• Single vs. bilateral mastectomy?

    Asked by nancyjac on Saturday, January 14, 2012

    Single vs. bilateral mastectomy?

    Once I finish chemo (mid-march), the plan is to do a mastectomy. I will need to decided whether to have just my left breast removed or have both removed. I'm told that my right breast is cancer free and that removing will not have any effect on lowering the risk of recurrence, so it is really more of a cosmetic or practical choice rather than a medical one. I'm wondering if anybody else opted for a bilateral mastectomy rather than just having one breast removed and what your thoughts are on the convenience or any down sides to having both breasts removed instead of just one.

    14 Answers from the Community

    14 answers
    • charku47's Avatar
      charku47

      I think this is a very personal choice. When I was diagnosed with breast cancer it was in the left breast only but they checked when they saw something in the right breast. People questioned me as to why I didn't just do the bilateral mastectomy and my answer was "I don't want one breast removed why would I remove both". That was MY choice. I was told by almost everyone in my life to remove both my breasts. People who never had cancer, women who never had to lose both of their breasts telling me what they would do. Unfortunately I did have cancer in both breasts and 2 weeks later had to have the right removed. If I had been in your situation I would have never removed my right breast. You should do what YOU want to do. Do not let others who have not walked in your shoes make your decision and don't let me make your decision. Listen to your doctor and yourself. People who don't have to live without your breast can't make your decision for you. This is YOUR body. Always remember that.

      over 2 years ago
    • leepenn's Avatar
      leepenn

      Charku47 - I like your candid answer so much - I don't want one breast removed... so why would I have two breasts removed?

      Here, I will give my own perspective....
      I cannot handle asymmetry. This is huge for me.
      I also have bumpy boobies (cysts and fibrous tissue).
      I don't want to be absolutely paranoid every time I feel a new fibrous bit or a new cyst or - goodness gracious - a new cancerous mass. I don't want to be in for needle biopsies every time something bumpy appears. And, let's be clear. I have bumpy boobies, so I know that bumpy things will appear.

      Thus, I will be having both of my breasts removed. I am freaking out about it. I'm freaking out about how I'll look... whether I'll lose range of motion... and so on. I'm freaking out about surgery in general.

      I am absolutely looking forward to losing the port!!!!!
      I am looking forward to never wearing a bra again (unless I'm wearing something for which prosthetics would be ideal).
      I have ALWAYS wanted to have smaller breasts - I'm not huge... but I've always wished I were more like an A cup instead of close to a C cup. So, being flat doesn't really freak me out... but being nipple-less kind of does (how weird is that???).

      So, that's my own personal feeling on this.

      So, I'd like to present a few questions for you....

      Are you considering reconstruction? If yes, then reconstruction on both breasts is likely to lead to the most symmetry.... Make sure you talk to your surgeon about this....
      Are you sensitive to issues of symmetry?
      Do you hate bras? (I recently learned that women with reconstructed breasts after mastectomy essentially have an internal bra and do not need to wear them once surgeries are complete and healed!).
      Is the idea of removing a healthy breast problematic for you?
      Is the idea of keeping the healthy breast problematic for you?

      This is a timely question for me because I will have my surgical consult in just 2 and one half weeks. I have my last chemo on Thursday (I hope)... with my post-chemo MRI two weeks after that and the surgical consult the next day - including scheduling. I am freaking out - this is major surgery. But as I type this, I guess I'm realizing that I'm closer to peace over the surgery than I had realized. So, I thank you for your question....

      I'm so sorry we share this decision... And I hope that you are able to come to a decision with which you can feel peace.

      Hugs.

      over 2 years ago
    • kkkkk's Avatar
      kkkkk

      I was in the same position, however I had to chose between having a lumpectomy or mastectomy. Only one side was affected, but there were some abnormalities on the other side as well. After going back and forth many times I chose a bilateral mastectomy - I never wanted to have to make this decision again! The surgery (Sept)went fine, I have tissue expanders (and yet another decision - how big to go?). I haven't worn a bra since the surgical one was removed(a plus). I was lucky and was able to do a nipple sparring mastectomy which I would recommend to anyone -it really looks like I just had breast augmentation - scars are underneath and hidden by my breasts. My advice to anyone going thru this is to be sure and do the exercises diligently afterwards. I have a frozen shoulder which is far more painful to me than the breast surgery was! I go to physical therapy 3x a week. I will be swapping out my expanders for implants soon and am told that they will be much more comfortable. If I had to do it again I would make the same decision simply because I hate having to make decisions and now I won't have to worry about every little thing. I've had multiple biopsies, sonos, mamos and mris. Again, this decision is yours alone - everyone has their own thoughts but you're the one who has to live with the results. It might be nice to have one normal breast.... only having one removed wasn't something I really contemplated. Good luck.

