bilateral vs unilateral mastectomy

Tina, this is a very personal decision. Many factors enter into that choice. They are different for each of us.

Though I only had DCIS, my oncologist recommended a bilateral mastectomy. The combination of grade 3, ER-/PR-/Her2+ with a cardiac history makes me a poor candidate for 'strong' chemo or Herceptin if I ever have a recurrence. Radiation with a history of systemic lupus isn't highly recommended, either. That left surgery. The only question was when. Waiting until trouble developed didn't appeal to me--but for some people, it's a choice they are comfortable making. I wanted to know I've given it my best shot. Good luck to you in this difficult decision.

I had a bilateral mastectomy because further testing after my initial diagnosis in my right breast, DCIS was found in my left breast as well. I had the choice of a lumpectomy in the LB, but my breast surgeon said there was no guarantee that it wouldn't recur as a later stage IDC. Although the MRI-guided breast biopsy on LB showed only a small area of DCIS, the surgical pathology report found multi-focal DCIS in the upper and lower outer quadrants. (The DCIS was ONLY picked up by MRI, not visible by mammogram or ultrasound.) 

I had my re-excision about 5 days ago. I now regret not doing the unilateral mastectomy. My PS said mastectomy was the way to go because of difficulty with recon later due to the radiation. I am only 37 and I do want to look good cosmetically (I am sure most people do at any age). For some reason, I chickened out.

I want to call my onc surgeon back and say let's go ahead with the mastectomy, I changed my mind. I am so indecisive, but feel like I made the wrong choice. My port has been placed, sentinel node was negative. Just waiting on path and will start chemo (TCH). I wonder if I can do the mast soon as possible after chemo (expanders).

So much stress over this. I am also really nervous about the side effects from chemo, the hair loss, weight gain, fatigue.  I have four young sons (6 and under) but I do have a lot of help around with family and friends. What does anyone think about going back for mastectomy now or waiting until chemo is done?

Hey Tina,

Thanks for yor reply. so great to have a site like this-people who truly can relate. No discharge from the other breast. Not yet anyway. I would kind of like to keep one natural breast with sensation and all, and just do the other for peace of mind and get me back to my normal size of a full C. Did you gain weight with chemo? I am hoping I won't, although that seems to be what the norm is from the posts here. I recently lost weight with tthe stress of the diagnosis (plus  I am going thru a divorce), so I thin right now. Were you able to function with the kids during chemo? How bad was it as far as being in bed, fatigue, etc.? So much at once. I almost want the margins to come back positive so I can go ahead and get this breast off and start with the reconstruction.

ok, my lumpectomy (re-excision) was not with clear margins. pretty much all the way around. They will need to go back and do the mastectomy to clear the DCIS. Question is, do I do this in 10 days and delay chemo 3-4 more weeks or start chemo next week? My onc said she would consider waiting if it was no more time than that, but may consider giving me a dose of tamoxiphen to decrease the hormones in my body so something is being done. My original surgery was November 19th (they got all the IDC out then). My stats were: 1.5 cm IDC, grade 3, ER+ PR+ Her 2 neu+. Lymph node 0/1 negative. i did have lymph and vascular component present. I am 37 yeras old. What would you guys do in regards to the surgery, now or after chemo is complete? I almost want to get it done and over with so I will just be dealing with the exchange surgery after chemo.