[Shirley]

Lizz,

I had a unilateral nipple sparing mastectomy one year ago, followed by radiation and Herceptin. My docs were fine with nipple sparing and I decided to take the risk, especially since I was going to have radiation and did not have metastasis. I also do not have any family history of BC. I'm glad that I made that decision and in the off chance cancer returns I will deal with it.

As far as a prophy mx, I agree with Cool Breeze: there is no evidence to suggest increased survival if you remove the healthy breast. Between the two issues--prophylaxis mx and nipple sparing, the latter probably has the biggest association with recurrence. They say that a recurrence in the opposite breast is a completely separate, unrelated cancer.

Keeping as much as I could was important to my sense of self. I would have chosen differently if I was younger or had a family history, as both of those factors seem to correlate to increased risk. A reconstructed nipple or tattoo is one extra surgery and I don't think I would have been ok with the results.

Expanders are hard as a rock and I'm glad I don't have them on both sides. My plastic surgeon emphasized to me recently that silicone implants will not make the breast anywhere near what it used to be. I want diep reconstruction but was advised that I didn't have enough fat (my regular ps disagreed--hey thanks--so he wants me to get a second opinion). This surgery would be out of question if I had both breasts removed.

In the end you have to go with your own instincts, especially if your docs have given you the choice. Some women don't want to live with the risk, which I understand. Either way I will live for the rest of my life with a sense of risk that the cancer will return, but this would be true even with a double mx.

I don't want to tell you one way or the other; these are just my immediate thoughts about it. I hope you make a decision that is just right for you. You'll be having your surgery at about the same time I did last year. September is a nice month to take some time for yourself to recover.

Best wishes to you,

Shirley