Unilateral vs bilateral, how'd you decide

Hi,

I had a BMX on 8/7. I was dx with breast cancer on the 7/28. My sister had BC @48. I always thought since then that if it happened to me I would do a mastectomy, but you never know until you face it. Im 51, When my dr told me, she said I could do a lumpectomy with rads. I told her flat out, I wanted a bilateral. I have dense breasts and have numerous biopsies which until now were always benign. I also knew I would be riddled with more anxiety having to be monitored every 6mths alternating between MRI and Mammo/Sono. My left had always been the troublesome one with biopsies, yet the right popped up with cancer out of the blue. I had enough anxiety once a year. Funny thing is after my sister was dx I was told I was higher risk so i was approved for MRI's which i did and alternated every 6mths. After 3 years my ins said I was no longer high risk, go figure. 2yrs later I was dx. Perhaps had they let me continue I could have been dx"d earlier. Anyway, it is a very personal decision. It may sound strange but I had no attachment to my boobs. I went into survival mode and felt I was doing the most I could do to make me feel better mentally.. Due to lack of fat to use and tight skin I could not do expanders or Diep. My ps used the smallest implant he had(similar to my former size anyway) and had it done at time of surgery.

I have no regrets, it is what worked for me mentally. You will figure out what works for you.

Have your consulted with a PS yet? Understanding your cosmetic outcome may help you decide. When I met with the PS he said if I did a uni, he would do a breast lift to the other side so they would match. I thought if I'm having surgery on the natural breast anyway, I might as well do the double because a breast lift would leave me with scar tissue and I'd lose sensation to the nipple anyway. Of course I could have turned down the breast lift, but that would have looked really funny. My BS recommended the double to achieve symmetry. I had immediate DIEP recon. I'm pleased with the results.

As a bonus, with a bmx i no longer need mammograms. I just had a breast mri, three years out from dx and I guess that will continue every three years, but better than mammograms every six months.

I was 42 and had ilc. I was told the chance for it to show up in other breast was high. So I did the bilat mastectomy. Gentle hugs to you.

I am a uni who never had reconstruction. My (kept, right) breast is fairly large, but I didn't have a problem finding a prosthetic to match my size and I have the appearance of symmetry in clothing. It's very important to find a good fitter. My BS advised a BMX if I planned to do reconstruction. I was pretty certain the PS would advise that as well, but I didn't want additional surgery, recovery, and months more in the process plus potential problems, so I never did consult with the PS. I just wanted surgery over and done. Maybe it was because I was 56 at dx and I would have felt differently if I had been 40, but now I'm over two years from dx and still happy with my decision. The BS prescribed a mammo every 6 mos. for the first year, but after two all clears, I'm now on a yearly schedule. At the time of dx a growth in my kept breast was biopsied, but found to be benign. So far, I haven't considered mammos a drawback. The BS said I may experience back problems, and of course it's only been two years, but so far I haven't had any trouble. I wear the prosthetic, which is weighted, most of the time, so I really don't anticipate an issue. IMO, it all depends on your unique situation and your gut feeling about what's right for you.

hi - I chose BMX because 1) didn't ever want to go through chemo again, 2) was told/ read that matching breasts during recon was better, 3) although my genetics testing indicated no increased familial risk, my mom and both of her sisters had BC and all 3 of them had at least one recurrence and I decided not to take any chances. My surgeon, PS and radiologist all advocated for a lumpectomy - and I initially agreed but was uncomfortable with that decision and changed to BMX two days before surgery. I don't regret it.

I chose BMX mainly because there were areas that they wanted to continue to watch in the "good" breast and symmetry was important to me as well. I also felt like having similar sensation on both sides would be easier to adjust to.

I was on the fence about this decision until today when the US on my "healthy" breast showed that it most likely wants to kill me too. My surgeon told me Friday that he only wanted to do the one breast because there was only a 2% risk of the other breast getting cancer. I said I wanted up to date information on the healthy breast before I made the decision so went for US today. I am very glad I asked. While I haven't had a biopsy, given what's happening on the other breast, it's a very good chance that it's the same thing.