Preventative Mastectomy

[graciesmom]

I've been seeing a surgeon for the past 2 years for fibrocystic breast disease. I'm only 18 and I've had 6 lumps removed from my breasts. All were benign and were swollen lymph nodes and fibrocystic tissue. I briefly mentioned having a mastectomy to my surgeon months ago and she just said "No way, I would never do that to someone your age." I have tried every suggestion, the vitamins, limiting caffeine, you name it I have tried it. The pain is just getting so unbearable, it hurts constantly and I keep feeling more and more lumps. I don't want to be going back for surgery of another lump every few months. The pain is getting to the point that its interfering with my activities of daily living, and I don't want to live with it for the rest of my life. I've read that having fibrocystic disease slightly increases your risk of breast cancer and I'm scared out of my mind I'm going to end up with it because of all the pain. I think my great aunt had breast cancer and just about all of the other women in my closer family have fibrocystic disease, but none as bad as mine.
I know that I need to talk to my doctor about it, but I'm trying to get some information before that. I'm really considering having a preventative mastectomy and I'm wondering if insurance usually pays for that? And do they pay for the reconstruction of it too? Is this something that any surgeon would even consider in my situation? I really feel like I have just exhaused all the options. I'm currently in a 2-year nursing school, so its imperative that I get back to school asap and I really can't miss any school. Generally, how long does recovery take (at least recovery enough that I could get back to class)?  

[Archibald S Miller III, MD,FACS]

The recovery is around one month. The time it takes depends on how the reconstruction is done. Very few general surgeons are trained in breast reconstruction, and they are trained by plastic surgeons.

                            arch miller ms md facs

[graciesmom]

Thank you, thats very helpful to me. Do you know about how long generally the recovery lasts? So, this procedure can't be done by a general surgeon, but rather a plastic surgeon?

[Archibald S Miller III, MD,FACS]

Yes, insurance companies will pay for something like you describe. You must get a referral from your primary care doctor, and the surgeon who has been doing the biopsies to a good reconstructive plastic surgeon. That plastic surgeon will then examine you, take pictures and write a letter to the insurance company likely recommending a subcutaneous mastectomy with immediate reconstruction.  I hope this helps you, respectfully,

                    arch s miller ms md facs