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Debbie L. · 01-14-2009, 06:02 PM

It's an individual decision with no single right answer.

It sounds, Celeste, like you're making this decision in a reasoned and deliberate manner. You're not being rushed, and you know that it won't make a difference to your survival, either way. So I'd say - go with what you think is right for you, and if your surgeon balks, push harder or get another surgeon. If insurance balks, same advice. Appeal and do so assertively.

A mastectomy is not very major surgery, from a medical/healing standpoint. Emotionally it's big but that's another subject. The part of a mastectomy that typically causes the most problems (pain, restriction of movement, etc) is the axillary part of the surgery - the SLNB or axillary dissection. At least that was the case for me - I did have bilateral mastectomy with axillary dissection on one side and the simple mastectomy side was a breeze. The other side wasn't nearly as bad as I thought it would be, either. (I'm assuming that your mention of radical mastectomy was a typo and that you really meant modified radical. The true radical is rarely done anymore. It would qualify as major surgery.)

I chose bilateral mastectomies, for some of the same reasons as you and also because they couldn't find the tumor in the cancerous breast even when they knew it was there so I was not very enthusiastic about the worry of trying to watch the other one.

Now a few devil's-advocate thoughts, just to make sure you've thought of everything. If you're thinking of reconstruction, it is probably true that a better match would be possible after bilateral mastectomies. Although it might be worth talking about this with a plastic surgeon now, to get that input. If you do have radiation, that could affect the symmetry of the results somewhat. In addition, bilateral reconstructive surgery would be, well, twice as involved - and reconstruction is closer to major surgery than mastectomy is (depending upon what type is done) so one side vs. two is more of a factor. In addition, after bilateral surgery, some women wish that they still had a breast with normal sensation, even if it didn't match the other one perfectly.

Are you married or in a relationship? What does your partner think? I know that it's a personal decision but if everyone is in agreement it does help.

Let us know what you decide, okay?

Love,
Debbie Laxague

01-14-2009, 06:02 PM	#4
Debbie L. Senior Member Join Date: Jul 2006 Posts: 463	things to consider It's an individual decision with no single right answer. It sounds, Celeste, like you're making this decision in a reasoned and deliberate manner. You're not being rushed, and you know that it won't make a difference to your survival, either way. So I'd say - go with what you think is right for you, and if your surgeon balks, push harder or get another surgeon. If insurance balks, same advice. Appeal and do so assertively. A mastectomy is not very major surgery, from a medical/healing standpoint. Emotionally it's big but that's another subject. The part of a mastectomy that typically causes the most problems (pain, restriction of movement, etc) is the axillary part of the surgery - the SLNB or axillary dissection. At least that was the case for me - I did have bilateral mastectomy with axillary dissection on one side and the simple mastectomy side was a breeze. The other side wasn't nearly as bad as I thought it would be, either. (I'm assuming that your mention of radical mastectomy was a typo and that you really meant modified radical. The true radical is rarely done anymore. It would qualify as major surgery.) I chose bilateral mastectomies, for some of the same reasons as you and also because they couldn't find the tumor in the cancerous breast even when they knew it was there so I was not very enthusiastic about the worry of trying to watch the other one. Now a few devil's-advocate thoughts, just to make sure you've thought of everything. If you're thinking of reconstruction, it is probably true that a better match would be possible after bilateral mastectomies. Although it might be worth talking about this with a plastic surgeon now, to get that input. If you do have radiation, that could affect the symmetry of the results somewhat. In addition, bilateral reconstructive surgery would be, well, twice as involved - and reconstruction is closer to major surgery than mastectomy is (depending upon what type is done) so one side vs. two is more of a factor. In addition, after bilateral surgery, some women wish that they still had a breast with normal sensation, even if it didn't match the other one perfectly. Are you married or in a relationship? What does your partner think? I know that it's a personal decision but if everyone is in agreement it does help. Let us know what you decide, okay? Love, Debbie Laxague __________________ 3/01 ~ Age 49. Occult primary announced by large (6cm) axillary node, found by my husband. 4/01 ~ Bilateral mastectomies (LMRM, R elective simple) - 1.2cm IDC was found at pathology. 5 of 11 axillary nodes positive, largest = 6cm. Stage IIIA ERPR 5%/1% (re-done later at Baylor, both negative at zero). HER2neu positive by IHC and FISH (8.89). Lymphovascular invasion, grade 3, 8/9 modified SBR. TX: Control of arm of NSABP's B-31 adjuvant Herceptin trial (no Herceptin, inducing a severe case of Herceptin-envy): A/C x 4 and Taxol x 4 q3weeks, then rads. Raging infection of entire chest after small revision of mastectomy scar after completing tx (significance unknown). Arimidex for two years, stopped after second pathology opinion. 2017: Mild and manageable lymphedema and some cognitive issues.