After a woman has a mastectomy for locally advanced disease, she usually does not have breast-reconstruction surgery. The focus then is to treat her cancer as aggressively as possible.

If, despite these efforts, her cancer spreads to other organs, her disease then becomes stage 4 metastatic breast cancer, a chronic condition for which there is no cure. The goal now is simply to control the disease. Reconstruction is no longer discussed.

But this view is changing, and there’s some thoughtful discussion going on among breast cancer experts and patients about whether breast reconstruction should be an option for women at this stage of the disease. It’s true that most women with stage 4 breast cancer will die of their disease, but who says they have to die breastless?

Reconstruction may not be part of the "treatment" for metastatic disease, but should a woman in this situation be denied the opportunity to live out her remaining time as a two-breasted woman?

Some people think that the trauma of having breast-reconstruction surgery would be too much for her to handle in her condition. Others believe restoring her breast could provide her with psychological well-being and the quality of life she deserves.

If you were faced with this situation, would you ask for reconstruction or forgo any discussion of it? Do you think your surgeon and medical oncologist would agree to breast reconstruction, or would they steer you away from it?