I was diagnosed today with invasive ductal grade 1. I am a nurse and have had a more radical view than most. What are your thoughts on bilateral mastectomy?

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DrAttai (Physician - Surgery - Breast (Verified) ) - 09 / 27 / 2011

I agree with all the responses so far - and will reinforce that this is the time to take a few steps back, breathe, and consider all of your options. A prophylactic mastectomy (removal of the unaffected breast) will not improve your overall survival from breast cancer, and if you have an estrogen-receptor positive ("ER positive") tumor and are placed on tamoxifen or an aromatase inhibitor after surgery, these medications will reduce the risk of a new cancer developing in the healthy breast. Women who test positive for a BRCA mutation have a much higher risk for developing a new cancer which is why bilateral mastectomy is often recommended or at least discussed. In the absence of a BRCA or other gene mutation however, prophylactic mastectomy while an option, is often not a recommendation. Again, take your time with your decision, and consider all of your options.
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member4039 (Survivor (5 - 10 years)) - 09 / 26 / 2011

I just wanted to say I am SO sorry for what you must be going through today. You are a nurse so you know all of the options. I opted for the most aggressive measures when I was dx'd. For me, it wasn't about recurrence. I get all the stats and I see the likelihood of recurrence with the different treatment options. I carefully weighed all of that out. What made me choose was simply this. I was in a quite high risk category to develop a 2nd Primary Breast Cancer somewhere down the road. When I put that into the equation, I decided I did not want to have to stare down the barrel of this gun years down the road. In my case, I found out immediately I made the right choice as the pathology on the good breast didn't look too great. And, if I needed any further reassurance about my choice, my mom DID get a second primary. It was 20 years after her first dx and one year after my own dx. I think this is such a personal choice and the best I can say right now is BREATHE. Take time to think and bounce your thoughts off someone who can be more objective to answer your questions. I have sampled every internet pine box out there. It's a very emotional time. Again, I am so sorry to read this. I, too am here if you need anything. AnneMarie

jackiefox12 (Survivor (2 - 5 years)) - 09 / 26 / 2011

When I was diagnosed with stage 0 cancer I decided pretty quickly that I wanted to deal with one breast at a time so I had a single mastectomy. I know women who have chosen the preventive bilateral for their stage 0 breast cancer, and I also know women who have done a single mastectomy for stage 1. I think it's very important for you to give yourself time to think and to make the choice that's right for YOU--not me, Wanda Sykes or anyone else on this forum. You need to look at your family history, risk factors and personal risk tolerance, and make the decision that won't make you second guess yourself. Best of luck to you.

member817 (Survivor (10 - 20 years)) - 09 / 26 / 2011

Hi -- I'm sorry to hear about your diagnosis. I agree with the previous great replies to you... the bottom line most important thing is that you must do what is right for you and *only* you. It's complicated and as you know, there are so many factors to consider (age, grade of the cancer, family history, other risk factors, etc) as well as your personal comfort level. Take the time to talk with your medical team and consider your options so you can make an informed decision and not have any regrets. It's so great that you reached out to us for information and support. Keep coming back. Best of luck!

member4136 (Survivor (2 - 5 years)) - 09 / 28 / 2011

I was diagnosed with triple negative which is a grade 3. Although no one likes the diagnosis of cancer, grade 1 of course is not as aggressive as some. My personal belief is to try to conserve the breast whenever possible. The statistics for re occurrence are no different whether you have a lumpectomy or a mastectomy. However, there may be circumstances when a mastectomy may be advisable. Some people may think a mastectomy may guarantee them to be cancer free which may not be the case at all. This is a personal decision and you will need to weigh your options very carefully. Take into advisement what you surgeon and other doctors recommend, think about it, research what you can, and then make a decision that is good for you. I, myself did just that-my surgeon advised me to have a mastectomy after a second lump was discovered, I researched, thought about it, got several opinions and decided against it. And I am glad I did since on the third surgery which was exploratory there was no cancer found. Each person is different so just try to decide what you really feel in your heart is the best way for you to go.

afreshchapter (Survivor (1 year)) - 09 / 26 / 2011

My heart goes out to you. What a tough, tough day it must be for you. I remember walking around in a shocked limbo state for a few days.

I was diagnosed with a grade 3/stage 1 tumour in October of 2009. Given my age (30) and my BRCA1 gene mutation, my doctors recommended that I start with a lumpectomy and four rounds of chemotherapy, but also suggested a follow up bilateral mastectomy and reconstruction as a precaution against a second breast cancer diagnosis (either in the same or the other breast). All of this being said, my aunt who has the same genetic mutation had breast cancer (stage 2) 18 years ago and opted to have a lumpectomy instead of a mastectomy. She still gets screened regularly, but has been cancer free ever since. It was not an easy decision, but I went through the double mastectomy in May of 2010 and had my final stage of the reconstruction in January of this year. I won't lie and tell you it was easy (physically or emotionally), but I am so relieved to never have to get another mammogram or MRI again. The results don't look as good as I imagined, but I am alive and cancer free. For this, I will always be grateful.

Know that there is no right answer because what might be right for me; might not be right for you. Although so many of us have been through breast cancer, we all have a unique story. Thank you for reaching out to the community and please let me know if you have any follow up questions or just need an ear. Big hugs, Terri
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