Single vs Double

One argument I would put through is that genetic testing, as it is now done, does not include each and every gene, so potentially there could be something lurking that the genetic testing hasn't caught because they only test for specific gene alterations. I would also say that since science has not yet fully discovered everything there is to know about the causes of cancer, there could still be something common to all the family that is hidden from sight at this time and could potentially still put your mother at an unknown higher risk.

From there, I would go to point out the mental health aspect, the worry that would be caused by not having the other breast removed, but I would base it first in the above points.

If the surgeon still is difficulat, ask their reasons and go from there. Do not sign agreement to anything you are not happy with, and if needed, ask to be referred to another surgeon.

GreyCats thank you so much you have been amazing on all my posts i really appreciate it.

i want to write it all down and read from the paper to show them we have done our research and its not a flip decision, my mum is going to make her own notes but if you don't mind reading what I have so far and if you think i should add or change anything 

• GENTIC TESTING

• The genetic testing does not include each and every gene therefore potentially there could be something lucking that the genetics hasn’t caught because they only test for specific gene alterations.
• Since science has not yet fully discovered everything there is to know about causes of cancer there could still be something common to all the family that is hidden from sight at this time and could potentially still put mum at an unknown higher risk

• METAL HEALTH

• With the family history I seriously worry about my mum’s mental health if she has a single mastectomy I know she will live her life in utter fear of the cancer returning, she will become a shadow of the woman she is now, which is not what any of the family want especially since she has 8 grandchildren that she wants to see grow and be part of their lives
• She is already on antidepressants
• WEIGHT / RISK

• Being over weight is the second biggest cause of cancer in the UK, the risk is higher the more weight you gain and the longer you are overweight

• AGE
• She is 58 now IF cancer came back on other breast in 5 – 10 years time she will be 63 – 68 will she be healthy enough to under go another surgery???

Hi Amanda - I just want to reiterate, as I have in replies to your other posts, that this should be your mother's choice.  So please do be firm. However, she may need to demonstrate that she has understood the additional risks of a double, but ultimately it is her not her surgeon's decision. I would add to your list below that she understands those additional risks: i.e. it's more major surgery, higher risk of infection etc. I had to go through a psychological assessment to demonstrate that I understood the additional risks. 

Thanks Zanna38 i really do from the bottom of my heart appreciat all the helo you have given me.

I have added onto the bottom the following 

My mum fully understands the additional risks of having a double mastectomy i.e its major surgery, higher risk of infections etc, and she has not made this decision lightly.

My mum has a large support network of family and friends.  We as a family are here to support her decision and shall be her support network mentally and physically before and after surgery and long after the cancer has gone.

I’m not making in comment on the request for a double here, I totally understand it, but I wanted to tell you what my surgeon told me.

In the absence of a genetic factor there is no medical reason for having a double mastectomy. It is the equivalent of saying, I’ve got breast cancer, please can you remove my bowel as well. The breasts are two independent things and because you have breast cancer in one breast there is no reason you will get it in the other. Having a double mastectomy does not guarantee you symmetry. As such my request for a double mastectomy was refused. I am 50 and healthy in other aspects. They weren’t interested in my mental health about it at all, they could refer me for counselling. Just so you’re ready for that response and can think of answers for those points before you get them given to you x

Thank you for sharing that with me Anna, yes I did chat with my mum yesterday to say she needs to go with an open mind and be prepared for them to say no to the double and to only have the single.

If you don't mind me asking do you have a high family history of breast cancer? I'm thinking maybe this might help our case 

I am so scared of what will happen to her if they do refuse her the double :( 

Well this is my second breast cancer in the same breast but no, I am the first to have breast cancer. That said my siblings have both had cancer, Hodgkin’s Disease and Bladder cancers, they are however unrelated to breast cancer. Hopefully as you say that will help your case that you have a family history of breast cancer, good luck x

Thanks Anna sending you all my love and thoughts x

Hi Amanda, I've been out all day so only just saw this. What Anna said is exactly why I said to base the mental health concern in the science stuff I mentioned first, because, as Anna said, they can sometimes disregard MH concerns, making it necessary to go the psychological assessment route. But, when you can present a reasonable scientific argument, they will listen. 

If the surgeon is adamant he will only do one-sided mastectomy, your mother may wish to consider doing the other side privately. Even if this is wholly unnecessary, I believe in our autonomy over our own bodies, and I would only require that the choice made is a fully informed choice, meaning, someone goes over with her in detail over the science, and assuming she still wants the other breast gone, do as she asks whether or not they share her opinion. It is her body, after all.

Wow this is rough.

I know it depends on the type of cancer your Mum has if there is a likely hood of it being found in the 2nd breast.

I would be asking the Dr. Is there a certain type of Cancer that is more likey to travel to the 2nd breast? Does my Mum have that Cancer? And most importantly...What would the Dr. tell his WIFE or DAUGHTER to do.....That is what I would do with MY BODY.

Hoping for the best for your Mum.