Monday, August 3, 2009

To cut, or not to cut.....Prophylactic Mastectomies

Back when I had my mastectomy, I opted not to have the other breast removed as well. I felt that it was healthy, and I just couldn't face any more surgery (read mutilation) than I had to have.

In addition, I figured it didn't make much difference because even if you had a
prophylactic mastectomy, it wasn't a guarantee that it wasn't going to come back.

When I moved to Ohio, my new oncologist asked me about it as he thought it would be a good idea. I responded that it wasn't fool-proof, so what was the point.

Now, I wonder if I should. Of course, I am not BRCA1 or BRCA2 positive, I have yearly mammograms and P.E.T. scans. I think that somehow I felt that leaving the remaining breast was like a "cancer catcher", that is, instead of attacking my brain, lung, bone or liver, it would go after the breast (this is not true, for instance, my recurrence included mets to the bone, but the right breast wasn't affected...just the left, but it was my magical thinking after having been diagnosed the second time).

I guess that reducing a second primary to the opposite breast by as much as 93% would be a good idea, even if the remaining breast tissue on the chest wall or in the nodes was still at risk of developing cancer.

I don't relish another surgery. I suppose, I should think more about this after having my yearly scan and hopefully ruling out any involvement with the pelvis which is still giving me problems.
I'd love to hear anyone's thoughts on this as I'm completely on the fence. Some of my friends have had bi-lateral prophylactic mastectomies...I think at present, I'm just chicken and that's OK.


  1. I have also been seriously thinking about having my breast removed. After going through chemo and now having to look forward to radiation. While there is no problem may be the time to act. I don't look forward to another surgery and had I known what I know now I would have had them both removed. we have to be proactive when it comes to our self preservation...Once I complete the cycle I am considering seriously my options.

    Alli xx

  2. Though I can't speak from personal experience, a dear friend of mine (who was diagnosed at 32 with Stage IV breast cancer) did opt to have both breasts removed, though the cancer was diagnosed in only one. For her, the surgery offered peace of mind.

  3. Alli, I think that is the best we can do. It is so hard to make the decisions. I know that we are in better shape than years ago (well, ok, even as recently as the early 1980s) where people would go in to have a biopsy and come out with a mastectomy with no input. Sometimes, though, I feel like the doctors are sitting back and waiting for us to make all the decisions at a time when we are very fragile....

    Vivien, you are so right...peace of mind is important, as I just posted in my most recent blog on this topic. :)

    Hugs to you both!