Hi @prc73 - You probably feel very anxious and concerned about what to do. I understand! Most of us have or are feeling that way. You may even find that you make a decision only to begin to doubt it shortly after making it. It's OK to feel unsure, or ambivalent.

The stress of the diagnosis and the weight of the decisions to be made are truly heavy; however, I would say that the main thing you would want to decide right now is when to have your DCIS surgery. Since your cancer is Grade 3, I wouldn't wait too long. Reconstruction is something that can be done at any time. You don't need to do it immediately.

The reason your surgeon wants to do a mastectomy, as you may know, is due to the large area covered by your DCIS. When it is multifocal and located in more than one quadrant of the breast, the surgeon can't do a lumpectomy or a partial mastectomy.

If you were to decide to have immediate reconstruction, you could choose to have a "Nipple-Sparing" mastectomy (if the nipple and areola are cancer-free):
- https://www.mayoclinic.org/tests-procedures/mastectomy/about/pac-20394670:

"Nipple-sparing mastectomy. A nipple- or areola-sparing mastectomy involves removing the breast tissue only, sparing the skin, nipple, and areola. Breast reconstruction is performed immediately afterward."

You mention not having "the gene". Were you given a genetic test covering ALL the potential cancer-causing inherited genetic mutations, or just the mutations in the BRACA1 and 2?

I had a multigene panel of 85 genes. That's how I found I do have an inherited genetic mutation, though NOT the BRACA1 and 2. If you have NOT done a multigene test, I would encourage you to do so. The cost is NOT high. I paid $300 for the multigene test I mentioned - A small amount to pay for peace of mind!

HUGS,

D