Hi Lori! I am at the same point as you- triple positive, found by screening mammogram, one more treatment in a few weeks and surgery is scheduled for July. I originally decided on double mastectomy without reconstruction, but as the date looms I am going through my decision process again! My 2 reasons seem to be holding: I have some weird skin issues that make me want to avoid radiation if at all possible so that pushes me away from lumpectomy. Second, I am looking to reduce the anxiety, for myself and my family, induced by screening every year. Prior to my diagnosis in Feb, I had several false positives on mammograms in several years. The false positive rate on mammograms is described as 50% of women will have at least one false positive over 10 annual screenings and I understand that the false positive rate is higher after breast conserving surgery due the scarring etc. I’m still researching how screening works after mastectomy but it looks like it is a combination of physical exam and MRI, both of which have better false positive rates than mammograms. Be well!!

Lumpectomy and radiation was my choice and no significant issues. I haven’t experienced any long term effects from radiation. I hardly noticed any impact except some skin changes toward the end of my six weeks and within another week or two, breasts back to normal. All my friends that also did radiation had no problems either. Not as scary as some may lead you to believe. My chemo was the hardest part and even that was manageable though not pleasant. Btw, I’m 11 years out from finishing treatment (2015).

Hi Lori, it's a tough decision. Only you know best as to how each of the surgical paths will affect your self image. For me, at 62, I opted for single mastectomy, aesthetic flat closure. I briefly considered double, but it did not make sense to me to undergo a longer surgery, more lengthy recovery time, risk further range of motion issues, more opportunities for infection, etc. just because of removing a healthy breast. Like you I was offered both lumpectomy and mastectomy, as well as reconstruction options. I did not want to do lumpectomy because I would then have to have radiation. I have an extensve family history of heart disease, and have a heart murmur. My cancer was on the left side- and being HER2+, the drug protocols involved a drug that has a common side effect of heart and lung issues.
So, I decided mastectomy. I am not a patient patient, lol! so could not see myself being happy with reconstruction down-times, etc. So, flat it is. I just pop a prosthetic in the bra and roll on with my life. It has been 7 years since surgery- and I have not regretted the decision, it suits my goals and personality. I am just sorry that women still have to make this decision. So, I still pray for either a cure, or even better, a preventative so that one day bc is just a footnote in the medical books!
Gather all your info, second opinions if you are unsure, and then listen to your inner voice, so you can make the decisions that are right for you! Hugs!

Hi Lori, I didn’t have to make a decision like you’re facing. But I wanted to let you know that my experience with both a lumpectomy and radiation in 2024 was so much easier than I imagined it to be. I haven’t had any problems from either one. Good luck with your decision. 😘🙏