What I want is a simple double mastectomy. I loathe my big breasts and am quite happy at the thought of losing them. (I apologize to all of you who were upset at the prospect.) Here goes with the questions:

1) Anyone have any experience in getting insurance companies to pay for a double mastectomy when only one breast is affected? I have Humana. Any buzzwords I should use?

2) How soon after a double mastectomy do you feel like picking up a heavy suitcase and getting on a plane again? How long should I plan to be off work? I have always been a fast healer.

3) Anyone know any good (and patient-friendly) surgeons in the Las Vegas area? My dad lives there and he has invited me to come stay with him to recuperate. My insurance will also pay for more of it if I do it on the Mainland. What about Houston? (Yes, I know about M.D. Anderson. I am looking for an individual doctor, though.) I have some other relatives who want me there.

4) Do you feel awful all through the chemo process, or just for a few days after each treatment? Does the current medication make you lose your hair? What does it do to your skin? (I am awfully vain about my hair and complexion, dammit.)

5) I am obese. I am losing weight right now. My doctor asked me if I wanted reconstructive surgery, and I am not sure. If I get reconstructive surgery now and then go on to lose another 100 pounds or so (well, I can dream...), will the reconstructed boobs look funny?

-The suggestion of doing just the lumpectomy and chemotherapy for a 4 cm lesion is not in any way, or even close to, standard therapy. A lumpectomy should be followed by radiation therapy. The chemotherapy is indicated whether you have a lumpectomy or a mastectomy - it is dictated by the fact that you have a 4 cm breast cancer.

A bilateral mastectomy can probably be granted by an HMO (although Humana is one of the toughest). To have a single mastectomy would leave you very prone to back problems due to being off balance. I would get the surgeon to show it is medically indicated to prevent cancer and prevent back problems.

If immediate reconstruction is not one of your priorities, then wait. See what happens with your weight and your cancer, and then get around to it when you're ready.

-My mom has been confirmed stage 1 breat cancer. She had the lumpectomy and will do ratioation +tamoxifen. Her oncologist sited the Fisher study where even stage one patients can benifit from chemo. I live out of state and my mom is not stoo stong willed. For me it would be a no brainer to do the chemo, but I am concerned she would abandon chemo if she suffered some of the popular side effects. I asked the doc what he would prescribe in this situation for chemo and he jotted down the above (doctors handwriting). I am certain there are multiple typos in the drug name, but I could not find anything even vaguely resembling this name. This was reccommended twice
/month for 6 months.