Keeping One Breast as a Diagnostic Tool?

I've been wondering the same thing myself.  I opted to have a bilat and then realized later that since my chance of reoccurence was high wouldn't it be better to have it occur in a body part that could easily be removed.

I've come close to posting this question myself, but felt too silly to do so.

I asked the same question to my oncologist who said, a bilateral mastectomy does not increase your chance of mets. 

Actually I have heard the same thing from a friend who works at a bc center. She feels cancer that ended up in the chest wall of a mast patient might have gone into the breast instead. That is purely anecdotal though.

I don't think you can tell it to turn right though.

I will add she is not a doctor or nurse but a patient representative, so take that with as many grains of salt as you wish.

I think it depends on your situation.  If you are young, you may have 40% risk of bc in "good" breast over your lifetime.

 This risk can be reduced by hormone blockers if the cancer you have had happened to be ER+.

My best understanding is that people who have had breast cancer are at higher risk of having more breast cancer and other (especially "female" type) cancers.

This is a difficult area.  Breast cancer is / can be both a systemic and a local disease.

Generally, a local recurrance is a harbinger of more disease. Bad joo joo....more likely to accompany distant disease than other / previous cancer.

Of course, no one actually knows the correct answer.  Speaking personally, I would be disinclined to keep a breast as a "diagnostic" tool. 

There is no evidence that having a boobie prevents distant mets.  I'd sooner read tea leaves.

tl 

LJMorris - I sure hope your onc is right. I wanted bilateral but my insurance company would not pay for the healthy side. I really do not like insurance companies dictating our care and choices.

I asked my docs if I should get rid of both when it was time for my mastectomy.  All my docs said no.  I had IDC.  If I had ILC I would have had both removed.  I remember asking one of my doctors if I should get rid of the "good" breast and I was told that breast cancer happening in the good breast was not my biggest risk and that I was more likely to get mets.  Another one of my docs said, "well, you might get brain cancer someday but we don't cut off your head."  Lastly, one of my docs said, "We only get rid of a breast for risk reduction, not anxiety reduction." 

So glad I stumbled on this thread!  I thought I was weird for feeling *less* peace of mind after my unilateral mastectomy (turns out I wasn't a candidate for breast-conserving surgery), when so many other women choose mx precisely because it gives them more peace of mind.  My theory, entirely non-evidence based, was that the breast would give a local recurrence somewhere to go other than the chest wall.  Sort of like a decoy, as it were. 

 I've got a great relationship with my doctors, but I still felt too silly about this thought to ask any of them about it.  It was my private, middle-of-the-night worry.  At least now I know that others have had similar thoughts. 

(And I love cookiegal's comment: "I don't think you can tell it to turn right."  Too, too true.  I'll definitely keep that in mind.)

Linda

Am I wrong in thinking that if you later get BC in the other breast, they don't consider it a recurrence, but a new CA? Seems I read that.

I am a young woman diagnosed with BC. You all already know that....

I think I am one of the minority of young woman to NOT opt for a bilateral mastectomy. I asked all my docs, and they all said no. My surgeon said that same thing as caaclarks..." you could get cancer of the lung or brain but are we going to cut it off to try to prevent....no."

Iam though ER+, and have changed my lifestyle habits , I had good babits before I just need some fine tuning...all things that help reduce recurrence. Im also planning an ooph.

I  have thought If I was to remove the healthy breast and develop BC in it, it would probably be at the chest wall because most of the tissue had been removed . VS NOT removing the tissue and having a "new primary" caught earlier and easier to treat.

This is MY rationing. Is it right? Who knows. But I feel better in my decision. I am getting a lift/reduction on my healthy breast to match my implant and my PS assures me that I will be happy. I have also seen pics of other survivors who have had his work.

I must add though, if I was TN or obviously had one of the BRCA genes, I would be doing a bilateral.

blondie,

My PS says that he will do an "anchor" incision. So they will  make the incision around the nipple and then straight down. Best to google so you get a better idea...lol.

So scaring is less noticeable, he will remove breast tissue and then lift the nipple higher.

I was advised by my surgeon that my chances of survival would not be different if I had partial mx with radio over full or bi lateral MX and that if the cancer comes back, which is likely under my DX, I have breast tissue for it to go into rather than the chest wall which would be a lot harder to deal with. I'm checked every 12 weeks so am happy that I went with him and feel secure in the knowledge that I have tried to give my self the best chance and hopefully more time even if I lose a boob/boobs a bits at a time.

I was told the opposite actually.  I was told the tamoxifen is taken to reduce recurrance such as mets from the original cancer. I was told the bmx would reduce a new cancer by 30% over thirty years.  Lump+rads or bmx have a five percentish difference in recurrance however a lump +rads has a 1% increase per year for a new bc if you've already had bc.  Your estrogen receptors are blocked by tamoxifen so the (potential) lingering cancerous cells cannot attach to tamoxifen or estrogen and spread thru your system.

A new cancer and a recurrance are very different animals and should be treated as such.