IDC diagnosis in the right breast. I was offered the option to have unilateral mastectomy but chose to have BMX. My decision was driven primarily by thinking that if something happened in one breast the same problem is likely to occur in the other breast that over the years has had the same pattern of changes on mammograms. I didn't want to have to monitor the remaining breast every six months forever. I also took into account advices from friends, family and medical professionals. Reconstruction outcomes are usually better if both breasts are reconstructed at the same time.

BTW, surgical pathology of the 'good' breast revealed very extensive LCIS.

There is no right or wrong decision here so I wish you good luck in whatever you decide to do.

Nomatterwhat

Jlstacey, I was 53 when I was diagnosed and knew from the very beginning that I had ILC and DCIS in the right breast .  My BS tried a lumpectomy first and couldn't get clean margins.  During the lumpectomy the blue dye showed that the right breast was 98% full of cancer.  Further testing revealed that I also had micro calcifications in the left breast, that she thought would be cancerous in 3-5 years.  Since, I do not want to do this rollercoaster again, I opted for the BMX with no reconstruction and went through 4 TC rounds of chemo, 33 rad treatments and now I am on Femara.  I did the genetic testing and am negative for BRCA. 

You have a major decision to make.  It might be a good idea to go over to the flat and fabulous website and look at some of the ladies that have made the decision to have a BMX.  I wish you the best on your decision.  Keep us informed. Hugs to you.

Scwilly

I was dagnosed with TN IBC in Nov 2013, then had 5 months chemo, followed by surgery and rads.I decided to have a UMX because I wanted to minimise surgery as I definitely didn't want to risk anything delaying radiation. My BS indicated he felt there was no immediate risk. Afterwards I had a MRI of my right breast which came back clear. I had thought if I wanted to, I could do a right UMX when I had reconstruction, which I planned for later this year/early 2016. I was however dx with DCIS in my right breast in Feb 2015 (it's er+ so I don't think its a recurrence, and I personally think the lump I found was a cyst but the DCIS was along side it) I'm bringing forward recon and have booked in for bilateral DIEP on April 6th. I don't regret having a UMX as at the time it was the right decision for me. It's also not an issue having one boob now, I am really happy with the prosthesis and mastectomy bras and I still like having some feeling left. Hope this helps you. Best wishes Sarah

debiann

Of course the worry of cancer in the good breast is one reason some choose bmx, but there are other reasons too.

Some with larger breasts who do not want recon choose bmx to avoid the lopsided feel or the strain on their back from having one heavy side. Also, I think it is difficult to find comfortable prothestics to match a large breast. I spent some time researching prothestics before making my decision.

For those doing recon, some choose bmx for symmetry. This was part of the reason I choose bmx. My natural breasts were saggy. My PS said if I went with a uni he could do a lift on the other side, but it sounded like a lot of work. Plus although I'd keep my nipple, it would likely lose sensation. A double mx with DIEP recon gave me a better cosmetic result because they both match and they are larger and fuller than the originals.

Every situation is unique and there is no right or wrong answer, just the answer that you feel you can best live with. If I were younger and had perky breasts, perhaps I would have made a different decision. But I had 30 years of lumpy fibrocystic breasts that always worried me so after the cancer dx I just wasn't feeling the love for them anymore.

marykatek

Hi Jlstacey,

I am so sorry you are going through this.  It is such a hard decision to make.  I felt the exact same way.  Both my breasts were very dense and filled with cysts and all kind of garbage   Originally they only found microcalcifications in my left breast, did a stereotactic biopsy and found that it was IDC but the pre-op MRI showed more activity in other quadrants of my left breast and suspicious activity in my right breast.  Originally the surgeon was suggesting lumpectomy with radiation but then changed it to left mastectomy only.  I decided on having both removed because they still had concerns about the right (nothing definitive but a lot of wait and watch) which made me very uncomfortable.  Also I am only 48 and have endrometriosis.  They had wanted to put me on hormone therapy but it would increase my risks of uterine cancer which I already have an increased risk.  In the end, the pathology report on my right breast showed I had IDC in that breast as well so in a few years I would have had to make the same decision and by then reconstruction may have not been the best option.

I am at peace that I made the right decision for me.  I had both breasts removed with immediate reconstruction into the gummy bear implants and they look and feel great.  So far I have no complaints and I am a lot less worried about my health than I would have been if I had opted for a different treatment plan.  I found that I couldn't even talk to my mom about it because to her (she had colon cancer) there was only one treatment option available and she didn't have to make choices.  I understand how hard it is to make the best decision for yourself.  You are in the right place.  I send you prayers and help in figuring out what is the best option for you.  I agree with everyone's comment, there is no "one" way for each of us only what is the best for you. 

Peace and gentle hugs,

Mary Kate