HELP! I don't know what to choose!

Jgargasz27

Hello, In 2017-18 I had a lumpectomy in my left breast and tons of chemo and radiation to successfully beat triple neg. bc. In Dec. they found DCIS stage 0 in my right breast. The surgeon thinks I should lean towards a mastectomy. The oncologists was thinking lumpectomy with radiation. I can also choose bilateral mastectomy with or without reconstruction. I am overwhelmed! The first time I had bc it seemed a lot simpler...I didn't have as many choices. Now I am terrified of making the correct one. I would love some feedback! Thank you!

moth

sorry to hear about your recurrence. That just sucks.

What a hard decision. When I had a weird shadow on my contralateral breast (while I was still undergoing chemo for the cancer on the first side), I thought about what I'd do if it turned out positive (it didn't). Gotta say my initial & slightly hysterical gut response was to ask my surgeon to cut them both off. Not rational from the perspective of physical health but I think we need to also consider psychological health - how much can you handle the stress of having scans and finding shadows and biopsies and possible recurrence. Anyway - my shadow was benign and I never made the surgeon appointment but I've got scans coming up next month and I wonder how I'll react if they find something else that they want to look at.

I do know that IF I ever do a bilat mx I'm not reconstructing so at least that part is clear in my head.

In the meantime, I think my inclination would be to pick the least invasive surgery just because you can change your mind and go back for a full mx later but you can't change your mind the other way. But there's no right answer to this and again, I think really you have to pay attention to your feelings and emotions on this. Mx is a much more involved surgery, longer recovery, longer pain, potential lifelong adverse effects (lymphedema, pain etc) so I'd be cautious - but otoh, when you know it's the right decision, you'll know.

hugs

BrinkOfEternity

A friend of mine who had DCIS did BMX and found additional DCIS sites not found in imaging. In her case mastectomy was the right decision because lumpectomy would have missed the other DCIS.

I chose UMX because they found 2 tumors in my right breast through imaging.

Have you done genetic testing? I would have done BMX if I were BRCA positive.

NotVeryBrave

You can never really make the wrong choice if you choose what's right for you - right now with the information that you have. Make a list of pro's and con's and what's most important to you.

Have you had an MRI? Did they give you an estimated size for the DCIS? I'm sorry that you're having to make this decision - especially so soon after another BC treatment.

jessie123

I know how you feel --- a couple of months ago when I was diagnosed I thought that I wanted a BMX. Then later I thought for sure that I wanted a lumpectomy because some one said to start small and move up if you need to. Then after my MRI they found 7 cm of DCIS in the breast with the cancer. They didn't know about the DCIS until the MRI. The Oncologist is afraid with a lumpectomy they would have to take out too much tissue and may not get clean margins --- but it's my choice. So now do I do a BMX or just one breast. BMX means a 95% chance of no reoccurrence. However, the surgery is longer and I think will be more difficult to recuperate from. Now I'm beginning to want my last healthy breast to stay with me. AM I ever going to get used to seeing myself without a breast. There are too many decisions and it's almost cruel to make us make the decisions -- because the doctors can make no guarantees. I just keep thinking --- if it's safe go small and work up as needed. Good luck

Moderators

Jgargasz27, you've received some great advice here. Indeed, genetic counseling/testing could be helpful at this time, if you haven't already had it. Here is an article on mastectomy vs. Lumpectomy and on Prophylactic mastectomy. Getting a second opinion could also be useful in the decision-making. Hang in there, and best of luck with making this difficult decision.

Warmly,

The Mods

WC3

Personally I would probably get a mastectomy in your situation because I would think that my breasts had a cancer supression problem.

Jgargasz27

I had never heard of that. I will look into that!

Jgargasz27

I just did the blood work for the genetic testing. Thanks for your help!

Jgargasz27

Thank you to everyone that responded! I am 90% sure that I will get double mastectomy with reconstruction. I hope all of you are doing well!