Double MX or Single MX + Lump and Reconstruction (small breasts)

Happy, I did a bilateral as my breasts small and very hard to image due to density, and my cancer was close to my chest wall. My left was my cancer side, but the right was pretty disfigured as well due to an excisional biopsy from years ago. It is a lot of surgery and you have to factor in losing sensation in both breasts as a result. For me, it was the best decision. But take your time and weigh the pros and cons as it is a big decision. My very best to you.

I had petite breasts and I originally was diagnosed with cancer in my left breast. Through MRI they found that there were suspicious lumps in the right side (Birads 4). I quickly decided on a BMX even before knowing the results. The surgeon wasn't against it, but wanted to talk through it first. Then the biopsy results came in and one of the lumps in the right was Invasive Lobular Carcinoma, and the other was Atypical Lobular Hyperplacia. The surgeon no longer felt the need to chat about it and said ok to the BMX after seeing the results.

I'd been told that my left nipple had to go, but I could consider keeping the right. I decided to ditch both, and was glad I did. They found ALH in the right, but the left was clear, so exactly the opposite of what they'd thought originally.

My breasts are pretty dense and they found additional pre-cancerous issues in both breasts after doing the pathology. I'm very happy with my decision because for me they seemed like cancer factories and I'm happy that I get to decide the size of the new ones. I'm glad too because I really didn't want radiation or to have a lumpectomy on the right and have a disfigured boob.

I chose a BMX because: It was my 2nd breast cancer in right breast, although the 2018 cancer was new, unrelated, and not a 'recurrence' of 2003, but my 2018 2nd breast cancer did lift my chances of future breast cancers up quite a bit. I couldn't live with the notion of waiting for a 3rd breast cancer in the "good breast." I couldn't imagine putting myself through the psychological trauma of cancer there three times. My PS was clear about the fact that matching one implant with an original breast is never going to be an exact matched set, no matter what size we're dealing with.

2003 was a lumpectomy, but 2018 the location of new cancer was not going to make clean margins easy. And, you can't have radiation twice on the same breast, so at least right side mastectomy was my only option.

Having a BMX is absolutely 2x the risk of a unilateral MX in all ways, as far as the struggles, healing, and the chances of complications, and all that. Not to be entered into lightly, for sure, as my breast surgeon and PS both made a big point of discussing with me before my decision. It doesn't lower future breast cancer risk to 0%, unfortunately (axillary, chest wall, etc.) but ALMOST, so you buy some good peace of mind. I felt the same way as you allude, to, happyperidot: After all the trauma you're going through, physical and psychological, at LEAST let's have the new foobs look enough alike that clothes fit okay, and that might lessen the future emotional trauma of all this.

Well, here I am, out the other side of that tunnel. Glad I did it, but there are compromises and things to accept. New foobs do not feel like real breasts. Trauma of BMX, discomfort of TE were both very challenging. Final exchange surgery was NOT challenging; I healed quickly from that; it's just much less invasive than the original surgery, which is HUGE, don't think it it's not.

My two foobs don't exactly match, actually, and they're B cups, fairly small. That's because (invisible) radiation-caused scar tissue (in pecs and skin) didn't allow a lot of stretching, and although I was originally DD, I'm now small, and that's okay. They look symmetrical enough in a bra, but naked, not so much. That's okay. I'm fine with how they turned out. I'm glad to have foobs so that clothes look relatively okay, and glad to have had BMX for the better symmetry and for the reduced bc risk.