What a decision!!!!

I had a single mastectomy and 4 years out, I'm still very happy with my decision.

I had implant reconstruction.  Are my breasts a perfect match?  No, but then they weren't to begin with. In fact they are actually better matched in size now than they were originally, although the feel and movement is very different.  But one thing that I discovered is that with a mastectomy comes all sorts of possible side effects and I am so glad that I only have to deal with this on one side.  The phantom itching, numbness, the muscle aches, the occasional feeling of tightness across my chest....

For me what my decision came down to was my risk level to get BC again.  After having had all sorts of breast problems all my life (I had my first excisional biopsy at 16) and with a bit of a history of breast cancer in my family (my mother and one of her sisters), I expected my risk level to be about 40%.  When my oncologist told me that it was closer to 20%, I was delighted.  Since the average woman has a risk of 12.5%, I figured that 20% was bad at all.  Another way to look at it is annual risk, and my average annual risk is only about 0.5%.  So for me, those are risk numbers that I can quite comfortably live with and that made the decision to have a single mastectomy an easy one.  The other factor for me was that I really didn't want to lose all the feeling and sensation on both sides - I really wanted to keep one natural breast. 

Having had a single mastectomy only, I will be honest and say that for the first couple of years afterwards, I started to worry weeks (months even) in advance of my annual mammo and MRI.  But the amount that I would worry got a bit smaller each time and after 2 1/2 years, I realized that my worry level was back to what it had been prior to my diagnosis.  In fact if anything, it's less now, because I've been through breast cancer and I know what to expect. 

One question of course is whether I would feel differently if I am diagnosed with BC again.  I'm pretty sure the answer will be "no", I'll still know that I made the right decision (for me).  I made the decision based on the best info I had and I don't let myself look back.  Whatever you decide to do, that's one of the most important things to remember - make your decision and move on from there, don't second guess it because it's easy to drive yourself nuts.

Hello, I had a unilat mast - the thought of a bilat was just too confronting for me, although my surgeon was happy to do whatever I asked him too.  I had an immediate recon - LD flap with a small implant instead of expander, and everyone I have showed is *amazed* at how similar to the other breast it looks (Oh yeah, except the huge great scar & no nipple LOL).  The projection is different on the recon side but you can't tell by looking at me from the front, I see it more when I look down.  But shape and size it's remarkably the same.  It still feels weird (op was 2 months ago) but it seems to be getting softer and settling and the projection is improving too. The downside is it's MUCH bigger surg than just having an expander/implant done, and I sometimes wonder how long it will be before my back/armpit feel "normal" again...it's early days yet.

Re recurrence - I had a lumpy/'strange' spot for a long time before I was diagnosed so in my mind this problem started a long time ago and with plenty of warning which was unfortunately disregarded by my general practitioner of the time. That won't ever happen again. 

Debbie, I'm sorry that you are not happy with your decision but I do want to assure you that I don't think that you are having more of a problem with it than most.  Single mastectomy or a bilateral, reconstruction or not, it takes many of us quite a while to get used to our new look and our new bodies.  You had your old body since your breasts developed as a teenager; it's not surprising that after only a year, you are still not used to your new body and still frustrated by the changes.  It takes time.

As for clothing and matching, because my natural and my reconstructed breasts fall a bit differently, it took me a while to find bras that work well for me and to figure out what clothes work best to mask any differences.  I also started to stare obsessively at other women's breasts to see if they looked even - and that's when I realized that most women don't.  So it took a while (probably close to two years in my case) but eventually I figured out how to dress for my new figure and frankly, I stopped worrying so much about how I looked, realizing that nobody but me will notice if I'm a bit uneven.  If I'm uneven, I'll just look like everyone else!

The other thing to keep in mind - Cooltrainer, this is for you as well - is that having a bilateral doesn't guarantee symmetry, especially for those who have reconstruction.  Our breasts are not connected and our bodies are not symmetrical so even if the surgery is done on both sides at the same time, and even if you have a great plastic surgeon, there is no way to know if the results will be the same.  The structure of your chest might be different on each side, resulting in a different placement and look of each reconstructed breast.  The skin and muscle on one side might react differently than on the other side, resulting in a different shape and position of the breast.  One side might heal well and the other side might heal poorly (it could be either side; on this board there have been many cases where it's the prophylactic side that has problems).  I've seen lots of pictures of reconstruction; some women with single mastectomies have good symmetry and some women with bilaterals don't.  Most women, whether they have two natural breasts, one natural breast and one reconstructed breast or two reconstructed breasts, have some differences in appearance. 

So, while a bilateral might the right decision for lots of reasons, from what I've seen, symmetry shouldn't be one of those reasons because there is just no guarantee.  That's something else to keep in mind.

I chose BMX and had immediate diep recon.  I just did not want to ever deal with this again.  I am happy with my choice as they match very well.