On the fence between a UMX and a BMX with PalB2 mutation.

Chris - if you haven't already, be sure to visit facingourrisk.org - FORCE - Facing Our Risk of Cancer Empowered. That website has tons of valuable information about genetic cancers, guide lines for screenings and procedures, etc. A great resource site with a forum to ask questions, similar to this site.

I don't think anyone here can tell you what to do. Fortunately, time is on your side. There is no rush to do something. Have you had a chance to talk with a genetics counselor? They may be able to give you some idea of your risk.

In my case, I have a terrible family history of breast and other cancers, and I have the PALB2 and Chek2 gene mutations. My genetics counselor put my risk at 45% or more. Yikes. I'm 59, so well past child-bearing age. It made the decision to take off both breasts a little easier (I had a lumpectomy in 8/15 and BMX in 2/16.) Still, as you can see, I took several months to make that decision.

We just got word that my 22 year old daughter also has the PALB2 and Chek2 mutations. She needs to see a breast specialist to come up with a plan. That's what I'd suggest to you, if you haven't done so already.

Chris, I think one of the big challenges with PALB2 is, indeed, knowing just how high the risk is, since the range is fairly wide. (I'm not familiar with effects of the NBN mutation.)

I'd echo the advice to have a long sit-down with a good genetic counselor if you haven't had that opportunity yet. My session was pretty brief and all but uninformative. If yours was too you could ask for a referral to another, even if it's outside your health plan.

You do have time to not only research this but to listen to your own bodily responses as you think about this . Clearly, it must be dealt with but you've already dealt with a major issue.

If you've had an MRI of the right breast it could be helpful to sit down with your surgeon and discuss whether any issues of future concern are seen, discuss what a screening schedule might look like and what chemo-preventive steps (i.e., Tamoxifen) might be advisable or useful.

It's a tough decision and I wish you the best with it.

HI Chris-miss.

I was diagnosed with Stage 1 BC in November. Like you, I have dense breasts. Unlike you, I have a family history. My surgeon gave me all the options: lumpectomy, umx and bmx. I chose the bmx and I am glad that I did. For one thing, I do not have to worry about my right breast getting cancer and having to go through this yet again. Second, my surgeon told me that the recovery for a umx and a bmx were the same amount of time. Third, she told me that my non removed breast would continue to age and I would might not like the look of one perky breast and one saggy breast. (I had never considered that b/c I was so shocked and anxious about the diagnosis that I was not thinking if I would be "pretty" after all of this. I wanted to be alive.). I was told by the women at the cancer center that some women who opt for the lumpectomy or the umx began to obsess about their next mammogram or any unusual lumps. I KNOW that I would have been that person. Prior to surgery, one of the radiologist told me that I was "doing the right thing" by having a bmx. A total stranger but one that, no doubt, has seen a lot. So, here I am in February. I have the tissue expanders in (not comfortable) but I am cancer free! (Well, about 99% cancer free.) The pathology also showed that my right breast had some per-cancerous cells in it so it would have only been a matter of time before I would have had to have that one removed. Keep in mind - I have a family history. I do not have any genetic markers for cancer - zero - but my family seems to have a breast cancer gene (mom, cousin, aunt) so that helped my decision. It will all work out. Sounds like you have a lot of family/friends to help you out. And no it is NOT a free boob job! I get so tired of hearing that!!!!!!!!!!!!!!!!!!!!!! Take care. Big hugs to you.