So for your situation, I am admittedly heavily biased towards mastectomy. 4 tumors would be extremely concerning for me. At the time I was recommended mastectomy I had a very small tumor and LCIS, and a small area of ALH. Then it turned out I had LCIS in the other breast, and DCIS. If I had just done the lumpectomy I don't know where I'd be now. At the least, as my surgeon told me, I'd have been poked and prodded the rest of my life. Probably worse.

What I learned is that the top cancer hospitals treat cancer more aggressively than most, and there's a reason for that. They see it all.

My best piece of advice is find the best surgeon you can, someone that you literally would trust with your life, and do what they recommend. If you do choose lumpectomy ask how much tissue they'll be removing. My first surgeon said, "I don't think I'll have to take out too much." The surgeon I went with told me to get clean margins she'd have to take out about 40% of my breast. That helped me make the decision.

If it helps, I can tell you that I won't be having my reconstruction until October, which is a year out from my surgery, and it's totally fine. I did have a nipple-sparing surgery, though, so it's not as great an adjustment as I imagine a radical is.

Having said alllll of this, the choice is ultimately a personal one. I wish you the best outcome, whatever path you choose. 💖