Decision time

We saw my breast surgeon yesterday to finalize the plans for my surgery, and to schedule it. After much hemming and hawing over the various surgical options, I've finally made my decisions. Drum roll, please...

I have decided to have a bilateral mastectomy. My surgeon was understanding of my reasoning for removing both breasts versus just the affected one, which made me feel better about this choice. So what was my reasoning? Well, because of my age at diagnosis, I am at a higher risk for developing a new breast cancer in the healthy boob over the course of my lifetime. If I were to keep it, I would be constantly worrying. Not that there are any guarantees, even with the mastectomy. The surgeon will only remove the actual breast tissue of the healthy breast, leaving the lymph nodes. There's always a chance of developing a new cancer. Another reason for having a bilateral mastectomy is cosmetic; the plastic surgeon has a better chance of achieving symmetry by reconstructing both breasts.

This led to another big decision I needed to make—the type of reconstruction I would be having. The choice was between the DIEP flap transplant procedure or conventional implants. I decided that the implants are the way to go. For one thing, the post-surgery recovery time is shorter. Secondly, there were questions about whether I had enough stomach fat to form two breasts. Even if I did, my boobs would probably end up smaller that what I already have, which I don't want. They may have been able to transplant some additional tissue from my back, but that could lead to permanent weakness in my back, shoulders, and arms. No thanks!

More decisions: The first stage of implant reconstruction requires placing tissue expanders in the chest. Tissue expanders are basically balloons that the plastic surgeon inflates little by little, every 2 or 3 weeks. The purpose of the expanders is to create space for the implants, which will ultimately replace them. We've heard different opinions about when it's best to have the expanders put in. My plastic surgeon usually does it at the same time as the mastectomy. This means they would be in my chest during my upcoming radiation treatments. Some surgeons feel it's better to wait several months after radiation before putting the expanders in. Radiation can cause all kinds of skin problems, so the thought is that waiting on the expanders reduces the chances of complications (which can occur in as much as 40-50% of cases). On the other hand, the rationale for putting the expanders in prior to radiation is that they will help to keep the breast skin from contracting too much, a common effect of the radiation. It's all very confusing, and it's impossible to know which choices are the best ones for me because I can't know the future. All I can do is hope and pray my surgeons know what they're doing.

One thing I do know for sure is that I'm tired of obsessing over these major decisions! And that on September 28th, I will wake up from surgery BOOBLESS...yikes!!!