MIDDLE-AGED WOMEN 40-60ish

I am planning on having reconstruction and I thought the same way....esp for my health. If they take one, they might as well take them both. I want the least chance of doing this again! If I can get hubby behind me then I will find another surgeon if I have to. By the first of the year (when i have surgery) I will have private and social security disability insurance so it should be good...thanks for helping me validate my feelings on this!

Insurance should cover a double even if you only have cancer in one, it's done all the time.

Justamy, the first surgeon I saw said the same thing. I got another surgeon.

The argument is that your chance of developing contra-lateral is tiny, and so a BMX does not improve survival, statistically speaking. I am sure that is true. This numbers argument does not take into account, however, peace of mind, symmetry, QOL (no 3-monthly checks of the "good" breast) etc.

It is a big decision, and the docs are right that purely medically speaking, there is no reason to do it. But if you have other good reasons to do it, find yourself another doctor.

Calcium deposits on their own are not signs of cancer, it's when they start to multiply and group together right? Having fibroid cystic breasts can include calcium deposits that never turn into anything - that's what I've been told anyway by docs over the years.

justamy, my right "healthy" breast turned out to have ADHP which IS the first stage of cancer! It did not show on MRI or mammogram, but would have shown up within months of my surgery. I am so glad I only had ONE surgery to recover from. I did NOT have to have lymph nodes taken from my "good" side, so risk of LE was MUCH lower than if there was a suspicion of cancer! My body has learned to make breast cancer and I have Isolated Tumour Cells (ITCs) circulating in my blood and tissue. It would have developed in time in my "good" breast anyway. I have heard time and time again of women getting it in their left-over breast! Now you have to have yet another reconstruction experience (surgery), as well, as that is your choice at this time. I know of women that were told to wait 6 months to get the other one off. Why????? The surgeon said it would be "easier" to deal with one at a time! Are you kidding me? I NEVER would have gone through it twice and I WANTED them both off. I was so glad I did it at the same time. As well, my surgeon only got paid for one surgery....as well as OR time, anaesthesiologist, OR nurses, hospital, etc, etc, etc, etc, etc......get it??

Justamy- You are wise to completely evaluate your options and make the best decision for you.  After I was diagnosed and told I needed to have a mast I immediately thought that I would want a bi-lateral.  But discovering that cancer in one breast does not automatically mean cancer later in the other (only slightly increased odds) helped in my decision to wait for BRCA test results.  If positive, I was going to have a bilateral.  My result was negative, and my BS strongly encouraged me to have a uni, for reasons similar to what you were advised.

I am so glad I did.  I still have feeling in one breast, which really adds to my enjoyment of time with hubby between the sheets.  My chest is very symmetrical (nude and clothed) because I had a reduction and lift on my right side when an implant was placed in my left.  Not all results are great with any surgery, and I have two girlfriends who had bmxs and both ended up with one side that was acceptable and one that was problematic.  A bmx also will likely require a greater recuperation period with lots of help needed.  If you weigh all of the particulars to your case, I'm sure you'll make the best decision for you.  And once you decide, it will put your mind at ease.

staynsane, all good points. It is a difficult decision with many factors entering into it.

As for symmetry, I meant in case you do not reconstruct. 

some kind of microcalcifications are completely benign, such as 'popcorn' kind, or vascular m.c.'s, funnily enough, the vascular kind can be an indicator of heart disease. It is the clustered linear or branching kind that are most concerning for early disease process. i did a lumpy, cause i had no idea that the internal scar tissue would be so enormous. i don't like it. if i ever have another problem, off with, for me, no recon. i don't want to mess with my muscles. i still miss my breasts. they were nice and even. apparently i had a pretty good surgeon, as i do still have nip sensation, she is just a little pulled to one side.

justamy, you do have time to figure out whats right for you. just one question. is your surgeon a breast surgeon, or a general surgeon? 

My surgeon is a general surgeon. The only "breast surgeons" in this area are plastic surgeons. They do the recon.

My lumpectomy was done by a general surgeon.  If I knew then what I knew now, I would have had a BMX & I would have found a breast surgeon.  That's me.

My surgery will be in Springfield MO which is a fairly large city (3rd largest in MO). If I were to travel it would be at least 4 hours to St. Loius or Kansas City. This would be difficult for me.  The breast clinic here is one of the best in the nation and my Oncologist was the one who set me up with the surgeon. He has been doing surgery since 1974. I will inquire about the number he has done. I know it is a lot because he was describing some to me. I will do my homework. I never even thought about there being a specific breast surgeon until now...Thanks for your concern and info.

Thanks elimar. I also found he does most of the breast surgeries in Springfield which is a city of 162,900 people that also serves much of SW MO. I think I am good here as far as his credentials.... Now just the prophylactic thing.

He is over 60 I would say. The good thing is that he also does not take lymph glands unless the few he tests are cancerous...many older docs still do that regardless.

KatheC: you didn't scare me but you did make me check out my surgeons credentials which is a good thing. I need to know that the guy removing my breasts is qualified to do the job. I didn't know what to check out or about my right to a Bmx if I feel it's necessary. You all are amazing women and we will all get through this together!

justamy, I have to weigh in here. My breast surgeon was a female over the age of 60. In fact I had to wait a couple of extra weeks for surgery because she was recovering from a hip replacement! I was given the choice of having one side done or both. There was nothing found on the right side in the mammo, MRI, or the needle guided biopsy but I still opted to have the BMX and I am grateful that I did. My insurance never even questioned it and I don't think by law they can dictate if you do one or both. Turns out from the pathology done on the right, non cancerous side, that had I not had a BMX I would have eventually needed the other side done. As the surgeon put it, "is was a very busy breast". That right there validated my decision. Please get a second opinion. As far as the husband goes I am sure he is just as much in shock as you are and will come to his senses and support whatever decision you make!