Double or Single Mastectomy

What are their reasons for wanting both breasts removed? Is it just your age? Type of cancer? Genetic factors? Something on the imaging that they are concerned with? The more knowledge you have regarding their reasoning the better. I understand your concern regarding the loss of feeling in your breasts and your sex life.

My breasts were very small and my tumor was fairly large. I would have needed reconstruction on both regardless just to match up. That weighed heavily into my decision. I also had very cystic breasts which made it difficult to read themammograms. I too did not want to have to go through it again. Although I still worry about recurrence. I chose to have both removed. Pathology after my BMX discovered a .9mm tumor in my “clean" breast. I say this not to scare you and I know it is not the usual outcome but it happens. It did not show up on my imaging. I got lucky either my choice. On the bright side I did have nipple/skin sparing BMX and they look pretty much like they did before. I have sensation on the sides of my breast but not the nipple area. That may never come back.

I would delve into exactly why they are suggesting a BMX. My doctors left it up to me but gave me enough information to make decision that was right for me. It is ultimately your choice.

I’m close to your age, 34 now. I chose to do both a year ago and haven’t so far regretted the decision. I didn’t want to possibly do this again for the healthy side later. You’d probably do some surgery on healthy side anyway to get some symmetry. I’ve had 2 fat grafting surgeries since surgery, not that you have to, but it does add more hospital and mild recovery time later. I expected bmx recovery to be worse, it’s obviously not amazing but I wouldn’t want to do that again.

... another surgery note, does the type of reconstruction (if that's what you're doing) you'd have impact your decision? I was able to go straight to implants so it kept everything pretty simple. I'm not as educated about other reconstruction, but there's expanders/swaps that require another go into surgery.

Biggest reason was my kids. If they’d been older my decision might have been different, but probably not. They are little (almost 3 and 5 at the time) and need me. They did great with what we went through. I had DCIS and was able to skip out on radiation or chemo, but if something happened later on the other side that was more serious and I needed those things, I just couldn’t rock their world that much. We were also done having kids, which helped make it an easy decision to do both.

I’m way happier with my new boobs that I was with the real ones (thanks breastfeeding). I don’t miss my nipples. I don’t have any difference in my sex life. There’s some loss of feeling but not as much as I expected. Sleeping hasn’t been affected too much, I can still sleep on my side and stomach, just a little modified than before. Love not wearing a bra!

Like DebAL said, there’s always a chance that this can come back, but I don’t live with that worry until I’m at a 6mo check up appt and I’m in a gown waiting for the doctor and it hits me that while this is just probably an appt to catch up that they could discover something. It’s not even a thought on other days though. It would have been if I’d only done one.

I initially had planned on lumpectomy and radiation until my MRI showed a mastectomy would be better for me. From the beginning though I was considering bmx just to be done with this. It does feel weird having something so extreme be the easy choice to make. I struggled with that. It was a relief to me when they came back and said there was more DCIS and a mastectomy would be better. I’ll never know for sure but had I stuck with the pre MRI plan I think I’d have regret not doing more.

Big hugs while you think it all out for what’s best for you.

yes. The MRI will help with your decision. My Surgeon had me prepared for something in the other breast so there was definitely relief when all was good there. By that time I was pretty solidified with my decision to have both removed.

Mountainmomma is right. I have an onc appt this friday. I feel myself a little more anxious this week. I also agree, not as much loss of feeling as I expected too.

There is so much to understand and so overwhelming. Your PS should lay out all of your options. Also, keep an open mind. I knew before I went in I may be direct to implant or wake up with expanders. Tissue perfusion and blood flow is determined in surgery. I trusted my PS to make the best decision at the time. Many here also get second and 3rd opinions. That sometimes makes your decision a little more clear.

This is the tough period - all the testing, waiting, consults, and decision making. Ultimately, you need to be comfortable with your decision. You should consider a second opinion and consult with an oncologist, not just surgeons, regarding the recurrence risks. Also consider these things as you think about a double mastectomy (removing a healthy breast) - does it really reduce your risk or simply address your worry? Your surgical complication risk doubles when you add a prophylactic mastectomy. How will you feel if reconstruction complications happen on that side only? I'm not trying to talk you out of a BMX, just want to offer another perspective. I was older than you and my recurrence likelihood is low. My breast surgeon advocated for BMX with implants. My plastic surgeon would have done that but did raise the complication risks. Also, I understand that your children are young and you may be making decisions based on what might be the "fastest" recovery. Again, think twice about making a decision that lasts a lifetime on a short term need. Cancer is hard - there really is no short cut. Despite a unilateral mastectomy, I still have annual mammograms - no more often that before my cancer diagnosis.

