Unilateral or Bilateral--must choose soon
Hi,
I am 43 and was recently diagnosed with DCIS in one breast. The mass is on the larger side and my breasts are on the smaller side, so the docs have recommended a mastectomy. I've decided not to reconstruct (at least not at this time). I have no family history and tested negative for the BRCA 1 and BRCA 2 gene mutations. My anxiety about cancer appearing in the healthy breast is low, but I'm considering having a bilateral mastectomy because it seems "practical". I can go flat and/or use breast forms at will.
I would love to hear from anyone who has reflections on having a bilateral or unilateral from a practical, everyday living point of view. What are the pros and cons? Are you glad you went with the decision you did?
Thanks for your input! I hope this next year bring better health to us all!
Comments
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Moni2014-
First off, we want to welcome you to our community here at BCO. We hope you find to be a place of support and encouragement.
We're sure some of our members will be along to answer your questions and offer insight, but in the meantime, you may want to spend some time in our surgery forums. You'll find lots of good info there, and be able to connect with other members: https://community.breastcancer.org/forum/91. We also have a forum dedicated to our members who've chosen to forgo reconstruction like yourself: https://community.breastcancer.org/forum/82.
Please let us know if we can be of any assistance!
The Mods
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Hello Moni, so sorry you have had to join us here, but very glad that you found us!
I am considerably older at 61, but I decided to have a Unilateral Mx and SNB with no reconstruction, when I received my Dx.
For me, I couldn't in good conscience remove my other unaffected breast, even though, I am a "D" cup on that side. I have not had any regrets about my decisions and have settled into wearing a breast form, most of the time, but have the odd times, that I will go half flat. I have collected a lot of clothing and forms, which suit my every need and I don't find dressing difficult at all. I am pretty active, out and about all the time.
There will be others who will come and share their reasons for their decisions. The one thing I would say to you is, make sure that the decision you settle on, is your decision, not something someone else "thinks" is right for you. It is one of the biggest decisions of your life, don't be swayed by what others think. Unless they have been in this situation, no one actually "knows" what they will do.
All the best, let us know how you get on!
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Hi Moni: I too am older than you at 55 years of age, but not as old as Ariom
It is ok as Ariom and I are friends. I too had a unilateral mx and due to reasons that I cannot explain, I did not even consider having a bilateral mx, nor reconstruction. My BS asked me if I would like to think over my instant decision, to which I replied "no" and have never regretted my decision. I wanted the least amount of surgery possible. Like you Moni, my DCIS was large (5 cm) and my breasts small. My remaining breast is very small and I feel quite matched even without reconstruction. I am not certain that even if there was a great difference in size it would have mattered in the least. I have embraced my new body, as have my partner and all my close friends and family. I still feel sexy and feminine. I am sharing my experience, not to influence you in any way as you have to make the best decision for you (as Ariom stated), but to give you one perspective. All the best in whatever decision you make. hugs
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Hi Moni, Although I didnt have a MX, I have thought long and hard about this, especially last year when I had a suspicious spot (which turned out to be nothing). If I ever have another BC it will be bilateral MX with no reconstruction....i think... First, with a uni you still have to worry about getting BC in the other breast, with bilateral you do not (not much anyway). And I would not want to take Tamox to protect the other breast. Also, it would be nice (a new kind of freedom) to not ever have to wear an exercise bra or worry about jiggling when I go jogging, jump up and down, etc. Also, It seems like it would be easier to get a symmetrical look when using prosthetics, whether big or small, with a BMX. I think i could handle either being flat, or having a restored look, but I would have difficulty going 'natural' with only one breast.
The one huge drawback I see for having a BMX over a uni is the pain during recovery and possible phantom pains later on. Recovery would certainly be a lot easier if you had only one side to worry about. In the ideal world they would do one side first, then after recovery do the second, but I am not sure if they (insurance) sees it that way.
Like others have said, it is a very personal decision. What is right for others may not necessarily feel right for you. You will be beautiful whichever route you choose.
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It is OK to hold off on the decision on the prophylactic mastectomy. You could have a unilateral now and see how it goes. If it does not feel right you can go back later for the second
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Please think about the sexual issues of having no nipples. Too often this is not discussed. The loss for me has been immense.
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I made the BMX decision because whatever treatment and reconstruction I was in for, I didn't want to do it twice. Turns out very early stage cancer was detected in my opposite breast so for me, it was the right decision. The only regret for me is doing reconstruction. It's been an awful and very painful experience. Something I wish I never started but who ever knows until they go through it. I am hoping it all ends within the next few weeks. Good luck to you.
Amy
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I had a unilateral mastectomy. At the time I couldn't cope with removing a perfectly healthy breast. I also figured I could always change my mind later; not so if I chose bilateral.
It's been over 4 years since my mastectomy. I have nursed 2 children with my good breast, and that alone has made my decision worth it.
However, I will most likely have a prophy mastectomy later this year. I am a natural DD cup size so being flat on one side has been very noticeable, and kind annoying to manage. Add in the anxiety of my annual mammos on the good side (plus a cancer scare last month) and I am looking forward to getting the other side done.
Oh, also, I am reconstructed with a silicone implant and didn't have any problems with the surgeries or recovery.
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I agree with the individuals who suggested getting an MRI before making your decision. I had ILC in the left breast when my doctor suggested an MRI. The MRI found DCIS in my right breast. Therefore I ended up with a bilateral mastectomy. The cancer on the right side would not have been found without the MRI.
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