Removing healthy breast also?

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Justkeepmoving
Justkeepmoving Member Posts: 106
edited June 2018 in IDC (Invasive Ductal Carcinoma)

Great forum :)

Diagnosed last week with DCIS (large, palpable mass close to the nipple, intermediate to high grade cells, negative for hormone receptors, MRI showed other involvement 3mm away and another spot on the other side of the same breast) concluded with my surgeon that mastectomy may be the best option instead of lumpectomy with radiation. I have small breasts and nipple should be removed. My breast would require extensive restoration post lumpectomy - and my fear is the margins won't be clean.

So now with that part decided I'm now leaning towards getting a bilateral mastectomy. My right breast has absolutely no issues. Nothing shows up on the MRI or mammograms. But symmetry is important to me. I want a DIEP procedure using the fat from my abdomen and that is a one time deal. I also like that with a mastectomy I am almost certainly making my risk for future breast cancer almost zero. Here are some of my pros for bilateral mastectomy with DIEP reconstruction:

  • Less worry about recurrence
  • No need for high level monitoring of the healthy breast
  • Better symmetry? (Seeing the plastic surgeon next week)
  • If I decide against prophylactic mastectomy and later have issues requiring reconstruction I won't be able to use the fat from my abdomen again
Some possible negatives to removing the healthy breast
  • Removing a healthy breast!!
  • More chance for flap to fail (now 2 flaps instead of 1)
  • More pain?
  • More risk for complications?
  • Loss of sensation in both breasts
I am 49 yrs old. I'm healthy, active, single mother to 2 children (11 & 13yo). I'm in a committed relationship with a loving partner who says it doesn't matter to him - that he just wants me to be healthy and he supports whatever option I choose. But I worry about not being attractive to him anymore. More important I want the peace of mind that a bilateral mastectomy would give to me (will it give peace of mind? Will it really provide peace? I think it will).
Any insight would be appreciated. Thank you everyone for sharing your experiences!
Xoxox
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Comments

  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited June 2018

    I think you've got all of your answers already! It sounds like you've really thought this through and considered all aspects. It's a big decision so it's good that you are weighing the options.

    My story is different since I had IDC and could have opted for a lumpectomy. I had many of the same thoughts as you, though. I still wonder sometimes if I made the right decision. But I'm like that about lots of things of much less importance, too.

    I will say that I'm not as completely reassured about the "less risk" aspect as I thought I'd be. I still agree with the whole idea of removing as much breast tissue as possible. It's just that now I have no monitoring for recurrence. I should be happy about that - and am (no scanxiety) - but still ... a little scared.


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  • bella2013
    bella2013 Member Posts: 489
    edited June 2018

    Just keep moving, I decided on BMX with DIEP FLAP for all the reasons you have in your pro column. It’s a big surgery but so worth it for piece of mind and wake up with breasts made up of my own tissue. The next biggest decision is who is going to do your DIEP surgery? A very experienced PS and surgery center is key for a good outcome

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  • Lula73
    Lula73 Member Posts: 1,824
    edited June 2018

    you’ve already listed almost all the reasons I did BMX. If that’s what leaves you with a feeling of peace, that’s the decision to make. And yes that is possible. Bella is right...now that you've got your decision, the next decision to make is where to have your BMX and DIEP done. All DIEP surgeons are not created equal...

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  • Runrcrb
    Runrcrb Member Posts: 577
    edited June 2018

    as the others said, the decision is yours. My breast surgeon recommended bilateral with implants. The first plastic surgeon agreed - but she doesnt do flap reconstruction. I wanted to talk flap so saw another plastic surgeon. I had enough tummy to match my current breasts and would have gone down significantly in size if i had bilateral. Risk in the healthy breast wouldnt change much with bilateral mastectomy but surgical risks double. I chose single and have never looked back.

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  • Justkeepmoving
    Justkeepmoving Member Posts: 106
    edited June 2018

    thank you, everyone

    I was cosidering only doing one breast but wanted one surgery to be the end of it...

    I'm meeting with my PS this week. Maybe I don't even have enough fat to do both. Well, like all things here I'll cross that bridge when I have all of the information

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  • Lula73
    Lula73 Member Posts: 1,824
    edited June 2018

    some women opt for no stage 2 on DIEP flap. But most do. Stage 2 is quick and a far easier surgery with most being able to go back to work within 2 weeks.

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  • radgal
    radgal Member Posts: 100
    edited June 2018

    I initially considered bilateral mastectomy for many of the reasons you mentioned. I was diagnosed when Angelina Jolie had her prophylactic mastectomies and her example was impactful.

    In the end, I decided to not have anything done with my healthy left breast; a healthy breast is truly as good as it gets. In truth, my breasts are not symmetric anyway. Reading on these forums about the complications people face with bilateral surgeries made me not want to have to put my body and breasts through any more than necessary.

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  • kmb4
    kmb4 Member Posts: 41
    edited June 2018

    Hi,

    I'm sorry you are having to make this decision, but you are in the right place for asking questions. I too opted to have my healthy breast removed about a year ago. I had invasive ductal cancer in my left breast. they had been watching a different area and then this one popped up in the same breast. With that and the fact that I'm also very small busted my surgeon suggested a mastectomy on my left side. I decided to have a bilateral with breast reconstruction. (implants). my surgeon tried to talk me out of removing the healthy breast but my reasons were very similar to yours. I wanted symmetry with both breasts and also reduce the chance of cancer in the other breast. you do double your risks so I would suggest talking to your PS about that. I had no issues and am not sorry that I removed both.

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