Prophylactic Mastectomy

[Maree]

Hi everyone
I had a right mastectomy in 2003 followed by chemo, NED now. I have recently had nipple pain and a feeling of aching in my left breast. Mammogram and ultrasound were clear. I was wondering about ladies who have had prophylactic mastectomy on the unaffected side, in what circumstances was it done and how much resistance was met from the doctors. I would appreciate your responses. Maree

[mekasan]

Dear Maree,

At a follow-up with my plastic surgeon, he noticed that I was uneven and gave three suggestions (stay uneven, reduce the implant on the operated side exposing breast bone, or put a small implant under the unaffected breast). I suggested the fourth option of a preventive mast. He was immediately supportive and offered to follow up with my breast surgeon for me. Two days later, I saw my breast surgeon, who greeted me with a statement that she had already spoke to my plastic surgeon and she was "very pleased to hear" that I wanted to have the other breast done. She stated that she likes to see women make the decision to remove both breasts, but it is not her job to suggest that women remove healthy body parts. It is a personal choice. My onc indicated that he was all for it as long as the other doctors found no reason for me not to and as long as I waited 6 weeks after beginning herceptin.

Some background info:
I had my first side done after a diagnosis of only DCIS. However, after the mastectomy the patholgy report of the tissue found two tumors of IDC which were not found on any MRI, mammo, or ultrasound done pre-op. As a result, I went from stage 0 pre-op to stage 1 post-op. I then went through chemo and began herceptin. Because two IDC tumors could sneak by all other types of test, I decided I wanted the other breast removed. I hated the idea of worrying daily about what was growing that no one could see. Also, I found my first cancer by comparing my breasts. Removing one meant that I lost my measuring stick - I no longer had another breast to compare the remaining brest to. In addition, being ER-/PR- and Her2 positive (all factors suggesting aggressive characteristics), I wanted to remove the breast. I also just turned 30. Cancers in younger women tend to be aggressive, becasue they are more likely to be hormone neg. Considering I plan to live for awhile, all of us (me and my dr's) feel that removing the tissue is a good idea. My breast surgeon explain that although we have two breasts, they are one organ and therefore recurrence to the other breast is not uncommon. I had a pre-op MRI for the second mast and a new tumor had formed, this time it was benign, but I still had to go through a biopsy to find this out. That was the clincher. I knew I was making the right choice for me.

I have no children yet and breast feeding breifly crossed my mind as a reason to keep one. There are many benefits to breast feeding a baby. However, I could only drink soy milk as an infant and was not breast feed. My brothers were the same way. I imagine if I had a child, it may also end up on soy. So this factor carried little weight with me.

Now I have two perky and evenly matched breasts. I am very happy with my choice.

PS: My brother (of all people) asked what would happen if i only had one .. would one stay perky and the other droop over time? Now, I will never know.

I hope this helps. Please feel free to email if you need more info.

Sincerely,
Shannon

[madubois63]

PS: My brother (of all people) asked what would happen if i only had one .. would one stay perky and the other droop over time? Now, I will never know.

The answer is YES.

[tousled1]

I was diagnosed Stage III, ER/PR-, HER2+++, grade 3 tumor, axillary node involvement. I went through neoadjunct chemo and am now scheduled for surgery next Thursday (June 8). After considering my strong family history of breast cancer, the fact that I have fibrocystic disease, and very dense breasts, I have opted to have a bilateral mastectomy even though all tests show no tumor in the left breast. It was a very difficult decision to make and I do not regret it. Since I have to have radiation after surgery I will have to wait for reconstruction. I am crossing each bridge as I come to it. If you are comfortable with your decision then you know it's right for you. Good luck to you.

[R.B.]

There are quite a number of threads with in depth discussion links etc on this topic.

If you have not found it you may want to check out the search facility above - click on search above right purple bar and enter the term you are looking for.

RB

[jener8er]

Hi Maree, I am scheduled for a proph mast and immediate reconstruction of BOTH breasts on June 21st - just 3 weeks away (yikes!). Like everyone else who posted, I don't want the worry of it returning in my "good" breast, and I also want the symmetry. I'm having the DIEP flap recon at UCLA. It's a one shot deal so for me the decision was pretty easy. My husband, on the other hand.... but that's a whole other post LOL!
Good luck with your decision.
Jen