I’m afraid that you need to have a mastectomy”, said the breast surgeon with the dodgy wig who couldn’t meet my eye. This was when the wall of emotions that I’d been carefully building to protect myself from the future completely collapsed and I began to sob. Not only would I soon be bald as a result of the chemotherapy that I’d be starting in a month, but I’d also be single-breasted, or a uniboober as I came to call my lopsided mammary situation. At that moment, I couldn’t imagine anything worse.
A month earlier in January 2016, I’d been diagnosed with Grade 2 breast cancer in my left breast following my second routine mammogram at the age of 54. The original treatment plan was for me to have a lumpectomy followed by radiation – it sounded scary but doable.
The doctors thought that the tumour was only 20mm. How little did they know?!
Unfortunately, like many cancer patients, my treatment plan changed for the worse as the doctors found out more about my particular tumour. It turned out that the tumour was Grade 3, multifocal (in lots of places throughout my breast) and was actually 70mm in total. The surgeons couldn’t get a large enough clear margin around the tumour and this was why I had to have a total mastectomy.
What followed was one of the scariest video shows that I’d ever seen. I was shown many gruesome after and after photos. I think they were actually called before and after, but I like to think of them as after mastectomy – numb, flat chested with no nipples – and after reconstruction – numb, breast shaped chest with no nipples. There were no photos of women who had chosen not to have reconstructive surgery, so I thought that everyone went on to have new breasts created to replace those that had been removed.
It turned out that the only reconstruction option open to me, as a very well-endowed woman in the chest department, was the DIEP flap procedure, or tummy tuck as it was sold to me. I would definitely go down a jeans size after the 8-hour operation which would leave me with a hip-to-hip scar and a “breast” fashioned out of my own fat from my stomach.
Oh yes, and no nipple – that would have to be added later.
I would have to have delayed reconstruction because I was expected to have radiotherapy and they couldn’t do surgery until a year after my last radiotherapy session. So, I would be living as a uniboober for at least 18 months – this would be interesting for someone whose remaining breast was a GG cup. As it turns out, the enforced delay was a gift. I was in shock and had accepted that I would undergo the reconstruction surgery, and have the positive upside of being able to buy new jeans after the operation!
At this point, I want to say that I am not against reconstructive surgery. What I am against is the assumption that most surgeons make that all women want to have reconstructive surgery. Is this because the medical professionals think that we all want to look exactly like we did before our surgeries, and that our breasts define us as women? While this may be true for many women, I decided that it was not what I wanted.
It took me a couple of weeks and much soul searching to reach this decision. I spent a long time Googling and trying to find out if everyone always had reconstruction. It had never been suggested to me that another option was not to have a new breast but to stay flat after mastectomy. I think that it’s very important for all the options to be presented to us so that we can make informed decisions on what treatment we want.
In March 2016, I had my mastectomy and woke up with only one breast. That was one of the lowest and most shocking moments of my life. It took me a few days before I could look at the flat side of my chest and I really doubted my decision not to have reconstruction. As the days and weeks went on, it became easier to look at and I got used to seeing a scar where my breast used to be.
What I couldn’t get used to was my GG cup remaining breast. I hated being so lopsided and it took a long time to become used to wearing my huge silicone prosthetic breast. I did wear it every day but really looked forward to taking my bra off with my breast attached to it at the end of the day – it certainly made a thud as it hit the floor!
Eighteen months after my first mastectomy, I had my second breast removed in November 2017. My surgeon had finally agreed to remove my healthy breast after I had persuaded him that I wanted to be symmetrical. I had to persuade a psychologist that I wasn’t mad and, once I had achieved that (it wasn’t difficult), the operation went ahead. Having lost one breast to cancer, I had decided to face my fear of operations and have the other one removed – I found that to be very empowering.
We’re all individuals with our own viewpoints, fears and wishes. There are so many factors to consider and, early on in our cancer journey, we are bombarded with information and made to make many treatment decisions. I wonder why so many hospitals don’t give all the options when mastectomy is required.
Reconstruction wasn’t for me because I didn’t want to have any more operations than were absolutely necessary. If I had chosen reconstruction, it would have taken a few procedures to get the result I would have been happy with, and probably an operation to reduce my other breast. Reconstruction is definitely the right decision for many, many women – I’m just not one of them and it’s my right to decide that.
I’m so happy with my new shape – I feel as though I have the body that I always should have had. How extreme that it took breast cancer to get me there! I feel confident, brave and strong, not to mention that I don’t carry around two huge breasts. This is not to say that there are no down sides. There definitely are. I’m numb under both of my arms and over most of my chest, I have excess folds of skin under both my arms and I have strange aches and pains and sometimes flashes of pain. But these are nothing compared with the joy of never having to wear a bra again if I don’t want to and, if I do, to be able to choose the size I’d like to wear. I’m thinking a C cup!
I am trying to embrace my new life after cancer. I feel that I have made the best of a pretty bad situation and taken control of how I want to live. I want to advocate for the right of women to be given all of the options after a mastectomy, and that includes the option to remain flat. And I want to increase the visibility of women who choose to live flat. I’ve discovered that I don’t need breasts to feel like a woman. I think that I look pretty darned great topless – a little different to the norm, but great nonetheless.