Fourth lumpectomy or unilateral or bilateral mastectomy?

if it were me, I'd go with a double with reconstruction. But I have a strong family history. If I wind up in you situation that's what I'm planning on doing.

Angela

I was in the same boat as you..........doctor said if you were to have cancer this is the best to have. What a joke!

Dx with DCIS stage 0, had lumpectomy and biopsy found a micro invasion. Clear margins. I thought I wold be fine because the BS said we would just watch and I went every 6 months for mammo and sono. Long story short Dec 2014 I was dx with stage 3a Breast cancer. I had a masectomy and am now undergoing chemo and targeted therapy. I wish I had a masectomy back then! I wish you the best, just really think about it before making your decision.

Angela,

I wish you all the best as you make your way through this.  I was diagnosed with DCIS in my right breast, and IDC in the left this spring.  Before surgery, I consulted with all of the specialists, including the radiation therapist.  He earned my deep respect on my first visit by his obvious thoroughness and amazing thoughtfulness.  I had had several conversations about the lumpectomy-mastectomy decision with my BS, and when asked what I wanted, I finally told the BS what I wanted she could not give me, which was no BC and no surgery.  My second choice was the least invasive surgery for the maximal medical benefit.  If that was lumpectomy, then that is what I wanted.  I told the radiation therapist the same thing.  On my next visit to the surgeon, I was told that the tumor board was making the recommendation of bilateral mastectomy, which I had a month ago.  Apparently the radiation therapist had a pretty strong conviction that that was my best course. I wanted their best medical opinion .... period.  In my case, that decision was no doubt colored by the fact that both my mother and maternal grandmother had had BC. 

Separately, I chose not to have immediate reconstruction, as I wanted the chance to heal, to see how well or poorly I did with no reconstruction, and proceed with reconstruction later if I really feel I need to and want to.  There may be some compromise cosmetically should I choose reconstruction later, but it made more sense to me to wait. 

Have you gotten a second opinion?  I also wonder whether an MRI could be useful for you.  Has that been done?