Single or Double Mastectomy? Advice needed asap!

gajor4 Member Posts: 2
edited March 2014 in Breast Cancer #1
Hi everyone, I am looking for advice from those of you who have already had a mastectomy. I have breast cancer in my left breast, I have just completed chemo and will need a mastectomy then radiation. I am not a candidate for immediate reconstruction due to the radation. I KNOW that I want both breast removed, but since I will need two separate surgeries(initial mastectomy and then reconstruction(tram or diep), I am not sure when I should have my second breast removed. Here are my thoughts....

1)initially single mast. and then remove other during reconstruction.
Pros.. easier initial surgery, reconstruction will be able to use original skin
on right breast.
Cons.. Will be lopsided for 6+ months until reconstruction

2)Remove both breasts initially and then rebuild both during reconstruction
Pros... no lopsided-ness.
Cons.. will not be able to use original skin for reconstruction on right breast
harder post-op recuperation


1)Do you think it would be harder emotionally to see myself with no breasts compared to just one? Or since I have to deal with one being gone, it makes no difference if both are gone.

2)Is it difficult dealing with the lopsided-ness?? Once I have a prosthesis, will it matter? or will I always be conscience of the difference?

3)Has anyone had reconstruction using the skin from their abdomen? What is their impression? How bad are the scars and the different coloring of the skin? Would it look better to have one breast with the original skin or should I have a matching pair with the abdominal skin?

4)Any other pros/cons that I have thought of???



  • 24242
    24242 Member Posts: 1,398
    You certainly are looking at
    You certainly are looking at this realistic and that is all one can do. I can only ask how much of our your identity is attached to that part of your body and might want to consider that. I had no attachment it seems and knew what I wanted even before my diagnosis. Having a grandmother who had breast cancer sort of made one think, check an wonder the rest of my life.
    I think too we forget that surgery comes with its own risks no matter what it is for...
    I have been reminded many times through my years of survival and trying to get problems controlled. Where my cancer centre is they don't like to give you as much as they can in surgery and scans because they aren't good for us...
    Truly this is the reason for not even considering more surgery for me is I couldn't imagine having more problems alone the way I already had suffered through enough.
    Good luck to you and remember being comfortable with yourself is a big thing.
  • CarrWilson
    CarrWilson Member Posts: 111
    Hi Sally
    I had a single sided mastectomy, now I am sorry I did not have bilateral. I am constantly worried about occurrence on the other side. I am still going thru chemo, and maybe it is too fresh in my mind. After my surgery, it was disconcerning to look down and see only one breast. I don't think it would matter if it was single or bilateral, it is still tough to look down and not see the breasts you have been looking at for all these years.

    I had immediate expander placement but did not have fills for about 6 weeks, the lopsided-ness was not hard to handle because I knew there will be an end to this. I am now fully expanded and feel so much better in a tee shirt. (Not exactly symmetrical but good enough).

    I did not have the diep or tram flap, I was very concerned about muscle loss and refused that procedure, although my surgeon and PS both recommended it. There are many pictures on the web if you google it. There are also a lot of ladies on this site that have had the procedures and I am sure will chime in with their experiences. The coloring will always be different because the skin coming from different areas, but depending on your coloring it may just be a slight difference.

    You seem very organized with your pro/con lists, I am very impressed. You have definately came to the right place for support. I had lots of questions, and I had a difficult time making the "final" choice. Don't be afraid to ask for second opinions if you still have more questions.

    Best of Luck - Carrie
  • BethInAz
    BethInAz Member Posts: 203 Member
    Sally, You have really thought through all of the options! Good for you! As I went through the process of the decision making, I opted for bilat mastectomy. It was a bit of a no brainer for me as the cancer in my right breast never showed itself on any mammo or ultrasound so if I kept the other breast, I would have had to do yearly MRI on the other breast. My cancer was also the kind that could show up in the other breast. I didn't want to be waiting for the other shoe to drop. I do miss my breasts but I don't miss the cancer and the worry over the other breast. As I was recovering, I was happy to not have the lopsidedness and I've talked with many gals who have wished they did the bilat because of that reason. I'm still undecided about the reconstruction. I just don't know what I would do, IF I decide to do anything. Right now, I'm contented with my little prosthetics...
    Let us know what your final decision is. I will pray that whatever your decision is, you are confirmed in it by your doctors!
  • jphilpo
    jphilpo Member Posts: 177
    Hi Sally,

    I KNOW it's hard!! I too had that decision. I had a left breast mastectomy last July & ave completed chemo & rads... I have decided to do a bilateral mastectomy because of my cancer type and the continual fear of it coming back. I will have a pedicule or tram flap next month. I am very happy with my plastic surgeon & after I have a mammogram in my right breast in 2 weeks and it comes out good, I am going for it! Keep in touch!
  • m-star
    m-star Member Posts: 441
    Hi Sally,
    sorry to hear

    Hi Sally,

    sorry to hear about your dx.
    Well all i can say is,i had bilateral mastectomy in Feb for prevention as i was high risk of BC due to mantle radiation i received for hodgkins 20 yrs ago.

    I dont regret my decision for a single second! If i were in your position,i would be having bilateral for sure. I can only speak for myself,but for me,having both removed would be no worse mentally on physically than having 1 removed.
    Just remember...its not just your breast they'll be removing....but your RISK also!

    I had immediate recon with expanders but one of my clients at work had the trans flap stomach recon.Now i also know women who had it done sucessfully,but she has been through the mill.She ended up with infections at the surgery site and the scar is pretty much hip to hip,although low down. The surgery is a long one and the recovery time is long also. I could have had this recon at same time as my mastectomies but i was looking at being in theartre 10+ hours! Thats a long time to be under anaesthetic!

    As for prosthetics? I couldnt wear them. Its now about 9 wks post-op for me and i've only managed to wear a bra once cus they make my skin sore! The one time i did wear it i wore a proper post mastectomy one and i bought some of the 'chicken fillet' things and put them in the bra.They fely better than the foam type ones as they weighted the vra down a little so it didn't ride up as much.

    Try not to get too hung up on the recovery period after the op. If you're recovering from having 1 off,you might as well have them both off.They're just ticking time bombs waiting for their moment.

    This may anger some people,but i cannot understand ANY woman who has been dx with BC, just having a lumpectomy!some do and i find it incredible that they'd want to leave them!
    Even having just ONE removed seems senseless to me i'm afraid.I have heard of so many women getting BC that only had lumpectomy or single mastectomy,that went on the get BC back in the other breast later on. Is it worth that risk??? As long as there is breast tissue there,you can get BC. Even bilaterals dont get rid of 100% breast tissue.You can get tissue as high as your collar bone or under your arm or lower down in the top abdomen.But they are all places where a lump is palpable.

    sorry for going on! lol But it's really something i feel strongly about.But i guess it depends on how much you love life....

    All the best in your decision.My thoughts are with you