One breast or two?

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Elizabeth1959
Elizabeth1959 Member Posts: 346
edited June 2014 in Stage III Breast Cancer

Yesterday I had a consultation for diep reconstruction.  The surgeon recommended mastectomy and reconstruction for non BC breast.  She says that most of abdominal fat will end up in trash.  If the breast cancer recurs, reconstruction options would be less ideal.  Also, recovery would be essentially the same  i.e. time off work.  My breast cancer didn't image well and was missed for many years on mammogram.  Now I am post-menopausal and on AI's so I assume my remaining breast is less dense and would image better.  I am BRCA negative.  IDC and estrogen positive.  I assume my risk of second breast CA is much lower because I am on an AI. 

Anyone else in my shoes?  How did you make a decision.  Also, if I have bilateral diep would I have any yearly imaging i.e. breast MRI?   I understand breast cancer doesn't recur in abdominal fat but what about any small island of residual breast tissue?

My understanding is there is no survival benefit for me to have bilateral mastectomy.  I understand my risk of breast cancer in remaining breast is higher than in most women but how high?  My oncotype dx score was low.  If I didn't have bilateral diep and I had a new breast cancer I would be very upset, but I still wonder if this is fear talking or is this a good decision.

I am really curious what you (my fellow breast cancer sisters) have to say.

Elizabeth

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited October 2012

    Hi, Elizabeth.  I'll need to wait a while to let the radiated skin settle down, so my DIEP will probably be next spring sometime.  I am absolutely having the remaining breast removed and reconstructed at that time.  Here's why.

    The surgeon will get better symmetry between both breasts, but first and foremost, I can stop worrying about something sneaking up on me in my remaining breast.

    Like you, my tumor didn't image on mammogram and I had an "all clear" mammo in June 2011.  In September 2011 I found my own cancer, which turned out to be small but node-positive. 

    Yes, fear might be a factor, but I don't care.  I don't want to spend the rest of my life feeling my remaining breast and axilla for tiny but deadly lumps. 

    Good luck. This is a big decision, and I know you'll do what's right for you.

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited October 2012

    I don't think I would take this option if offered it. I think it is easier for the plastic surgeon to do it this way and that is why they are suggesting it (easier to make the match). I would'nt do it because I wouldn't want to sacrifice the feeling of the only breast I have left.  I feel normal on this side. No numbness, no nerve damage and no lymphedema.  And what if the breast fails?  Then you will still not have good options for that side. Yes, if it comes back on your good side, you won't have the option of taking fat from the belly to make a breast. But only if the cancer is soo advanced you would need a mastectomy.  You could get an implant, and then have an implant on the other side added to look more matched?  I would think that with close screening, a breast cancer will be found in the other breast early and will be dealt with via a lumpectomy.  That is how I see it for me. I hope this helps.  I am also considering the DIEP two years out here. I hope this helps.  What are your worries regarding this decision?

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  • Elizabeth1959
    Elizabeth1959 Member Posts: 346
    edited October 2012

    It's hard to get excited about more surgery when I feel good and don't have any limitations on my stamina or activities.  I worry that I'll go through all the surgery and the boob will still look crummy.

    The thing I'm excited about is doctor thinks diep will have positive effect on my lymphedema. 

    I have similiar feelings about having my one breast.  I had a breast reduction and nipple is numb, but sensation of skin is normal.  I don't look forward to even more numbness and more scars and no nipple.

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  • Kay_G
    Kay_G Member Posts: 3,345
    edited October 2012

    I had a uni mx with DIEP reconstruction. Just had nipple reconstruction, will be getting tattoos soon. I was really tempted to do both breasts so I wouldn't have to worry about recurrence, but the docs felt strongly that if i do get a recurrence, it will not be in the other breast, it will be in a distant part of the body. I am happy with what I did because of the sensation. I feel nothing at all in the other breast and have lymphedema in the other arm. Good luck with your decision.

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited October 2012

    I am curious as to how the DEIP will have a positive effect on the lymphedema?  I also have lymphedema.  I can relate to having trouble getting excited about a surgery when you feel good.  That is one reason I have put the surgery off.  It is soo major!!!

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  • jennyboog
    jennyboog Member Posts: 1,322
    edited October 2012

    I have not done any recon and had a BMX.  I am BRCA+ and was told its easier to recreate 2 breast that match as oppose to trying to match recon to 1.  It just seemed right to do them both to me being BRCA+ helped though.  I also don't have to where a prosth. if I don't want to and don't most of the time.  Good luck.

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  • Elizabeth1959
    Elizabeth1959 Member Posts: 346
    edited October 2012

    I appreciate everyone who took the time to answer. I'm still uncertain as to when I even want to consider such a big surgery, but your insights were helpful.



    Elizabeth

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