Single sided mastectomy?

Hi 27heart ~ I made the decision to take only one breast, and had a single MX on my left breast in November of 2013 after 8 rounds of chemo.

Because I had chemo first I had a few months to decide what to do at surgery time. My BS explained to me that taking both breasts (double MX) did not change my chance of recurrence. The worry would be the cancer that I'd already had and taking the other breast wasn't going to change that. In my mind taking the other breast out of fear of another cancer was letting fear win; letting the cancer win. I didn't want to create any more pain and scars than necessary and didn't want to lose all feeling in my chest. I know that there could be a possibility of another cancer in the healthy breast but I made a conscious, educated decision to deal with that risk.

I had a chance to meet with my PS prior to the MX to discuss reconstruction options and had further discussions with my BS and oncologist about my choices. I felt very good at the time of the surgery about my decision and still feel I made the right choice for me. I had a DIEP/TRAM recon a year after my MX in November of 2014, then in July of this year (2015) I had the right breast lifted to match the recon and had an areola and nipple created from the skin removed from the right breast lift. I am very pleased with the result, the breasts have great symmetry; they are not perfect but they weren't perfect prior to my MX. My PS did a great job of giving me a very "real" breast in look and feel, if someone saw my breasts today they would see the redness on my recon from radiation but otherwise the scars are minimal and I expect those to continue to lighten up as the years go by.

My PS had before and after photos of all different types of breast reconstruction; implants and otherwise, just one breast or two so I had a view into his work. I asked a lot of questions about different options. I was told implants make the most sense when you are doing a double MX because it is easier to match the breasts; doing one implant and a lift on the healthy breast doesn't get the same results as a DIEP and breast lift...there is a lot of information out there to sort through. I happened to know 2 people who had the same surgery as me and they happily showed me their "work" and that gave me the boost I needed to make my decision.

I also understand why someone would chose to do a double MX as well. It is a very personal decision and much of it will depend on your age, lifestyle, personal choices and many other factors. No matter which option you chose it will be the right one for you; there is no right or wrong here. Make the choice that is going to make you feel at your best when all is said and done. Best wishes to you, you'll do great!

Mary

Heart ~ keep us posted on your PS visit.

They will have some advice for you for sure on keeping or not keeping your other breast, having a reduction, etc..just be sure you think it all through. My BS and my Oncologist were great in giving me advice outside of the PS opinion (they typically go for perfection so might suggest a double MX because they can get better symmetry that way or try and tell you that you should be afraid of not taking the other breast etc...). I think getting an opinion from several people will help you make the best choice. Are you married, dating, do you have a spouse or significant other who might want to weigh in on this? I talked it over with my friends too, just looking at different sides was helpful. I am much older than you; 50 almost 51 at diagnosis but when my BS told me that I would lose all intimate feeling on the MX side and the same on the other if I did a double MX that was part of the decision for me. While I am divorced and have been for quite a while I still look forward to being in a relationship and wasn't willing to give up feeling on my chest as part of an intimate relationship; as I said above I am prepared for the risk (although small) that may bring. These aren't easy decisions and I am sorry you have to go through this at such a young age. Good for you for seeking advice and looking at change to help you get through this journey.

Mary

Hi I had left uni mx in 7/2012. Was going to DIEP, had TE but under my pectoral muscle. Got expanded, then "TREATMENT " done, including rad. Changed my mind and did fat grafting with md not that experienced who took out the TE. Did the fat grafting 5 times with 2 severe infections. Lost most of the fat, got to an A cup.

Finally sick of the whole thing so found new, more competent PS and had a TE put in OVER my pectoral this time. Much, much,much, much more comfortable over the pectoral than under it. In August had implant exchange to 420cc's Mentor Anatomic silicone implant, again, done OVER my implant. Infinitely more comfortable over the pectoral. Having had it both over and under my pectoral, it would be crazy to choose to have it done under your pectoral. There is now a research study done about doing it that way. I don't get rippling when I raise my arm now. I also have full strength in my chest and arms, can even do pushups. I couldn't do squat with the TE'S under my pectoral the first time, couldn't open a bag of potato chips with the TE under my pectoral. Was sheer torture that way. Don't even get me started on how much it hurt under the pectoral. Most doctors are not willing to do that, over the pectoral, really important if you are active. I think that if doctors had to live with having their pectoral demolished to make way for an implant, everyone would have the surgery done the way I did. They lie to themselves that it is not that bad that way, although if you ask them, they don't ever ask how it feels to have your pectoral cut and stretched. I begged my current PS to do it that way. He had only done it prior to me under the pectoral and he wasn't sure about it. I begged him and am so glad I did. He is pleasantly surprised how well it has worked out. On the boards there are scores of women who gave up on reconstruction and went flat instead because they couldn't stand having something under the pectoral. If your PS says that it isn't possible to do it over the Pec, just tell them to look at the research Pre pectoral implant placement and complete coverage with porcine acellular dermal matrix: A new technique for direct to implant breast reconstruction following a nipple sparing maectomy.

http://www.ncbi.nlm.nih.gov/pubmed/25455288

Had a couple fake nipples made, so when I attached that, with prosthetic adhesive,finally L breast looks real again. Then nearly 3 weeks ago had R breast lifted with avertical lift. The PS got really great symmetry. This December I will go back to have a nipple made and to have some fat grafting in the scars. After that I plan to have my areola tattooed by Vinnie Myers either in California or Baltimore. I also plan to have medical tattooing of those incision scars to erase them as much as possible.

This is a decision only you can make, as difficult as it is. I was given the option of having a double mastectomy for cosmetic and peace-of-mind reasons despite the fact that no evidence was there that my left breast had any higher cahnce of reoccurrance. I weighed my options and agonized about it for a bit but in the end had to go with my gut - just one breast, and I don't regret it, it ended up being the right decision for me.

I have a friend who was opposite to me - double mastectomy from the get go, no questions about it. She wanted everything gone.

At the time the immediate reconstruction got infected, got removed, and then I had radiation. I always said I'd give reconstruction one more try. I have the date set, and the surgery will be more complicated this time around than if the immediate reconstruction had worked (so of course I'm over thinking things) but I just have to have faith that all will work out (and if it doesn't I won't be any worse off than I am now, except for I'd be down one lat muscle).

Good luck - remember this is your decision, go with it.

All of your posts are so helpful and encouraging. Thank you for sharing!

I was diagnosed with BC in left breast on Sept 16. After meeting with oncologist BS and PS we decided a BMX would be my best option. I am still in shock after the phone call from insurance co denying payment for BMX. No cancer in right breast is reason given. Has anyone else had insurance denials for BMX?

Gloco - welcome to our Community!

You may want to post your question about insurance on our Employment, Insurance and other Financial Issues forum to gather advice from others who can help.

We hope this helps! Please let us know how your surgery goes!

--The Mods