To Be or Not to Be a B Cup

pdub recon

This Cancer Survivor’s opinion about Reconstruction

Overwhelmed and dazed. That’s the best way to describe how I felt when I was diagnosed with cancer in 2015. My version was Stage 2A invasive lobular breast cancer. After returning home from a magical Mexico vacation with my husband I discovered a lump in my left breast. This little lump quickly turned me into a person with an overflowing binder of cancer info and contacts. Oh the dreaded “binder”.

binder

Like most patients, I was overwhelmed when I was diagnosed. It didn’t help that I had to learn a whole new language of medical terms, and make enormously important decisions that would impact the rest of my life. And with all of this I had to consider many uncertainties including whether or not I was even going to survive.

While I was in my fog decisions were made in quick and often seemingly casual conversations:

We’ll remove just the one breast including the nipple but likely not the other one. We’ll remove your lymph nodes during that surgery. Fat from your back to inject into your chest cavity? or Implants during mastectomy or implants at a later post treatment reconstruction? “

“Wait, what? What do I need to do? What’s going to keep me alive?”

I am simplifying these conversations but there is a systematic approach to managing breast cancer diagnoses. The conversations and treatment paths vary depending on what type of cancer you have but it’s a decision tree. Do you have breast cancer; if yes then X. Did it spread to your lymph nodes, if yes then Y. But I have learned from both my own experience and from talking to other breast cancer patients that a common part of the tree is this:

Reconstruction is an assumed course of action as part of our treatment.

But why?

Is this the optimal path for us for our long term health, and our long term emotional and psychological health? Is our culture’s idea of what a woman’s body should look like be influencing this direction? I also assume there may be a little bit of ‘that’s how we’ve always done it.’ I could be wrong, but the question is still ‘why is it assumed?’

I wish I had asked: “What is going to keep me alive and what is going to make me feel ok in the long term?” The answer to the second part of this question is most likely different for every single patient because there are so many physical, cultural and psychological things that go into answering it. For me, I prefer less pain over aesthetics.

After my reconstruction, I had pain and swelling issues, which resulted in a second surgery, which has left me where I am today. My left ‘breast’ contains a small implant , no nipple and is significantly smaller than my right breast. It looks weird and kind of ripples and is uneven so I don’t know why I didn’t just opt for nothing at all. Having nothing might appear odd to some, but I would have a lot less grief on a daily basis. I wish I had skipped the reconstruction altogether.

This is easy for me to say now that I’ve actually gone through it all and know what the outcome looks and feels like. It is also easy for me to say because I am nearly 50, and in a loving supportive marriage with a husband who is proud of his survivor wife no matter what my body looks like.

But my point is this: I believe when facing these decisions the information presented to us should be equally weighted to offer no reconstruction as an option as well as the reconstruction options.

I love my plastic surgeon, he did a great job and I think he’s a superstar. But I don’t recall much, if any conversation about not doing reconstruction. Maybe that should have been discussed with my general surgeon who was the first stop in reviewing my treatment plan? In my case it felt like it was just the normal path to take and it never even occurred to me to say “hold on is this reconstruction thing necessary”?

Regardless, I think the responsibility falls on us, the patient, to be our own best advocate to stop and ask those questions before we move forward with this or any portion of our treatment. Especially while the systematic approach seems to be in favor of reconstruction.

If I ever were to get diagnosed again (always a fear) I would have them both removed and live with a flat chest. I would not feel any less feminine, it would just be my personal preference knowing what I know now.

Even with all of this I am grateful to be here and proud of my chest. I wear wire free undergarments and bathing suits that are comfortable and don’t hide my lopsided-ness.

There are some beautiful options that allow for inserts if I want to look balanced and like my old self.

There are wonderful companies out there like AnaOno Intimates that offer a ton of beautiful product options during all stages of treatment. They sell bras and swimwear for every version of our new bodies, while simultaneously building a supportive community. They are breaking societal norms by showing us what different definitions of beautiful are.

This post is in no way judging anyone for the very personal decisions you make during an undeniably super stressful time. But if you, a friend or a loved one are diagnosed with breast cancer, and breast removal is part of it, I hope you will have the conversation and talk about your options.

So, while you are talking about ‘what size’, how about also asking ‘what if’?

Pamela

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