[jessica]

Hi~
Technically, a local recurrence is not metastasis - distal recurrence from the primary site is true metastasis. a local recurrence of disease does not necessarily change your prognosis. But it is a huge pain & i know we all would love to minimize how many rounds we have to go in the ring & start swinging again.

You may get lots of people offering their opinions (if I had a dollar for every time someone said "why didn't you just get a mastectomy from the very start" then having to explain the circumstances of Stage IV, blahblahblah...) Ultimately, it's a matter of what YOU are most comfortable with. As my doc said, "You can't get breast cancer if you don't have a breast."
Make the choice that's best for you- that you will be most comfortable with, whatever it is that will help you sleep at night & get on with life without feeling threatened by the potential of a recurrence.

I'm a Stage IV'er-(liver metssince primary dx in 5/02), so my breasts have been the least of my worries. I did finally have a Skin Sparing Mastectomy on the L side (after 1st lumpectomy in 5/02, then excisional biopsy after a local recurrence in 2/06, then mastectomy after another local recurrence & very high grade DCIS in 12/06) but chose to leave the R side since the R side has always been clean clean.
I could have chosen a prophylactic Mast on the R side, but my doc said he would just be altering healthy tissue & not necessarily changing my prognosis/survival. A local recurrence I can handle...distal mets again - ugh! I don't want to think about it.

Go with your gut...& as Bev said, you've got to make peace with your decision~

Best of luck & Keep the Faith~