Plz help! -single or double mastectomy?

Cat, Dr. Jew is one of the best in the business.  Whatever you decide you are in good hands. 

I go along with "less verbage". I knew from the minute the mammogram tech said that the Dr. wanted another angle that they had found something and I was correct. At that exact moment I told myself if it was cancer, I'm doing a double mastectomy. Within 5 days I had a double, no rebuilding, and was home recuperating. For me it was a breeze. Suffering from several chronic illnesses has made me realize I need to cut my losses any way I can. No pun intended. I couldn't be more comfortable with my decision or the course of my life one year later. Good luck!

Catlady44: For me I had the same choice you did. My first surgeon was all for the lumpectomy and radiation. My first response was to remove both breasts not do reconstruction. I have a lot of health issues and don't want to be in worry mode for the rest of my life about getting cancer in my breasts again. I saw a second BS who suggested mx would be a better choise to avoid the radiation since I have heart and lung issues. After gathering all the data I have decided on dmx with immediate reconstruction. This will be performed on May 18. It's scarry, but I know for me if not gettting the dmx I would be a basket case of worry the rest of my life.

I wanted a double mastectomy but my surgeon talked me into doing one at a time, due to some other health issues. I had the first surgery 3/6 and have a mastectomy on the "good" breast scheduled for 5/14.

One surgeon says there is a 2% risk of cancer in the other breast; another insists on MRI or sentinal node biopsy because once the breast is gone, there is no way to find the sentinal nodes. I would prefer an MRI to make sure the "good" breast is really healthy, especially since biopsy of the cancerous breast showed some things that did not show up on mammogram.

Also, if I do hormonals for 3 weeks before surgery, how much will that impact pathology on that breast (and nodes)?

My Story, I look back and I can't believe it's real.

 1996- twin sister had ER+ bc with a mx. When I heard ER+, I said we had to get to work and have those puppies out(oophs)--Total hyst and oophs. Wasn't the treatment at the time. But I had been reading. My sense of it was that the total story wasn't in yet. Approached a gyn, he went along with it. We kept hidden my twins story. He went out of town. Insurance asked for more info. Secretary sent it. Cat was out of the bag. Insurance denied surgery coverage-----I intervened and said "My doc has recommended that I have a total hyst and oophorectomy on Wednesday. If you don't approve it and I end up with estrogen + BC your responsible. It was approved the next day. 

2008 I had considered a prophy BMX since 1996. Thought hard since 2005 and talked each year with PCP. After getting a new job, I decided to pursue a prophy. I made an appointment. Before the appt. I was on the home health job. I was sitting in my car. My flipping clipboard --flipped closed on my left nipple and the three inch ring binder fell on top of it. OUCH---Yikes.  This became important when I talked to the MO about a prophy. He said it was going to be hard to get approved. The nipple still hurt. He said GREAT we can use that. He wrote it up as a problem. Mammo was ordered. Mammo in August 2008--NED(still have the letter).

September had a fall on the job off a 2 inch step. Right ankle turned> left ankle turne--I was airborne>>>>fell left>>>left side of head(very important to story)>>left face/jaw>>all cervicals crunched to the right>>left shoulder& maybe boob>>left hip>>went forward on wrists>>knees hit>> rolled on right shoulder>>landed on left hip. Got up and walked----When I made the incident report out. At the end after reviewing it I said "Elbows okay"........I never declared workers comp. Imagine.

Dec 8th, had the Breast MRI, I was late in getting the exam b/c the August mammo was negative. Mo lied( from the june exam) and said he felt something behind the nipple and I had pain from the nipple injury(true). That got the insurance coverage. Two days later I got the call." Okay I've been putting it off Got it done" He says" There's something there' I said Dammit That's exactly why I came to you in the first place. Damn it. I never wanted to get this call.  Then I had to without a show of emotion go in an admit a patient to home health.

Jan 20th---Mri of brain--b/c of headaches, --trumped up confusion---basically head wasn't right since fall in sept.

