Don't know what to do....Private vs NHS and reconstruction now vs later.

I am 31 diagnosed with Breast Cancer thats all I know so far.  They say a lumpectomy will get rid and then 10 days after surgery they will figure out what treatment i need that is Radiation and or chemo. 


I really want a bilateral Mastectomy, even though only 1 breast is effected.  The only reason being is that I am scared of it returning.  I have 3 yound kids under 4 and I want to pick a surgery option that is going to require me being away from them the least amount of time.  I have fully thought about all the pysological problems that may come around with the removal of both breasts, but I think that this out weighs the feelings I may feel with 1 real breast and 1 implant.  I would like to go for bilateral mastectomy with reconstuction in the same surgery.  Though dont fully understand if the implants then would be safe with radiation therapy. 


I would like some help, deciding whether to hold off on the reconstruciton until treatment is over after the surgery.  Also has anyone went on self funded private surgery.  and what would the general cost be for the mastectomy and reconstruction (i have £10k set aside for this.)


Rachel why are you looking to fund this yourself ?R u not in the UK?

Hi Rachel,
I have no idea of the full cost but just wanted to tell you of my experience.
I received all treatment in a private hospital thanks to private health insurance that comes with my Job.
I was told I needed a right mx, followed by chemo and uncertain until after op & path report whether I’d need rads.
I asked for double mx - my surgeon explained that firstly the other breast was cancer free and IF cancer was going to come back it could just as easily come back in my kidney or liver or bones… so what other bits did I want him to chop off?
I do know now that there is one type of cancer that if you get in one boob they recommend a double mx and also if you have brca mutation.

A double mx is a big operation to recover from, best in mind that if you need chemo they need you fighting fit before you can start so they wouldn’t want to risk any delays.

If there’s a chance of rads you may not be able to have an immediate recon - I think the usual timing for recon after rads is at least a year.

I was told let us get you cancer free first but if you still want an mx of the healthy boob you will have to talk it over with a counsellor first.

As my cancer was deep I had a skin sparing mx with temp implant, then a week later an axillary clearance as cancer found in sentinel node. Then chemo. No rads as all nodes from armpit were clear. 6 months after chemo temp implant replaced and boob tidied up (too much skin was left after first op). I was tested for brca mutation and that was clear so I had remaining boob reduced to match about 8 mo this later.

Sorry for the long post but I wanted you to see the advice you are getting does not appear to be money related.

Take care x

Hi Rachel,


Very sensible advice from everyone who has commented so far. I’d just like to add that if you are UK based then the treatment offered by the NHS is, in my experience, top notch. I would certainly explore that before commiting to spending so much cash from the offset. It really may not be necessary. 


I had a single mastectomy with implant reconstruction and am very pleased with the result - much better than I could have imgined. I realise that things will need tweaking in years to come but can live with that. 


I didn’t need radiotherapy in the end but obviously that is a consideration if you are going to have implants. In my experience, different surgeons tend to be influenced by their own specialities. My consultant, who is an expert in the strattice mesh implant technique, did not hesitate in recommending immediate reconstruction to me. When asked what would happen if I needed radiotheraphy he simply said “we will do it again.” I know that some surgeons advise delayed reconstruction and at this stage you would no doubt don’t want to be thinking of more surgery in the future but I just wanted to point out that this is an option.


How long do you have to make your decision with regards to lumpectomy vs mastectomy? It’s certainly worth giving it more thought and doing more research before deciding on your surgery and possibly spending a lot of money. I believe the possibility of recurrence for both procedures is pretty much the same and for both that’s pretty low.


Good luck with your decision. Lets us know how you get on.


Ruth xx

I went NHS as had private appointment booked (£13,500) and the NHS rang up and offered me a date 3days after the private one was supposed to be so I cancelled it. I am really pleased with how I have been treated and the surgeon was amazing and has been from diagnoses till surgery. I am over the moon with the decision that has been made.
Just now awaiting oncologist appointment and then chemo. ???

I am NHS and I really do not think my treatment could be any better or quicker. I mentioned a nipple discharge to a nurse when I went to have my blood pressure/statin review. That was on Tuesday and the nurse told the GP who then emailed the breast clinic a referral, they phoned on the Wednesday and I had an appointment on the Friday of that week. There followed mammograms and ultrasound plus biopsies. Three weeks to the day of my mentioning it to the nurse I had surgery - a lumpectomy and sentinel node biopsy. I am due to go an get my path report tomorrow. I think it will be chemo next because mine is HER2 positive.


I would go private if there was a 6 month wait say for a knee replacement but with anything serious the NHS is quick. I could justify paying for new knee rather than going on holiday if I was uncomfortable but my life was not in danger. My husband paid for sinus surgery because there was a very long wait and you don’t die from a stuffy nose.