      over 2 years ago
    • laurie's Avatar
      laurie

      I love everyones response. Perfect example of there being no"right" answer. I made the choice to remove the breast with cancer and have it reconstructed with a tram flap. They also did a lift on my other breast and the results look good! I am Only three weeks out from surgery and there is still a lot of swelling but I love that both breasts are perky and the tummy tuck is a plus too. The new breast has no feeling at all so I am glad I kept my other breast. I can't live with the "what if's" I just try to stay positive that I won't get cancer in the other breast.

      over 2 years ago
    • lbardos' Avatar
      lbardos

      I chose to have both breasts removed. I had large breasts and they were going to have to do a breast reduction on the healthy breast, so I decided to just have it removed. I don't regret that decision, but I do miss my real breasts. I had silicone implants placed in Nov and now the reality of the scars is hitting me. I'm not having the nipples reconstructed at this time. Good luck with your surgery and know that whatever you decide is the right decision for you.

      over 2 years ago
    • teddyfuzz's Avatar
      teddyfuzz

      I have Invasive Lobular Carcinoma (ILC) in the left breast. The doctors said that I have a higher than normal chance that it will eventually show up on the other side. I am with leepenn - I don't want to have to worry about every little bump I feel. I don't want to have to go through all of this again. I want to get it over with and move on with my life. Because of that, I am opting to have a double mastectomy with reconstruction. Surgery is scheduled for Thursday, January 19th.

      over 2 years ago
    • MeToo's Avatar
      MeToo

      I had a double mastectomy five months ago. I had breast reduction in June 2011 and got the news seven days later that my left breast had cancer. With recommendation from my doctors, the decision was made to remove both breasts. I too was very large, but I am not bothered now by not having my breasts. I am still adjusting to the scars (which will get better), but I do not miss trying to find clothes that fit properly or bras that were uncomfortable anyway. I would have worried about getting cancer in the right breast. I have been advised that the cancer will not spread to the rest of my body; however, I dread having to have periodic blood tests to follow up on this.

      over 2 years ago
    • PetraW's Avatar
      PetraW

      It is a very personal decision and we all have to find our own paths, but this is how I decided for myself: I was diagnosed Nov. 24, 2010 with invasive breast cancer. It was discovered early (stage IIA), but I was faced with the same question about bilateral or unilateral mastectomy or lumpectomy. Well, I had one lumpectomy, but the margins were not clean.Then I decided bilateral mastectomy with immediate reconstruction and was referred to a very good female breast surgeon. When I came to her with my decision, she helped me to re-evaluate. She suggested to do some further testing (Mammogram and MRI of both breasts) to determine if the double mastectomy was really necessary. In the process, I discovered for myself, that I was in such shock at the beginning, that I wanted to eliminate the "cancer problem" once and for all from my life. My decision to do the double mastectomy was based on fear. The tests showed, that my other breast was perfectly healthy. With the help of my breast surgeon I made the decision of first going for another lumpectomy. The margins were still very narrow. I also had cancer in my sentinel lymph node and during the lumpectomy had an axillary dissection. The next step then was the one-sided mastectomy with immediate reconstruction. My reconstruction route is the expander method. It is not an easy surgery to have. The mastectomy is not painful. You don't feel anything afterward, as all your nerves are removed as well. The reconstruction, when the expander is inserted under your breast muscle is very painful. Your muscle is just not used to being stretched that much. But all is bearable. I am extremely grateful about deciding not to do the bilateral mastectomy and cannot thank my breast surgeon enough for helping me to re-evaluate my initial decision. Now after over a year, I am still not completely done with the reconstruction. I still have to have the surgery to replace the expander and put the implant in. Just like my breast surgeon said, it will never feel the same. I have no feeling in the reconstructed breast and it does feel like a foreign object my new breast. It is no problem - it is amazing what we can get used to and I am happy that it is what it is. But I am also so incredibly happy to have my other real breast.

      One more thing: Surgeries can always be followed by complications. I had three severe infections 5 weeks after the mastectomy /initial recon surgery. Just the thought that this could have happened on both breasts makes me shudder. The infections were worse than the surgeries. It was a time filled with pain, fear and uncertainty. If it gets very bad, the expander has to be taken out again. that was my worst fear.

