Lumpectomy/radiation -vs dbl mastectomy/recon

[onemofaux]

My R breast was diagnosed with DCIS  1.5 weeks ago (after stereotactic biopsy): solid type, intermediate to high nuclear grade, etc. and a follow on ER/PR of 95%/25% tumor cells positive for DCIS.  MRI also showed "area of persistence" on R appearing to be a cyst they want to monitor every 6 months.

6 years ago, I went through a wire-guided biopsy for more microcalcifications but on the L breast and they were benign.  Nasty scar, rotten experience.  For the last couple weeks, I haven't been able to breathe debating what to do.  I've read some of these threads where the microcalcifications keep coming back and one woman was diagnosed malignant after her 8th round of them.  Every year I hold my breath through the exams and actually expected this one to come back benign as well but it didn't.  My L breast always hurts near where the incision was and I suspect is a combo of a larger cyst that's there and maybe some scar tissue(?)

I'm only an A+ cup so really don't have much to keep removing if things keep coming back.  I'm currently scheduled for a lumpectomy/radiation but wondering about a double mastectomy for peace of mind.  I REALLY don't want to keep going back and forth with biopsies/radiation especially with the stress this is bringing on.  Reconstruction options get pretty crazy once you've had radiation and I never know what insurance is going to approve/deny down the road.  

Right now, I'm almost thinking that removing them both and getting perky sports-model reconstructions would be the much saner way to go for peace of mind instead of the constant fear of "what if it comes back on which side?"  I've met/talked to a couple women who have gone both ways and they both have great reasons and insights into why they did what they did but the mastectomy/rebuild women seem calmer.  

I'm looking to see what other women did with their DCIS surgery options and if they're happy with their decisions or what they might change/do differently.  Thoughts?

[onemofaux]

Thanks for the pointers and reminders.  I'm trying to do that frantic do-dilligence work in that precious little window of time you get between finding the bad thing and dealing with it before I make a decision.  At least I have the luxury of a few weeks to think and I know many women don't get that opportunity.

I have consults with my gen surgeon, a plastic surgeon and a radation oncologist this week to keep digging on facts I can balance out.  The most interesting thing I'm finding so far is all my friends/aquaintances who are, or have dealt with, breast cancer also had or started with DCIS so apparently it's not something to ignore!  

Will follow up on your recommendations.  Thanks again.

[japdip]

This is definitely quite a decision to be pondering. As you know it's a personal decision that only you can make in the end. I certainly see your point and might opt for the bilat. mastectomies under similar circumstances. You do realize that even with mastectomy you might need treatment after surgery and you are not "home free" as far as breast cancer is concerned. Many women feel that once both breasts are removed that there can be no breast cancer but this is not true.  May I suggest that you visit the following website and post your problem there also. There are several sections but I suggest you post on "meeting place for survivors" or the "reconstruction" sections. There are many women who have all been there (and back) and are more than willing to share thoughts and experiences. A great group.   ( bcsupport.org )
Best of Luck whatever you decide .....