Borderline DCIS, LCIS, ADH in both breasts; 2nd lumpectomy tk

Laadeedah

Hello, all. After being diagnosed in July 2016 (dense breasts = mammo/sono/stereotactic biopsy/MRI/lumpectomy) surgical pathology on the RIGHT breast revealed "severe" hyperplasia, LCIS and borderline DCIS. Lumpectomy was in September 2016.

Had my year followup mammo/sono at Sloan Kettering a month ago and the radiologist found the exact same pattern in the LEFT breast this time (had the mammo/sono that morning; stereotactic biopsy that afternoon). My MSK surgeon who I have great respect for is recommending a lumpectomy which is scheduled for December.

I'm having two very different reactions. First: I'm being treated at MSK, one of the best cancer centers in the world. Trust them, have the lumpectomy, yearly mammo/sono follow up; see what follows next year and hope this is the end of it. Consider Tamoxifen or radiation if recommended post-surgery. Consider bilateral mastectomy if DCIS is found next year, in either breast so I can be done with the annual worry-fest following the mammo/sono/possible biopsy.

Second reaction: Over treatment? If it is indeed "borderline," then can't we take a watch and wait approach? If DCIS was found, and I was being treated at Duke University Hospital, I could (presumably) be part of the COMET study researching treatment for DCIS with and without surgical intervention. Since MSK is, after all, a business, I'm concerned that I'm now part of their business plan as well as a patient.

My instincts tell me to just have the junk taken out. I'm clearly not afraid of surgery, though if I ended up having to make the choice to do a bilateral mastectomy, would not choose reconstruction as I have very reactive skin/tissue (ie. I get a hematoma after each biopsy/surgery and reacted to a stitch left in my breast the last time which meant the incision couldn't close completely until it was removed). And have to have liquid stitches to close the exterior incision because my skin reacts to the steri strips. Fun.

Would appreciate others' thoughts. Thanks so very much.