Why I'm not having breast reconstruction

As you have discovered, decisions are largely dependent on individual circumstances. At the time of diagnosis, my cancer had already worked out how to metastasize. I had metastatic cancer in my lymph nodes. As far as we know (I had a bone scan and CT scan before surgery) it has not gone elsewhere. This really controlled my choices, however, as the priority was to treat the cancer I already had. A double mastectomy increased my risk of infection and complications from surgery. As we did not want to delay chemo, a single mastectomy was best. My surgeon did say we could always do this later in conjunction with reconstruction if I wished. Fast forward to the end of treatment which included chemo and radiation (because of those 5 lymph nodes with cancer and the fact that there was no tissue between my tumor and chest muscle). The good news in my situation was that my cancer was highly hormone positive. Tamoxifen was going to make a huge difference to my chance of staying cancer free. If I wanted further surgery such as a preventative mastectomy and/or reconstruction then I would have to delay or stop taking tamoxifen, due to the increased risk of blood clots. Looking at what statistics they could give me regarding risk of recurrence and risk of getting cancer in the other breast, it did not make sense to undergo further surgery. Without tamoxifen my risk of recurrence was about 50% (tamoxifen improves this to only 19%). As far as they can tell me the risk of getting cancer in my 'good' breast is only slightly higher than anyone's risk of getting cancer in the first place. So health wise I am better off keeping my 'good' breast. Body image wise I am fine with one breast. I actually feel better now than before BC because I exercise and eat well so am fitter, a healthier weight and more toned. From a practical point I think it makes wearing a prosthesis easier because I have one real breast to keep my bra in place. I am only a C cup so my prosthesis is a comfortable size. So we monitor everything closely and hopefully my 'good' breast stays good. A second mastectomy would only make sense for me IF it became necessary health wise. Taking tamoxifen actually helps decrease the chance of getting cancer in my other breast as well as reducing my chance of recurrence. This is why I am comfortable with one breast. I think it is so important that we realise that everyone's circumstances can be different and doctors (plastic surgeons especially) need to present us with the best advice for our health not just aesthetics. Why would you not want reconstruction? Because you want to live? Deanne xxx