Unilateral vs Bilateral

BlueFeltFedora

Hi all.

I was diagnosed 4/15 with IDC ER/PR+ HER2- in my left breast. I don't know grade or stage, but the lesion is small and right under my nipple. I'm currently awaiting results of genetic testing.

Many years ago, my GYN noticed a "thickening" in my right breast. Needle biopsy determined it was dense tissue and nothing to worry about.

Now I have a decision to make. Do I go for a unilateral or bilateral mastectomy with reconstruction? Both have pros and cons, and both are covered by insurance.

I'm not asking for anybody else to make my decision; I know I have to decide that for myself. What I'd like to know is if you had the same decision in your journey, which choice did you make and why? It's very possible your decision hinged on a factor I haven't considered, and I'd like to consider everything I can. This is a huge decision!

TIA for your input.

-L

MountainMia

For me, my decision hinged on the results of my genetic testing. If I had been gene positive, I was prepared to have a double mastectomy. However, I was gene negative so chose to have a lumpectomy with radiation. My tumor was 1.5cm on the left, upper outer quadrant. The surgery was minimal, as was the change to my breast. I had a pink scar about 2" long from the incision, and it's faded to the point that I don't see it anymore. (My surgery was a year ago, April 2019.) Recovery was very fast. Radiation was not difficult. Given the size and location of my tumor, I wouldn't have chosen a single mastectomy.

Good luck with your decisions and treatment.

ARmom4

I chose a BMX. I wanted to eliminate the chance of recurrence as much as possible. Later, after surgery I learned I have an ATM gene mutation which raises the risk for bilateral breast cancer. So, I'm glad I did the double mx.

OCDAmy

I chose BMX because I have dense breasts and a mammogram 6 months earlier missed my cancer. I didn’t want to be constantly worried about the other breast. It’s a hard decision but I’m glad I did it. Best of luck with your decision.

ajminn3

My mass was almost 8cm (DCIS) and a lumpectomy would have been too disfiguring. I was going to do unilateral and consider some kind of reconstruction on the other side to “match” overtime, but ultimately I decided to go with the BMX and immediate reconstruction with implants. I had never had surgery and didn’t feel I’d likely chose to go back for more procedures if I could avoid it. I also have 3 kids under 6 and again, didn’t see myself returning for more of an elective procedure in the next few years. Another piece for me was that when it comes time to eventually replace my implants I’d be on the same “schedule” for replacement. Overall I am happy with my decision so far and was fortunate to have a relatively easy recovery.

cjm2183

I struggled hard with this decision but leaned towards unilateral because I'm young, no genetic risk, no kids, early stage, and just not emotionally ready to lose both breasts yet. Covid also helped make the decision for me as my hospital was not doing DMX in April.

I had surgery in April and VERY happy with my decision to do unilateral so far. Biggest concern was the cosmetic outcome would look uneven with one reconstructed boob, but I'm not even done with reconstruction yet (still tissue expanders) and it looks great, very even, surgeons hid the incision very well and saved my areola so I don't really notice the missing nipple.

I am small-chested so that makes it easier. I'm so grateful to have found a very highly regarded team that emphasizes cosmetic outcomes, and use created an incision that wasn't the most surgically straightforward to improve symmetry. I'm open to doing the second in the future depending how I feel. I will be on ongoing hormone treatment so my team thinks the risk of recurrence in the other side is low.