Dilema

hello LAnne! My first thought is that if mastectomy (either bilateral or single) can help you avoid radiation and hormone pills...I would heavily consider this. Some women do not tolerate the hormones well. Then again some do fine. I think I would have done anything surgical that I could to prevent having to take the hormones. I definitely did not want radiation either. My mom had it when I was young and the idea of it just scared me. Although I would have done it if I had to. My BMX was pretty easy in terms of recovery. I don’t regret my choice at all.

These are my thoughts. Everyone’s decision is so personal. The right choice is the one you feel best about. Good luck and hugs!

I don't think it's vain not to opt for the mastectomy. Surgery itself has risks and side effects and less drastic surgery has real benefits. Plus, your relationship with your body, and feeling comfortable and happy in it, that's real stuff. Calling it vanity diminishes it. Each of us has a different relationship with our body and breasts, and there is no point in being judgmental (of others OR of yourself) about it.

It sounds like you have a lot of confidence in your surgeon, so hopefully that conversation will be helpful and clarifying. I went into my conversation with my surgeon assuming a mastectomy and felt such a relief when I learned I could get (and that she recommended) a lumpectomy that it made me realize that I actually did have a strong preference.

My impression is that the most important thing is that you feel empowered and informed to make the best decision for yourself (or confidence in your MD, if they are driving it). Women feel content with both options, and it seems to me that the ones least likely to be happy are the ones who felt pressured into one direction or the other.

Double all the way for me. No nasty radiation, which is really scary to me.  I did not want to risk heart, lung and rib damage. No ongoing meds, which often seem horrible. No more mammograms and the anxiety they brought me. 

Going double is not a cop out. It's a really smart decision, in my opinion. 

I also did a BMX with direct to implant for DCIS and Pagets. Recovery was much easier than I imagined and most days this time in my life last year is a distant memory. I wanted to treat it the most aggressive way possible, not wondering if something had been left behind. Not have to do radiation or worry about hormone blockers. My pathology also had no surprises but I'm certain I would have second guessed every little thing had I chosen a different route.

Hi, LAnne47 --

Sorry that you find yourself with such lousy options. What grade is your DCIS?

Some thoughts after having been in the same boat:

* A 2nd reexcision is an easy recovery if it puts your mind at ease that you have done all you can to avoid MX.

* An MRI might help you determine the extent of the DCIS if it is grade 2 or 3 (citation out there). However, after 2 LEs, you might have a lot of swelling that might be hard to interpret.

* A UMX without reconstruction would not be a bad recovery. I've heard as fast as 2 weeks!

* A BMX has higher risk of complications (it's just 2 UMX's) and both of your arms are shot. It's nice to have one good arm and some areas without numbness. I had BMX due to a suspicious MRI (apparently false positive) and a desire for symmetry, but I think I'd have opted for UMX if I'd had all the facts.

* If you can have your BS mark, but not take, your sentinel nodes, you will have only a small risk of developing LE. I have LE after losing only 3 nodes, and it is a long-term hassle. In the unlikely event that invasive DC is found during the MX, they can go back and take the nodes.

I wish you peace with your decision!