I opted for a single mastectomy with reconstruction. Firstly because i was told immediate reconstruction would give the better esthetic outcome while the skin is still full of blood supply and can heal well. Secondly because I was told that women often underestimate the loss of their breast. That was very true for me. Sexually speaking it is a huge part of me and it is hard enough missing the one. But if that were not a factor in my decision or such a part of my sensuality experience then I would maybe feel differently. Only you know that aspect of yourself and any relationship you re in. Once a breast is gone it is gone forever so I went with my surgeon's advice that I could come back at a later time and change my mind and he would be able to remove it later. It has been 4 years. I went with the choice that left options open for me to think about it. I was rushed into that first decision with just 4 weeks between diagnosis to surgery and I just was not going to be pressured into it. The science overall does not support the fear most women have. You can always change your mind both on prophylactic mastectomy and reconstruction at a later time and insurance must cover, but while a reconstructed breast is a far cry from the real thing, i am glad i did reconstruct.

Maria I also opted for the bilateral even though I had cancer only on the left. AFter the biopsy reports came back on my healthy breast, my surgeon told me it was a good choice. The "healthy" one was loaded with abnormal pre cancer cells too.
Some of my other reasons were the same as yours. I was also guided by my mother's experience. She had a single and six months later they found cancer in the second breast. Like you I was large breasted and did not want to try to match one large breast. This is a completely personal decision. My experience is only mine. I just wanted you to know, I went against my Dr. and it worked out for the best.
Whatever decision you make will be the best for you and your circumstance.

My doctor recommended the same thing to me, a unilateral mastectomy, and she wanted me to reconstruct. Instead I went with a bi-lateral mastectomy without reconstruction. I couldn't stand the idea of assymetry plus I've just heard too many anecdotal stories, of "two years later it came back in the other breast." My doctor thought I was a little crazy and actually tried to talk me out of the bi-lateral mastectomy. Family also tried to talk me out of it. I think it's considered an old-fashioned surgery in this day of skin-saving, nipple-sparing reconstruction.
But...because of my more radical surgery I did not have to do radiation! And my chemo was mild. And I'm entertaining the idea of saying "no!" to Tamoxifin if I don't like it. None of those would have been the case if I'd kept a breast. Also here's a thing no one ever mentions--if the cancer comes back in the other breast they have to take the nodes from that side as well! With me, they took the sentinal node on my left cancer side, and now I never have to worry about them taking any of my right nodes. I'll always have one arm that is not at risk for lymphedema!

I've know women who opted for a bilateral mastectomy and they are doing just fine. It is difficult to match the reconstructed breast to a large remaining breast. However, they very often will do breast reduction on the remaining breast for a better look overall (e.g. reduce the size and give it a lift). So either way, you will likely have surgery to your remaining breast.

MamaH is right - the replacement breasts don't feel the same and can feel numb. They can look terrific, though. Best of luck in making the decision that feels right to you.

@A MyBCTeam Member I too only had BC in the right breast, but opted for bilateral so that my chances for dealing with this ever again would be slimmer. I chose immediate reconstruction because I too had very large breast. It was easier for me emotionally to wake up with a little something there as I think I have been used to having large breasts since 5th grade. Good luck with your decision. I hope this helps some.

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