Deciding between surgery options

Hi all

I’m new to the forum (and breast cancer).

I’m 35 and about two months ago I was diagnosed with breast cancer. It was, obviously, quite a shock, as I’ve always been very fit and healthy.

It later transpired that I have triple negative breast cancer. A few weeks later the testing confirmed that I’ve got BRCA1 gene which is to blame for my cancer.

I’m currently going through the neo-adjuvant chemotherapy and started thinking about my surgery options (also bearing in my BRCA1 mutation). My surgeon seems to be keen to do a mastectomy on the breast that has a cancer tumour (it’s my left) and I need to decide what to do with my healthy (for now) right breast. My surgeon is very sceptical we would be able to catch a new cancer in time if I choose to go for regular screenings instead of mastectomy because of my triple negative history. However, my genetics consultant was quite positive we should be able to do so, as cancers take a few years to develop. I don’t know who to trust and not keen to undergo a surgery that may be a bit of an overkill. Another consideration that I have is that I may not have enough body fat for both breasts, even though they are quite small (I’m quite skinny) and having an implant may be difficult because of the size of my breasts (I’m afraid it would show).

It would be great to hear from you how you decided on the surgery and what you were considering.

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Welcome to the forum @tinatin

I’m so sorry to hear about your diagnosis, it’s no wonder you feel shocked.

The forum is full of kind people and I’m sure someone will be able to share their experience of deciding on surgery with you.

Please also know that our nurses are here for you any time, here on the forum on the Ask our Nurses your questions or over the phone 0808 800 6000.

We’re thinking of you,

Hi I was 35 when I was diagnosed with tripple negative breast cancer and in lump nods under arm I had the flap surgery were they took the fat from my tummy and put it in my breast I don’t have a nipple it was also my left breast but tbh I don’t care about no having a nipple. And surgery wasn’t as bad as I thought IV always been healthy I don’t get poorly ever and never been in hospital unless I have my children so when I was told I had breast cancer I was so scared and worried I have 7 children I’d just had my baby he was 3 weeks old I had chemo and radiotherapy after my surgery chemo 1st did 8 cycles off that and 3 weeks off radiotherapy every day for 3 weeks. Feel free to meAssge me if u want to ask anything good luck xx


Thanks so much for your response! Was it critical to have enough fat for the flap? I’ve got a bit of a tummy but I’m size S at the moment and I’m concerned that it won’t be enough. I don’t mind gaining a bit of weight if it helps!

I was a size 6 to 8 when I first started chemo but I gained weight threw the steroids witch helped for my flap surgery I literally just had enough fat for the surgery for one boob I’m glad I gained weight and same as you I’m small boobed aswell. Xx

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My surgeon told me that if I do a flap, I should do both breasts at the same time but I don’t think I want to have my healthy breast removed at this stage in life. Do you think it’s possible to use my fat (new fat!) again if / when the time comes for my other breast to be removed? Appreciate that it’s rather a question for my surgeon but just gathering different opinions.

With BRCA1 it’s an automatic double mastectomy here in the states. Triple negative is associated with it, your chances of developing it are weirdly high, and it doesn’t take years to develop usually. That one is usually quick and you counting on scans to catch it before it spreads is a risk. In saying that though we do have a goldilocks procedure that can give you a small breast mound using skin as an implant and not an actual implant. I don’t know if that is an option in the UK but I read about people being very happy with that choice on-line. I would also let you know that over here, your ovaries would be taken out at some point, too.

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Hi Tina. It is not possible to go in to your abdomen again for the next breast at a later point. You either do them both or one but you get one shot either way. And I was 122 pounds and they had enough abdominal fat for two sized C breasts with me.

Thank you so much for your response! Here in the UK I can choose but based on my genetic test results the chances of developing cancer in my healthy breast are around 40% which is actually quite high. I was thinking of doing screening for now instead of mastectomy but the more I think about it the less arguments I see for delaying the inevitable.

Thanks for sharing your weight, it’s so helpful! I’m actually bigger than you are (62 kg; 136 pounds), so it’s a relief to hear that it should actually be enough!

Hello @tinatin
So sorry you are in this situation at such a young age. This is a huge decision one that may very well save your life.
I was diagnosed Brca2 after a triple negative breast cancer diagnosis 3 years ago. I was offered a double mastectomy and for me that was a no brainer. Firstly I was tasked with doing whatever it took to get rid of cancer, secondly to reduce the risk of cancer in my good breast, so I had the double mastectomy. I lost weight during chemo and didn’t have fat for reconstruction so have had implants. It’s the closest I could get to a normal chest. I have kept my own nipples. The implants can wrinkle at times but overall even in a bikini I am happy.
Being confident I have done everything to beat cancer makes the decision right for me.
Hopes this helps and if you want to chat direct feel free
Wishing you well with whatever you choose xx

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I was five foot two by the way so a size small but still I carried weight in my abdomen which was enough. I didn’t look like it though and everyone was surprised (including me) when I came out with my sizable C but they did it and I was glad :slight_smile:

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Thank you so much for your message, it is really helpful! The key point is indeed to ensure that cancer doesn’t come back.

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Hi @tinatin

Sorry to hear about your diagnosis and dilemma in deciding on next steps.

My surgery experience is current as I have been undergoing treatment for DCIS, since January I have had a lumpectomy followed by a re-excision both procedures were a logical choice. But, in Feb I found out the re-excision hadn’t been successful so I was advised to have a mastectomy, my surgeon was willing to offer a MRI scan or try a 3rd breast conserving operation, but I felt that both options would probably just delay the need for a mastectomy. I decided on having a single mastectomy to get rid of the cancer and reduce the risk. The next stage was deciding what reconstruction to have, and I decided on a DIEP reconstruction, after researching implants, reviewing photos of work done by my surgeon with my breast cancer nurse, and knowing i didn’t want to go flat on one side.

Having made a decision, I felt relieved. I then started worrying about my other breast, as I had undergone successful breast-conserving treatment for DCIS in 2020. This was a more difficult decision but I had a lot of factors at play having had radio theraphy if I had a reoccurance then I was require a mastectomy, also, due to the radiontheraphy implant reconstruction would have a high risk of failure, so it would invole going flat or having another part of my body used for a rebuild. After weighing up options, risks, outcomes and future scan anxiety, I have decided to go for a bi-lateral mastectomy with DIEP reconstruction. I am waiting on the surgery date but I am settled mentally that this is the right decision for me moving forward at this time.

I would say do your research and that there is no right or wrong decision, and whatever decision you make, it will be right for you at the stage in life you are at.

Some resources that I found useful for reconstruction support were this Forum and website, the Ask our Nurse service, and

Thinking of you and all the best with deciding x

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