How to choose between therapeutic mammoplasty and double mastectomy?

Recently diagnosed with double breast cancer and trying to decide between therapeutic mammoplasty and double mastectomy. I’m well past retirement age and have diabetes so am looking for low risk approach. Worried about losing the use of my arms. Mmadeleine

Parents
  • A very warm welcome to our forum.

    I am sorry to hear that you find yourself on this journey and hope that you are managing to cope with your diagnosis. Don't worry about having to have a double mastectomy. None of us like the thought of losing our breasts, but, with reconstruction, many say that they look better after surgery, than they did before. I have had both a lumpectomy and a double mastectomy, as I discovered a second cancer within my original breast, less than a year after my initial surgery. I was not a suitable candidate for reconstruction, due to previous, non-cancer related surgery, but I manage well with a selection of prostheses for different activities. I manage fairly well with these, although I often go flat these days, as it is more comfortable. 

    Surprisingly, I found that I recovered better after my mastectomies than I did after my lumpectomy - I too have Diabetes, but I healed well. I was 60 when I was first diagnosed. Do you plan to have reconstruction and if so, what type? If you have any questions about this procedure, please feel free to ask. One thing that I found useful to have after surgery, was a small heart-shaped cushion, that I could place under my arm, especially when sleeping. It was also helpful to have some nightwear that opened at the front, as this saved having to pull things over my head, when my arm was tender. I extended this into day wear too, as it was difficult to raise my arms on both sides.

    I have been left with a legacy of bilateral lymphoedema, which I now wear day and night compression bandages for. My operations were 15 years ago, but I understand that, with the newer techniques used since then, this happens much less frequently these days. I did find my arms tender for the first couple of years post surgery, but I still manage to do most things with them. Do you know what type or stage your cancer is? Mine was Stage 1, Pure Mucinous breast cancer, both times. Fortunately, there was no lymph node involvement.

    Therapeutic mammoplasty or double mastectomy? - this is always a difficult question. I always feel that it is unfair to leave this to the patient. The persons who know the best procedure to go with are your surgeon and your breast care nurse. They have met you and know your full medical history and they also know a lot more about the type and stage of cancer you've got, than you could ever know. Place your faith in the experts, who do this day and daily.

    I asked a friend to draw up any questions comparing the 2 procedures, as I found that 2 heads were better than 1 and she added some very valid questions, that I hadn't even thought about. I took this along to my consultations and discussed them all with my surgeon. I was quite worried about further recurrences, when I had pre-cancerous lesions in my other breast, 6 months after my lumpectomy and then a second primary cancer in my original breast, so soon after that. I had already lost my mum to secondary breast cancer. At that point, I just wanted to extend my life for as long as possible. My surgeon was in agreement with me, so we opted for a double mastectomy.

    This is a decision that was the best one for me and I have never looked back. Having said this, it is very much a personal decision and has to be the right choice for you. Put your surgeon on the spot and ask " If I were your daughter/wife, what would you advise?". Whatever decision you make, I sincerely hope that it turns out to be the right one for you.

    Please keep in touch and let us know how you get on. We are always here for you.

    Kind regards,

    Jolamine xx

Reply
  • A very warm welcome to our forum.

    I am sorry to hear that you find yourself on this journey and hope that you are managing to cope with your diagnosis. Don't worry about having to have a double mastectomy. None of us like the thought of losing our breasts, but, with reconstruction, many say that they look better after surgery, than they did before. I have had both a lumpectomy and a double mastectomy, as I discovered a second cancer within my original breast, less than a year after my initial surgery. I was not a suitable candidate for reconstruction, due to previous, non-cancer related surgery, but I manage well with a selection of prostheses for different activities. I manage fairly well with these, although I often go flat these days, as it is more comfortable. 

    Surprisingly, I found that I recovered better after my mastectomies than I did after my lumpectomy - I too have Diabetes, but I healed well. I was 60 when I was first diagnosed. Do you plan to have reconstruction and if so, what type? If you have any questions about this procedure, please feel free to ask. One thing that I found useful to have after surgery, was a small heart-shaped cushion, that I could place under my arm, especially when sleeping. It was also helpful to have some nightwear that opened at the front, as this saved having to pull things over my head, when my arm was tender. I extended this into day wear too, as it was difficult to raise my arms on both sides.

    I have been left with a legacy of bilateral lymphoedema, which I now wear day and night compression bandages for. My operations were 15 years ago, but I understand that, with the newer techniques used since then, this happens much less frequently these days. I did find my arms tender for the first couple of years post surgery, but I still manage to do most things with them. Do you know what type or stage your cancer is? Mine was Stage 1, Pure Mucinous breast cancer, both times. Fortunately, there was no lymph node involvement.

    Therapeutic mammoplasty or double mastectomy? - this is always a difficult question. I always feel that it is unfair to leave this to the patient. The persons who know the best procedure to go with are your surgeon and your breast care nurse. They have met you and know your full medical history and they also know a lot more about the type and stage of cancer you've got, than you could ever know. Place your faith in the experts, who do this day and daily.

    I asked a friend to draw up any questions comparing the 2 procedures, as I found that 2 heads were better than 1 and she added some very valid questions, that I hadn't even thought about. I took this along to my consultations and discussed them all with my surgeon. I was quite worried about further recurrences, when I had pre-cancerous lesions in my other breast, 6 months after my lumpectomy and then a second primary cancer in my original breast, so soon after that. I had already lost my mum to secondary breast cancer. At that point, I just wanted to extend my life for as long as possible. My surgeon was in agreement with me, so we opted for a double mastectomy.

    This is a decision that was the best one for me and I have never looked back. Having said this, it is very much a personal decision and has to be the right choice for you. Put your surgeon on the spot and ask " If I were your daughter/wife, what would you advise?". Whatever decision you make, I sincerely hope that it turns out to be the right one for you.

    Please keep in touch and let us know how you get on. We are always here for you.

    Kind regards,

    Jolamine xx

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