Good luck in the coming weeks as you make your plans.

hello sweetie it is your choice but I chose Lmast only I was planning our wedding when found lump in shower first I had some pain under arm. Well long story short I decided on just Lmast and my Fiance at time was very supportive. Worked in medical field at the time so biopsy in September diagnosed then 3 mo chemo before and after Lmast then we got married then 7wks rads and 5yrs on Tamoxifen This yr will be a 25yr Survivor Praise God still have my right breast.Had reconstruction but body rejected it wear prothesis in bras. So stay Positive and keep Hope. msphil idc stage2 0/3 nodes Lmast chemo adriamycin.cytoxin 5fu, 7wks rads 5yrs on Tamoxifen. Still a little long.

If you are in doubt, you could do things in phases. You could do whatever surgery makes the most sense in the cancer breast, and see how you feel about the outcome. Then you could decide about the other breast based on that. There is absolutely no rush on the 2nd breast. In order to get a less invasive number of lymph nodes taken I agreed to get a second surgery if there was not a pCR. I would have been SO PISSED to wake up with no lymph nodes and then find out 5 days later that they did not need to be taken. I did get a pCR, so there was no need to go back for more nodes.

I am very fond of my breasts and they are sensitive, and I was really happy to keep them, and to be able to get a lumpectomy plus Rads. I also told my surgeon, "if you have to make a choice between appearance and sensation, please protect sensation." That was my biggest concern. If I had had to do a MX, I would have definitely kept my healthy breast. Some people are more or less body-aware... I am very body aware and I am pretty sure it would bug me to have an insensate fake breast. I have a semi-insensate finger (almost cut it off years ago) and it took ages for me to get used to it.

Personally I would want to do what was medically intelligent and prudent, but no more than that. You need to know the chance of a recurrence in the other breast and weigh that against the chance of recurrence even if you get a double MX (which is not zero). If your cancer is low grade and you don't have a genetic issue that's very different than a high grade, involved nodes or BRCA+.

It's great to weigh all your options, and think things through ahead of time. In this community there are women who have experienced all of the possibilities so whatever choice you make you will be fully informed!

Motheroftwo --- I just noticed that you are in Mobile --- I recently had to make the same horrible decision and finally decided on lumpectomy -- had it done 2/21. Where are you being treated? I started at providence, but got angry with them so switched to Mitchell Center -- My Oncologist and surgeon are at Mitchell, but I'm using Mobile Infirmary for radiation.

Motheroftwo36,

I'm sure this must be a hard decision, particularly at your age. A mastectomy was recommended (by two different doctors) for my cancerous breast. My DCIS was high grade, and ER-/PR-. They had to do additional staining because a few cells looked suspicious for invasion. (Fortunately for me, everything was DCIS after final pathology). I chose to have both breasts removed. I hated every second of the diagnosis, the worrying, the waiting - way more than I loved my breasts. I made my decision instantly, as soon as the first doctor recommended mastectomy on the cancerous breast. More than anything, I just wanted to do as much as I could to ensure that I never had to face this again. I have not regretted my decision for one minute.

Please know that whatever you decide, it will be what you thought was best for you, at the time you made the decision. Try not to second-guess yourself. This is an awful disease, and I'm so sorry you are having to make these decisions.

Anyone experienced swollen ankles after chemo? Im Its been almost 4 weeks since Ive stopped. is it something to be alarmed about? will it go away on its own?

Just had my Nipple Sparring BMX. In some pain, have discomfort and numbness. Tissue Expanders hurt. Breast surgeon took only 3 lymph nodes and pathology report came back good , all negative. Resting a lot and trying to heal and brace myself for the next surgery.

Cant wait until this process is over and I can regain my normal.life and movement.

Thanks @Romashka hugging you back.

My PS expanded my tissue expander to the max this last visit. The next day I felt sick and vomited one time. I assumed it was the medicines. I had back pains and headaches. A day later more pain and now my right expander is red and swollen and hurts like hell. Feel like there is a slight rash in some areas. it looks like little hives. Nothing is wrong with my left side and he expanded that one as well though. Does this mean I have an infection or something else? anyone experienced this? Im getting worried.

This is a holiday weekend so not sure if I can even reach him now.