mastectomy recommended

It's up to you about a bilateral. In terms of reconstruction women do seem to feel they have better symmetry with bilateral reconstruction.

Maybe you should talk to a PS and see what your options are. 

Debwa100-

I was in your same place last December.  I understand how overwhelming it can be to try and figure out what the right thing is to do.  So many options with treatment, reconstruction, etc and not every doctor tells you the same thing.  Try to do as much research as possible, ask a lot of questions at every appointment and find a surgeon you are very comfortable with.

No one can tell you what the right thing is to do.  For me, I didn't want to have to worry every time I had a mammogram for the next 50 years.  I chose skin-saving, nipple-saving bilateral mastectomy.  It meant no chemo, no radiation, no Tamoxifen and better reconstruction options.  I am going through reconstruction now and when I am done my surgeon said you won't even be able to tell I had a mastectomy but I get the peace of mind knowing I have decreased my risk considerably.  Without the mastectomy I just felt the gamble was too high for me.  Whatever you choose, I wish you well. 

i was in the same exact5 situation that u r in, now. a year ago.i knew myself, and i knew i had only "one shot " in me.my surgeon wanted to start with peices of the cancer breast.more tests he did, worse things looked. i never..thought there would come a day that i would beg someone to cut off both my breasts!!that's exactly what i did, tho. i knew if the "good" one went bad, i wouldn't have nerve left over 2 face it again.after surgery, we found the ca.breast had involvement 2 the chest wall;he had to do a modified radical there, and there was a and i quote "very suspicious amount of questionable tissue " in the "good breast" so, i had hit a home run!it isn't an easy decision 2 make; let me tell u the part i think is the best..they will always match, if you do both!!i didnt have reconstruction. my general health was too bad 4 that..i hope its an option 4 u if u want it...but, i get to choose what size,what shape etc. i want my breasts 2 be everyday, anfd, they always match, no chance of them trying to kill me! i'll pray ur gut or God will give u a little "nudge" in the right direction 4 u.do what "feels" best 4 u.know it's a great loss, and don't be afraid to grieve, and cry. a yr. later i am still sad that the "girls" had 2 go, and really relieved they r not there diseased anymore. I'll be praying 4 u, any direction u go.   light and love, 3jaysmom

There are lots of discussions going on right now in other threads about the single vs. bilateral decision so you may want to check some of those out.

To your comment about not wanting two different breasts, while it's true that if you have reconstruction on one side and a natural breast on the other side that there will be differences, the degree of difference depends on the type of reconstruction you choose - the difference may be hardly noticeable if you choose to have a DIEP or GAP.  The difference will be greatest with an implant, and while certainly there will be a difference in movement, but from an appearance standpoint, many of us have very good symmetry even though we've had single mastectomies with implant reconstruction.  But, there is no guarantee.  By the same token, there is no guarantee that you will get symmetry even if you have both breasts reconstructed at the same time - my plastic surgeon warned me about that.  There are so many variables that are unique to each side that it's very possible that you could end up with one breast seeming to be a bit larger, or each breast falling differently and appearing to be uneven, etc..  Or, one side might heal perfectly and the other side doesn't.  It's not unusual to need revisions after reconstruction surgery and those who have bilaterals have double the chance that this will be necessary.

Here are some of the other current or recent discussions on this topic, where you'll get lots of dfferent perspectives and experiences, good and bad:

http://community.breastcancer.org/forum/91/topic/751596?page=1#idx_14  

http://community.breastcancer.org/forum/91/topic/750039?page=1#post_1765906

http://community.breastcancer.org/forum/91/topic/751514?page=1#idx_12

http://community.breastcancer.org/forum/91/topic/750454?page=2#idx_35

http://community.breastcancer.org/forum/44/topic/749080?page=1

Edited to try to get the links to work.