DCIS, mastectomy with immediate reconstruction advice please.

Hello all,

This is my first blog as I have only recently been diagnosed with DCIS, high grade.

I had been getting strange pains in my right breast and my doctor sent me down for an ultrasound and mammogram. From there I was sent to a general surgeon who told me that they had found a very small area of calcification in my right breast. I was then sent on to have a stereotactic biopsy. It was only a few days after this that my surgeon had wanted to see me again, this made me worried. This is when I was told that they had discovered I had DCIS, high grade.

I went straight on to have a lumpectomy with sentinal node(s) removed. I was still quite positive because in my mind it was only small and hopefully they would get it all out and I may only have to worry about following up with radiotherapy afterwards. Within a week I had my results. Thankfully my sentinal node results were clear and there were no cancer cells found within my breast. Unfortunately though the area was bigger than they had thought and they removed 3.5cm. Three sides had clear margins but one side didn't. This was when the reality of it all really kicked in. We touched on my options, another lumpectomy followed by radiotherapy, mastectomy or mastectomy with immediate reconstruction. I was quite numb at this point and thought I'd just go ahead with the lumpectomy. However being small breasted I knew that after two lumpectomies and radiotherapy my breast was going to be different. After spending some time researching my options I now feel that a mastectomy with immediate reconstruction is possibly the way I want to go.

For several reasons I don't want to have an implant. So I have been researching flap reconstruction, mostly DIEP. I understand this is a major operation that can have a lengthy recovery period. I have been blessed to be able to read many stories from this site and have already read over all the reconstruction links that have been posted. They have been wonderfully helpful in my decision making.

What I really wanted to discuss with you all was my options. I will be going through the public system and I am really worried that I am going to be persuaded into implants particularly considering I haven't had radiotherapy (and possibly because my breasts are small). At the end of the day will I get to make the choice of what I feel is best for me or will I not have that option? I can be quite intimidated by doctors/specialists and scared I'm going to be talked into something I really don't want to do or that they wont listen.

The next choice I need to make is do I do both breasts at the same time. Oh so many decisions!

I would be ever so grateful for any advice on all of this. I would also love to hear from those who have had mastectomy with immediate reconstruction, followed by flap reconstruction - TRAM flap or DIEP. Also from any one who has had bilateral mastectomy with immediate flap reconstruction-how long was the operation, recovery time etc.

I am a 39 year old singly mummy to two beautiful young children. I live in country Vic and would need to travel 3 hours to melbourne to be able to do any of this.

Thank you for reading my 'very long' story :) I hope it all makes sense!