What is your "magic number"

I am BRCA1+ (Dx 12/18) and was doing close monitoring of breast health. My first MRI revealed suspicious spots in both breasts. Long story short, I was dxed with stage 1 bc in July of this year and had bilateral mastectomy b/c recurrence risk is 85% for both breasts w BRCA1. There was no hx of bc in my family which is why I was doing monitoring.....I regret not having prophylactic mastectomy but given the short time between BRCA1 dx and bc, it’s likely the breast cancer was already there. My sister is also BRCA1+ and b/c of my bc, had prophylactic mastectomy a few weeks ago. So, I’m not exactly sure what you mean by “magic number” but this is how things unfolded for me and my sister re: genetic mutation. It is completely an individual decision and I encourage you to get good information, taking into account your factors, so you can make an informed decision. My Best to you.

No, there is no “magic number” for me, because the risk calculators are little more accuate than a coin toss for many “high risk” conditions

I was originally diagnosed with DCIS in one very dense breast. Serious fibercystic condition. Now I don't think that is even called "cancer". I opted for a BMX up front. Glad I did because they found problems in the "good" breast too. So my magic number was - nothing was acceptable.

You might consider that “any risk” is over and above the approximately 13-14% that all women have. Personally I’m not that bent out of shape at the 7% difference between “normal” and “high risk.” The difference in risk pales in comparison to the possible lifetime complications, pain and lifelong discomforts or infection risks from prophylacticmastectomy + reconstruction if you go that route.

I’ll make sure I refer my NCI designated Cancer Center physicians to Santa Barbarian for her superior knowledge

Melissa, why the snark? I was saying some beneficial things have potential risks alongside the benefits, and some do not.

SantaBarbarian - we can argue until we're blue in the face, but that's not what this thread is about.

As I've said on other threads where you post, I'm in favor of traditional, science based medicine working in hand with complementary wisdom. Diet is NOT going to cure my cancer. Will it make me stronger, likely so as will my exercise classes 3x a week - but neither are a magic bullet.

Everyone has to make their own choices. I don't enjoy the snark that moderation is basically irresponsible, when in fact life style choices are just as important to our happiness as deprivation.

Amanda1, best wishes with any decisions you make! I'm currently recovering from a PBMX. For me it wasn't a 'magic risk number', although my Tyrer Cuzick risk was high (75% lifetime due to LCIS, family history, other risk factors, but no identified mutations). Since I unfortunately have very 'busy' breasts, with the high risk imaging protocol alternating 3D mammo with MRI, they found something almost every 6-12 months - call-backs, extra 6 month 'watch and wait' imaging, lots of biopsies... I did this for 5 years and I just couldn't handle having a cancer scare at least once per year and continuing to do this for the next 20+ years of my life - and if they were going to keep chipping away at my boobs anyway, it made sense to me to get rid of them and be done with it. Tried tamoxifen (twice) but couldn't handle side effects that eventually developed. Although we know I had LCIS, it turns out that my boobs were so full of various kinds of atypias that I feel like it was only a matter of time until the odds caught up with me and that I made the right choice. Make no mistake, this is not an easy surgery or recovery (and I'm still early in the process - who knows what will happen or how I will feel about this long-term), so be sure you get as much information as possible to decide on what is best for you.

Right now the magic number for me is 6 or 7, depending on how you are counting. That's 6 biopsies, but not a 7th. I've had 4 biopsies and no cancer, just many high risk lesions and pre-cancerous conditions. I would do 2 more biopsies tops. It's 2 because I'd probably need a needle core biopsy and then a followup of the more comprehensive excisional biopsy. Regardless of what was found in that 5th and 6th biopsy, even just more atypia, I think I'd say enough stress, take 'em off. Of course, after maybe 10 more years of surveillance every 6 months, I might also say, this is too much stress, take 'em off. I have only been to 2 surveillances since my diagnoses in one breast and then the other.

Just one word on those risk assessments where you input your info and out pops a number...Just about every "breast professional" I have seen (and I have gotten second and third opinions on several occasions) assures me that those high numbers on risk assessment models help with getting an MRI covered by insurance, but they are not accurate. Tyrer Cuzick was ALWAYS mentioned as way overstating the risk and inaccurate. I know it seems ridiculous that the tool we rely on for a life altering decision is not trustworthy, but that is I what I have been told numerous times by those who know the models and even know Cuzick personally.

Best of luck to you all as you consider your risks and work to reduce them.