Jan23rd----11:55am---woman calls "Dr. Levine want's you to know that you have a brain tumor". Me "Huh, What kind?--I don't know__-where--I don't know---what does this mean---i don't know. Me " Well I'm have a stereotactic breast bx at 1pm that we know is going to be positive and you are telling me without any verifiying information that I have a brain tumor" Poor gal, silence. My response was " Well when the shit hit's the fan"

Bx--reviewed films with doc----pointed out landmarks asked a few questions-----said that tells me it's very aggressive-----his response was yes.

stopped at bosses office told them---said we figured out how my Dh could drive me on my homecare calls. I had gotten him approved as an official volunteer for the organization months previously. BUT the boss said " We have to have clearance thatyou are safe to work with patients, I have to relieve from duty"

In the space of < 4 hours, I was told I had a brain tumor, Breast cancer, and lost my career.

Catlady & Hopeful, Oh ladies I got it all out........ Thank you. I miss my Greg the most

catlady hi, I am also her2 positive stage 2, younger than most, and my tumor was 3.5 cm when diagnosed. It was too big for a lumpectomy then but chemo shrank it so I got a lumpectomy and radiation. I too have family history, three aunts with BC and my mom did prophylactic bmx years ago. I tested negative for the genes they have identified so far. I did not even think twice once lumpectomy was an option after chemo. If mastectomy was needed, I would have done just an mx. You cannot get back what you take out, and right now emotions may influence judgment. So, my humble opinion is mx now and if you feel the same way about it later, and are comfortable with how you feel with your mx breast then you can always do the second one later. I read somewhere that they can achieve symmetry with mx as well if the doctor is good. BC can recur locally even if you get bmx, and the bmx has no bearing on distance recurrence which is the real scary part of BC.

Cat and Hopeful--Hugs---it helped, sorry I dropped out I took a break.

Wind and Chloe---the worry is the worst.. when The BS asked if I wanted one or both. I said "Off with them, They are nothing , but time bombs!"

Felt like the Queen from Alice in Wonderland. "Off with them". Only regret is--- I wish I'd had a better PS.

I was diagnosed Stage 3C - right breast only but also with lymph node involvement. Finished 6 rounds of neoadjuvant chemo (manageable but not fun) end of March. Scans showed good response to treatment but not complete resolution. Have dense breast tissue so decided to be aggressive and had double MX with lymph node removal and reconstruction started on April 20. Ended up being very good decision. Pathology on left showed microscopic cancer not detected on any previous scans. Four pathologists reviewed tissue and reached diagnosis of stage 1. Start radiation next week with oral chemo. And still doing Herceptin infusion through December. Will finish reconstruction after radiation. Bottom line, research, talk to as many people as you want and do what feels right and best for you.

Hang in there. WE CAN DO THIS! Best to you

Catlady, I chose a UMX. I am a D cup, so my missing breast is noticeable when I don't wear anything in my empty bra cup. I've made do with one breast and a foob for so long that it's just part of my life.

I had a chest wall recurrence a few years ago, right at my mastectomy site. That moved me from stage 0 to stage III. They had to take out a chunk from my pectoral muscle. I call it my "upgrade surgery".

My surgeon occasionally mentions doing a prophylactic mastectomy if I wanted. She only recommends it as the standard of care if the patient has lobular bc (I don't), but she'll do it for others if they insist.

I've never really been tempted. Partly, to be blunt about it, is that they've already cut off enough of me for this damn disease (left leg for bone cancer as a teen, and now my left breast and part of my chest wall). If I had cancer on the other side, of course it would have to go, but not until then.

The other part is the loss of sexual sensation from my nipple. That's what I miss most from losing my breast. I find it somewhat more difficult to get things started, and also somewhat more difficult to reach my orgasm. I'd be really sorry if I lost the other one as well. If recon would give me that sensation back, I’d have it in a shot, but of course, it doesn’t.

Anyway, that's what works for me. I wish you the best in this tough decision, and in all of your bc journey.