Ectomy Schmectomy!

Ever since that call, surgery has been on my mind. Which one should I get? Which one will be better for me, for my family? I always said if I ever got breast cancer, I would just get a bilateral mastectomy and call it good. But that was before I actually got it. I thought I would be old. Or at least older. Not 25. Not still wanting to expand my family and breastfeed my babies. Its easy to say what you would do, until you actually are in that situation. I talked to my oncologist today. Dr. M. I asked him which surgery he would suggest, given my age and triple negative cancer, he said he would suggest a mastectomy. I knew that is what he would say. As an oncologist, his life is dedicated to getting rid of and preventing cancer. 


I also asked him what my chance of recurrence will be. This depends on a few things. How the tumor responds to the chemo (if its all dead or close to being all dead, or if there is still a large portion of live cancer cells), if my lymph nodes are affected, and if it has spread according to MRIs. All of this we will find out in October/November before and after my surgery.  If the tumor is all or mostly dead, there is no spread, and the lymph nodes are not affected, my chance of recurrence is 15%. If it has spread at all, lymph node involvement, or the tumor hasn't died, recurrence rate goes up to 50%. And from what I've read recurrence happens within the first 2 or so years. 


I know what surgery I have is up to me. But I need to choose which will give me the best rate of survival. I have two sweet baby boys and a wonderful husband to think of. I've thought of just having a single mastectomy, so that i could breastfeed our non-existent future child(ren). I know that sounds ridiculous, but nursing my children has been one of the absolute best experiences of my life. In fact, ever since my diagnoses, the only time I have cried about having cancer is when I had to wean Little W. And it makes me incredibly sad that I may never nurse again. If I had been diagnosed 5 years from now, when we were done having children, I would choose bilateral in a heartbeat. I would have done lots of things differently. I probably would have done the clinical study as well, but one of  the side effects is early onset menopause. I don't want to go through menopause at 25. I thought I had 20 years before I needed to worry about hot flashes and mood swings and mustaches. 


Another issue with a mastectomy is reconstructive surgery. I would definitely want it. Including nipple conservation or reconstruction as well. I don't want to go the rest of my life looking like a 12 year old boy. Going with unilateral mastectomy I feel I would look lop sided. I also don't want to look like the uniboob from Kung Pow. And also, with reconstructive surgery, how long does it last? Will insurance cover it? Will I need surgery again in 10-15 years? Every 10-15 years? And how does one pick a good plastic surgeon? Should I start reconstruction at the time of my surgery? Wait? This is all overwhelming. And it all sucks.