Breast Cancer Decisions

I opted for a bilateral. I only had cancer on the right side, but after finding that and getting my MRI, something popped on the left. We weren't sure what it was. I could have had it tested, but at that point I just knew I wanted to have both sides removed. So I chose to not get that side tested and proceed with a bilateral mastectomy.

After surgery, pathology showed it was not cancer, but I don't regret
making that decision. It was 100% correct for me.

That said, what is right for me, may not be right for you. And it's a hard decision to make. And I wish you best of luck making it. You have to do what you think is right for you, and only you. ((hugs))

Time enough to absorb the volumes of information provided, discuss issues with family, obtain second opinions if desired, and consult with other specialists such as radiation oncologists and plastic surgeons. Usually this will be two to three weeks. An MRI may be ordered as well, in the time between diagnosis and surgery. I usually allow a week between MRI and a surgery date to act on the results if need be. There is no set time limit. Some patients want surgery as soon as possible; others wish to research more themselves.

For me this was not a difficult decision. When I learned that there was no survival benefit for mastectomy in my case, I decided to keep my breast and have radiation therapy. The prospects of a smaller surgical procedure as well as my appearance and sensation all seemed positive.

However, if I had carried the BRCA gene or if any other medical situation had made mastectomy an appropriate choice, I would not have hesitated to choose it.

I honestly never considered a lumpectomy. I wanted to be as aggressive as possible and leave no breast tissue behind. I was young and had a fairly large tumor and lymph node involvement so I felt like that was the best choice for me.

You're right, it can definitely be a struggle.

In terms of the results and the psycho-social benefits, reconstruction at the same time as the mastectomy is generally considered to be better than delayed reconstruction, hence the push.

Immediate reconstruction enables the patient to wake up from the surgery "complete" and avoid the experience of a flat chest completely. It is also generally associated with more natural results, and less scarring than delayed reconstruction.

Having said all that, I do agree with your point. Some women have so many other decisions to make at the time of diagnosis that they're simply not ready to consider immediate reconstruction. I do hope that women in that situation also realize that breast reconstruction can be performed at any time after the mastectomy, even years later, so the option is always there.

Dr C
www.PRMA-enhance.com