Bilateral Mastectomy vs. Tamoxifen

That's a tough decision, it seems that either way there will be some side effects. As far as recovering by the time the baby comes - you may not be back to your old self by that time but you can be there for emotional support.

WAY - You absolutely should be able to do all those things. I'm not clear if you are having recon or not. Either way you should ls be fine. I had pretty strong pecs and my one and only fill was rough. You could have your PS delay fills or go low and slow w the fills. It will be ok. The best feeling in the world was when I woke up from the Mx thinking I'd outran the beast. Three days later the path report proved otherwise but that made the PBM a very good thing

hi Whatayear,

Like you, I was a size 34A, with heterogeneously dense tissue, and diagnosed with ADH on St Patrick's Day. I pushed for an MRI, and was stunned to learn the ADH lesion was 2x larger than the mammogram revealed. They told me the MRI had more range than a mammogram, and this was further back near my chest wall where mammograms can't reach. That was my turning point. I underwent prophylactic bilateral nipple-sparing and skin sparing mastectomies with immediate DIEP Flap reconstruction on June 8, which was 7 weeks ago. I'm back to being my 34A, and couldn't be happier; my new breasts were made from cake, cookies and ice cream from a little belly I could never exercise away!

I am 51, and have spent the past 15 years feeling like a lab rat with mammogram call-backs, stereotactic biopsies, MRIs and ultrasounds, all with negative results. Once I learned I had ADH, I was ready to stop playing this game, as I did not want Tamoxifen to impact my quality of life. A significant lumpectomy with scar tissue on my already small, dense breast made no sense. The MRI was my nail in the coffin; in my case, insurance dictates i would wait another year for an MRI. We just proved what the mammogram missed on me, and none of this ever showed up in the past 3 years of mammograms.

The surgeons at Beth Israel agreed this was a smart decision in my case, once they listened to my rationale. To be fair, when I first indicated I wanted this, my surgeon said "you are 10 steps ahead of the game". But after I spelled out my last 15 years of "being in the game", and explained myself with facts similar to yours, she said " wow, you've really given this a lot of thought! I completely get it now!".

I had no surgical setbacks, no cancer was found through pathology, and I feel wonderful - emotionally and physically. I rollerbladed 16 miles on Saturday, and feel like the old me in my recovery journey. By 3 weeks I was walking outside quite a bit, and was gaining range of motion back. Best advice is to follow your heart and gut with your decision. I will say that quite a few friends shared with me that they would have done the same thing I did, especially given the reconstruction options available these days; many had disbelief you can get tummy tuck boobs now! Some also wished their loved ones would have taken this aggressive step too. To be honest, i expected pushback from friends with my decision. I was completely surprised how many of them said they too would make the same choice. Some even told me my decision made them rethink their position on mastectomies

At the end of the day, it is your decision how you want to live life.

Hi All. I was accidentally diagnosed with LCIS after undergoing what I thought would be a simple breast reduction/lift. Big shocker when my PS said pathology found abnormalities. Never expected to have breast issues as I have zero family history, had two children. No obvious risk factors. Just extremely dense breasts. I was totally shocked. Anyway, I saw two surgeons plus spoke with my GYN over the course of 6 months before deciding on PBMX. My risk was calculated at 40%. I was offered Tamox but didn't want to take it. Some do fine on it but I was worried about side effects. It was a huge decision but one made over time and with the love and support of my DH (who didn't want to worry about me for the rest of our lives!). After all was said and done, I knew I didn't want to face MRIs and mammos every 6 months for the rest of my life. I just turned 50 (today!) so seemed like a long journey of wondering and worrying if/when the next shoe would drop. And I knew I didn't want to wait for cancer and have to face chemo and rads. In many ways I felt I had the gift of prevention, which so many women don't.

Anyway, had my nipple sparing PBMX in May with tissue expanders. I'm almost done with expansion and hope to have my exchange in late August or early September. The surgery was hard but not awful and I had loved ones to help me during the first few weeks. I've been through a number of surgeries so I wasn't afraid per se and sort of knew what to expect in terms of prep and needing time off and staying on top of pain. Hardest part for me was emotional. Losing your breasts is not easy. I'm not gonna lie. I have my nipples but I hate and even mourn the fact that I have no sensation in them. I think I'll look fine (maybe even great if i'm lucky) when my PS is done with me but I am not happy to be numb. It's all a tradeoff and an intensely personal decision.

I do not for a minute regret my decision. My surgeon found LCIS all over both my breasts on pathology but no malignancy. This was a blessing. And he said we made the right decision because I was likely to eventually develop something worse.

My advice is to take your time, know that docs and oncs may have differing views (which can get very confusing) and then follow your heart. Ultimately only you can make this decision.

Hi Whatayear -- i ended up with bilat mastecomties -- one recommended by my team and one my decision. Before the recommendation, I was still considering going that route, and also took into consideration my current support system in place as well as my own health re: being able to recover. I can't think of anything else that you haven't listed on the mastectomy list.

re: recovery -- I had DIEP reconstruction -- was really lucky re: range of motion/pain -- at about 8 weeks, I was on the beach for a week in Punta Cana -- walking fine, and enjoying a week in the shade, so I could totally see you being able to walk the floors with a little one by then, but everyone's different. Is there an option to delay surgery until after the baby is here for a while?

As for tamox -- I've been on it now for about 22 months -- I think my toughest time with it was at about the 6 month mark -- it started impacting my mood and I could feel myself sliding into what I thought was some type of depression. That along with hot flashes lead me to try a low dose of Effexor -- I've been on that ever since and it has helped.

Good luck with your decision!