Newly diagnosed--one mx or both

I understand your dilema, as I was in the same position in 2014.

My BS recommended a UMX, but was happy to do a BMX. The main reason for my choice was that to do both would mean I had double to heal, and in my mind double risk to delay radiation. In the end it took a week or two extra to completely heal and be ready for RX. I wouldnt say I liked being uneaven but I am happy with my choice. I was going to have reconstruction in mid/end 2015, but this was brought forward to earlier in the year when DCIS was found in my remaining beast. I think I would have always gone for a second MX when I had reconstruction. As for my DIEP reconstruction - I am delighted with the results.

So all in all I am happy with my choices

I wish you well and quick and comfortable healing whatever your decision.

Sarah

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How old are you? How healthy is your healthy breast, i.e. Does it have any conditions like calcifications for example that were found in the other breast too? Do you have dense breasts to begin with? Are you going to be OK with frequent monitoring of the remaining breast for an indinite period of time? How important is the cosmetic outcome for you? These are the questions you should think about.

I struggled with the same question too but I was significantly older at diagnosis. One thing that I found useful, when you talk to your breast surgeon and other medical professionals on your team nurses including, try asking what they would do if they were in your shoes and why. Try to sway them away from the standard talk and make it more personal. You might hear interesting answers. If it's a male ask what he would recommend his wife/daughter do in a similar situation.

Removing the left side does not change the odds of metastasis in the future but it does change the odds of getting a second primary in the left breast, eliminates the risk of missing something that might already be there and the need for frequent scannings. I am not trying to sway you towards BMX, just pointing out that every argument has a contra argument.

Good luck with your treatment!

I asked my BS what she would do if it was her, remove 1 or 2. She held up two fingers and whispered "two, I'd take two". When asked why she said for symmetry.

My MO was a different story. He was surprised I would remove a healthy breast. He wanted to know what my husband thought of this,lol, like I needed his permission. ummmmm, my husband says its my body, do what I think is right.

Hi Traci,

I asked this question too just 3 months ago. I really didn't want my healthy breast to go, but I also didn't want to regret not taking it later. It's a hard decision. My BS also told me that removing the healthy breast would not reduce my chances of having cancer return, so I had a hard time justifying removing it. Ultimately I took the advice of a friend (who had gone through breast cancer 10 years ago) who said I could always remove it later but would never be able to put the real one back on. I know many people decide to do it all at once because they do not want to experience surgery and recovery again, and I completely respect that. They also want to look even, which is important. I finally decided to gamble and keep my healthy breast, hoping that this is a one-time deal. I just wasn't ready to lose all sensation across my chest. I had my UMX with immediate TE placement and am extremely pleased with everything so far. My TE is above the muscle, which I'm learning is not the way most procedures are done. I think with only having one breast removed and having the TE above the muscle, my recovery has been much easier than most. It was really nice to still have one arm that had full range of motion during recovery. I didn't feel so totally helpless and was able to sleep fairly well. I was also ready to return to work two weeks later without much difficulty. I talked to my PS about the DIEP flap, and he told me that I would lose abdominal strength if I went that route. I'm a runner, so I decided that procedure was not for me. As you make your decision, get feedback from women who have undergone the procedure to see if that really is an issue.

As for symmetry, I'm still in the reconstruction process to see how that ends up. My PS is an artist and a perfectionist and has done an amazing job so far, but he told me right up front that it will be extremely hard to be perfectly symmetrical doing only one side. I'll eventually have a lift on my right side, but it will be a while before the final result. I was able to get some great bras and a prosthetic insert in the meantime, and no one can tell anything is different. I know when all is said and done I won't be exact, but I think I'll be pretty close...at least close enough that no one will be able to tell. My next surgery to swap out my TE for the implant is December 21. Maybe I'll have a different opinion once that's done!

Good luck to you as you weigh all your options to make the best decision that works for you. I know it's overwhelming! 

Donna

Hi Traci- Everyone has to do what's best for them, and it varies so much as you can see! My mom had BC twice (and then colon)- I have small breasts (A at best lol)- so I always knew in my mind if/when I got this (diagnosed at 49), take them both- I'm done. But again, I'm small- so never have been attached to them. My PS and MO both nodded their heads- didn't disagree at all. I have a cousin who did a UMX 9 years ago and tells me now she wishes she did them both. Another friend the same. Of course all hind site (and maybe they're making me feel better lol). Go with your gut after consulting all the experts. Agree even talking with the PS (it's a whole other complicated world there!) would help. I'm doing chemo now- so still wrapping my brain around the next step of surgery. Wishing you the best.... it makes me so sad to see so many of us not only on here because of BC, but so many have young kids (mine is 13). Stinks, but definitely motivating to be here for them.

thanks all for sharing. I just had lumpectomy for 1cm IDC. found out yesterday that I have no CA in the sentinel node, but there was over 6cm mass of DCIS. so it looks like I am looking at chosing one MX or BMX. leaning towards one, but wonder how easily I will know if other side has DCIS if it was not seen on 3D mammogram or MRI that I had B4 lumpectomy. This really came out of the blue! I wasn't mad before, but I am now. thanks for a place to share!

I think for me the UMX vs BMX is tied into the reconstruction question. I definitely need to get more info, and that can't come fast enough!

Here's to having a knowledgeable health care team for all of us!