I was offered the same option and chose a bilateral mastectomy. I will honestly share why I did this for your consideration but understand that this is a personal choice for each of us.

I had a lengthy conversation with the plastic surgeon who works with women who have had breast cancer and wanted reconstructive surgery as well as women who have had a lumpectomy and radiation and needed reconstruction following its effects. He honestly told me that depending on the radiation treatment (length of time and place in the breast etc.) he found it very difficult to do much for women whose breast became disfigured following radiation. He said the skin is not able to handle surgical reconstruction because it is so damaged and this can happen years following the radiation treatment. He sees women when they have one breast that is disfigured.

I felt that having both breasts removed also avoided the chances of my cancer coming back in the other breast (I had Invasive Lobular Cancer Stage 1A Grade 2 and no node involvement). I felt that I would prefer to have both breasts identical following cancer treatment. I had reconstructive surgery in May and now I have two smaller perky breasts and I am very happy with the result.

Because of the size of my breasts, the plastic surgeon was not able to save my nipples. He told me this before I made my decision about lumpectomy/radiation or mastectomy. I felt making sure the cancer was gone was more important than saving my nipples. I will have 3D tattoos done soon that look incredibly real. If you want to preserve feeling in your nipples they can do nipple sparing surgery but you should talk to a plastic surgeon to see if you are a candidate before you make your decision. If you are younger and your reoccurrence outcomes are similar, then your choice may be to do the lumpectomy. I would recommend a candid conversation about what your breast will look like years down the road following radiation.

I was able to avoid radiation altogether and I am also on AI therapy for five years. I had no pain following my mastectomies and rehab was fairly easy for me.

I don't know if my insight is at all helpful. To me I had a 15% chance of reoccurrence with lumpectomy and radiation and a 2% chance with bilateral mastectomy. I was happy to choose the latter option to make sure the surgeon got clean margins and avoid having to have a subsequent surgery. I also had a friend who had a lumpectomy and her surgeon didn't get clean margins and they had to go back and do bilateral mastectomy.

As others have said you have to weight your personal desires and your unique cancer markers against the likelihood of reoccurrence and decide which approach is better for you.

I wish you the best. There is a breast cancer treatment Handbook: Understanding the Disease, Treatments, Emotions by Judy C. Kneece which is an amazing guide my breast surgeon gave me. They sell it on Amazon. In the back of the book is a guide with questions you answer to help you make your treatment decision. I used it to decide about going the bilateral mastectomy route. I found this book to be immensely helpful every step of my journey and highly recommend it. Good luck. Whatever you decide will be the best decision ever.

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