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Considering Whether To Stick With Single Mastectomy Or Go Ahead And Do A Double

A MyBCTeam Member asked a question 💭
Lansing, MI

I was recently been diagnosed with invasive lobular left breast stage 1

January 15, 2024
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A MyBCTeam Member

Ok, I will try to make some sense of it- when they do a biopsy, they take a sample of the tumor, and they will test that tumor to identify "receptors". The receptors are what tell the cells of the tumor to make more of themselves, the more they make, the bigger the tumor grows. To date, researchers have identified three receptors, and they will test for each of those.

ER is an Estrogen Receptor
PR is a Pregesterone Receptor, and both of these are referred to as Hormone Receptors.

Then there is one that is actually a protein receptor, and that is the
HER2 Human Epidermal

A person can test positive for any of these, and that would be reported as ER+, PR+, HER2+.
A negative means the test did not show that particular receptor, so, ER-, PR-, HER2-
A person can have more than one receptor, or all three (Triple Positive) or none of those three (Triple Negative)

Knowing what receptors are passing on the messages to reproduce, helps determine what drugs would be the most effective. I am HER2+, so a drug meant to counter hormone receptors would be of no benefit to me, just as my drugs would be ineffective for someone with hormone+ receptors.

My husband early on would get excited when he heard about a treatment or promising research for HR+. It took some practice to listen for HR+ as Hormone Positive, vs, HER2+

There is so much to learn, and it's a ongoing process for all of us! Hugs

January 16, 2024
A MyBCTeam Member

When deciding between a single mastectomy (unilateral) and a double mastectomy (bilateral), consider the following points from the knowledge base:

Single Mastectomy (Unilateral)
- Definition: Removal of one breast
- Indications:
- If you have cancer in one breast.
- If you cannot have radiation therapy.
- If you Show Full Answer

When deciding between a single mastectomy (unilateral) and a double mastectomy (bilateral), consider the following points from the knowledge base:

Single Mastectomy (Unilateral)
- Definition: Removal of one breast.
- Indications:
- If you have cancer in one breast.
- If you cannot have radiation therapy.
- If you have already had radiation therapy.
- If you have a tumor larger than two inches or large compared to your breast size.
- If you have previously had breast cancer surgery that did not remove the cancer completely.
- If you have inflammatory breast cancer.
- If you are pregnant and cannot have radiation therapy.
- If you have two or more areas of cancer in the same breast that cannot be removed together without changing the appearance of the breast.
- If you have a connective tissue disease that makes radiation therapy difficult.

Double Mastectomy (Bilateral)
- Definition: Removal of both breasts.
- Indications:
- If you have cancer in both breasts.
- If you want to reduce the risk of developing breast cancer in the healthy breast (contralateral prophylactic mastectomy).
- If you have extremely high risk factors for developing breast cancer in the future, such as:
- Previous breast cancers.
- Strong family history of breast cancer.
- Testing positive for BRCA1 or BRCA2 or other genetic mutations.
- Conditions like atypical lobular hyperplasia and lobular carcinoma.

Emotional and Psychological Considerations
- Single Mastectomy:
- May leave more of your original breast tissue, potentially causing anxiety about cancer recurrence.
- Double Mastectomy:
- May provide more peace of mind but involves a more significant change in appearance.
- Can affect self-image and feelings about sexuality.

Reconstruction Options
- Timing: Reconstruction can be done immediately after mastectomy or delayed until later.
- Techniques: Skin-sparing or nipple-sparing techniques may be used if appropriate.
- Materials: Options include silicone, saline, or using your own tissue.

Decision-Making
- Personal Preferences: Many people choose based on personal and medical reasons.
- Consultation: Communicate openly with your doctor and care team to understand your options and make an informed decision.

For more detailed information, you can refer to the resources provided in the knowledge base:
- [Mastectomy for Breast Cancer: What To Expect](https://www.mybcteam.com/resources/mastectomy-a...)
- [Bilateral Mastectomy for Breast Cancer](https://www.mybcteam.com/treatments/bilateral-m...)
- [Reconstruction After Breast Cancer Surgery: Your Guide](https://www.mybcteam.com/resources/reconstructi...)

July 13, 2024
A MyBCTeam Member

I have a friend who was also Stage 1, but she has other pre-existing conditions that take her out of being a candidate for radiation, so the recommendation was mastectomy. Another person I know tested positive for a genetic predisposition for breast cancer, and so the mastectomy was the recommended protocol because of the high likelihood of recurrence.
I am sure there are other scenarios that would come into play as well.
Hugs!

January 16, 2024
A MyBCTeam Member

I was wondering why a lumpectomy isn't sufficient for stage one? Is her cancer HER2 positive or negative? Please correct me if I'm wrong. I'm new to this & trying to educate myself.

January 16, 2024
A MyBCTeam Member

I considered it, and decided just to rock the unicorn life. I pop the prosthetic in and go. To do both would mean longer surgery, more limitations (instead of just one side being limited in range, lifting, etc) a second area that could have complications, scar tissue buildup, etc. If I had a crystal ball, and could see that I healed with no problems- I might have done both, and just stayed flat altogether. But since there is no guarantee- I played it safe. No regrets, just wish women didn't even have to consider these choices- still praying for a cure and a preventative! Hugs!

January 16, 2024

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