      With the expander under the breast muscle there are certain things I simply can no longer do: i.e. using laupers to cut branches off shrubs and small trees in my garden. I no longer have the strength and it also feels very weird how the breast muscle squeezes my little new breast as if it was in a vice. But there are also funny things about this reconstruction process and my kids and husband all laugh about it. You will be able to flex your new boob (because of the muscle over the expander/implant) - not something many people can do!

      Petra

      over 2 years ago
    • nancyjac's Avatar
      nancyjac

      Wow, even more to think about than what I have already thought about. I still have have 2-3 months to decide since I am still in the middle of chemo. At this point, I don't plan to have reconstruction. Am concerned though about the possible limitations in range of motion and would appreciate any additional information from anyone who has experienced that.

      over 2 years ago
    • hikerchick's Avatar
      hikerchick

      I had a double. I did have a large area of Stage 0 discovered in the second breast well after beginning treatment of the first. I'm so glad I had them both removed! I certainly didn't want any additional surgeries so no reconstruction for me, and I'm very happy with that decision. I have the option of wearing any size breast form I want rather than trying to match the other. I now wear forms that are much smaller than my breasts were and I love that. I only wear foam forms (recreational) so I have no weight-in-the-bra issues, nor uneven issues (jogging is so much nicer!). Being left with scars is a natural consequence of surgery. I'm okay with that. I'm just really thankful I didn't leave one breast and create the challenges involved: matching breast weights between one side and the other to protect the back, finding a mastectomy bra that would EVER have enough support for one of my old breasts AND a silicone form of equal weight, matching a silicone form to my other breast visually, wondering if I had done all I could do to eradicate the cancer, and, the oddity of having one breast look back at me in the mirror. But mostly, besides removing ALL of the cancer-prone tissue, I had equal weight removed from each side when I chose to have them both removed.

      over 2 years ago
    • leepenn's Avatar
      leepenn

      Wow - Petra - your sharing this: In the process, I discovered for myself, that I was in such shock at the beginning, that I wanted to eliminate the "cancer problem" once and for all from my life. My decision to do the double mastectomy was based on fear.

      That is amazing.
      I think at first I had the same response... double due to FEAR!

      I think that chemo first surgery second is becoming more and more common, and it certainly helps with the above - the fear factor.

      I have found myself to be freaking out about the double mastectomy.... but feeling SOLID in that choice since mid-August, when I first discussed surgery with a doc.

      And nancyjac - I think we're lucky (in a relative sense) that we do have this time... Even though I sometimes wish the surgery part was already done already!!!!

      Hope everyone has a peaceful day,
      Lee

      over 2 years ago
    • papayagirl's Avatar
      papayagirl

      Thank you all for your question and the answers. I am new to What Next and facing the decision about lumpectomy or mastectomy or a double mastectomy. Only one of my breasts is diseased so it is a difficult decision. Your question and answers have given me more to be aware of and think about. You have helped me a lot.

      Papayagirl

      over 2 years ago
    • nancyjac's Avatar
      nancyjac

      Well my time to make this decision has come closer now. I have one more chemo cycle and then it will be surgery. I still haven't made a firm decision, but I am heavily leaning towards the bilateral with no reconstruction. I still have a couple of lingering questions to resolve:

      1. Will having both breasts removed increase the risk of having more upper body range of motion limitations or increase the risk of lymphoma? My scans indicate no lymph node involvement in the cancer, so the mastectomy should be breast only without lymph node removal.

      2. Are there increased risks of bilateral vs. single in terms of post op infection and recovery period? In other words, will it take longer to heal (at least to the point of no pain and resuming normal day to day activity) if both are removed vs. just one.

      about 2 years ago
    • DaveWaz's Avatar
      DaveWaz

      nancyjac,
      Thank you for your question. I hope all is well.

      Your question reminded me of some content we have on the site about mastectomy, double mastectomy, and breast reconstruction.

      http://www.whatnext.com/experiences/procedure/mastectomy
      http://www.whatnext.com/experiences/procedure/double-mastectomy

      https://www.whatnext.com/experiences/procedure/breast-reconstruction-flap
      https://www.whatnext.com/experiences/procedure/breast-reconstruction-implant
      https://www.whatnext.com/experiences/procedure/reconstructive-surgery

      One last thing, I wanted to let other WhatNexters know about our Beginner's Guide to Cancer, which includes a guide on how women chose between a lumpectomy and mastectomy.

      https://www.whatnext.com/cc/how_we_chose_between_a_lumpectomy_and_mastectomy

      Best of luck to all,
      David

      8 months ago

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