DCIS both breasts, should I consider masectomy?

My history-DCIS in right breast 1999, treated with excisional biopsy followed by lumpectomy to clear margins and then radiation.  Nov 2005 diagnosed with DCIS in left breast.  Had lumpectomy and sentinal node biopsy in Dec 2005.   Sentinal node biopsy shows lymph nodes negative (2 nodes removed).  2.5cm tumour, grade 3, necrosis / comedo.  Clear margin on side of breast wall is less than 1mm - surgeon said they went all the way back to muscle and does not recommend further surgery.  I have very small breasts (AA/A cup).  I am thinking about having double masectomy, preferably with reconstruction, as preventative measure.  Is this an option I should consider?   If I did choose a masectomy, would it still be advisable to have radiation due to low margin?

[CCF-RN,MSN-rf]

Dear LuckyOne:  This is a question that might be best discussed with your breast surgeon, a plastic surgeon, and perhaps a breast cancer oncologist.  As both diagnoses were DCIS, this means that there was no invasive cancer.  A mastectomy may reduce the risk of local recurrence.  However, depending on the proximity of the margin to the chest wall, it may be that radiation therapy will be recommended as well.  Finally, radiation can sometimes affect plastic surgery results so it would be advisable to talk to all these experts who can make good recommendations as they pertain specifically to your situation.

[lrc722]

A related discussion, DCIS was started.