bilateral mastectomy

It’s strange to lose your breasts, to lose a part of you that makes you a woman. For some people it’s a sensual area. For me it never was,. In fact, I never really liked my breasts that much. They identified me as female, they were objectively sexual but I never found them beautiful. They were small, oddly shaped – at least that’s how I saw them.

Now I actually like my breasts. I think I own them differently. I find them beautiful, sexual. There is not a lot of sensation in them but, regardless, I like the way they feel to the touch. For me, being a woman and feeling sexual – which was an important thing for me to find after a Breast Cancer diagnosis – came with body ownership, feeling integrated in my own skin. I owe much of this sense of ownership to the choices I made pre-surgery and to some of the sexual exploration I wound up doing after surgery (all of which I will write about in time).

I’m sure there were somatic issues, emotions I held in my original breasts, which were somehow walled off from the rest of my body. I’m also sure that some would say that was the root of my cancer. I will never know. But what I do know is that, while this is not a diagnosis I would wish on anyone, the silver lining for me is having a healed relationship with my breasts and a part of my womanhood I had unknowingly denied for so long.

In 2011, when I was first diagnosed with breast cancer, I was confronted with choices about what to do in terms of surgery. My tumor was fairly large and even with neoadjuvant chemotherapy (which means chemotherapy to shrink the tumor prior to surgery), it was recommended that I have a mastectomy.

The time and energy I put into the following decisions were pivotal in my body ownership journey. Being my own medical advocate was critical. Making choices based on health and aesthetics got me out of feeling victimized and hopeless. When I look at my breasts, I feel proud. Through something that made me feel so powerless, it was nice to find a way to be present and proactive. It was easy to hear that inner voice that said “I DON’T WANT Cancer” and how fantastic it was to be able to hear “I WANT…” and then do something creative with that desire.

My choices aren’t right for everyone but I am putting them here in case they can be of help to anyone. Because an extra voice may have helped me as I was trying to figure out what to do.

Bilateral vs. Single Mastectomy: The cancer was only in one breast and I had to decide whether or not to have both breasts removed or just one. I opted for both with silicon reconstruction.
- Symmetry: This was important to me. I was grateful to have life saving surgery and I wanted to go after what, for me, would be the most aesthetically pleasing choice.
- Less Stress: With Cancer there is already a fair amount of poking and prodding that happens on a regular basis. There are frequent scans and the stress that is associated with waiting for the results. I did not want to have to go in for a yearly mammogram and add that to my list of worries. Never mind that the data shows that survival rates don’t necessarily improve when you remove a healthy breast. Tell that to my emotional center!
- Question of Breastfeeding: Knowing I wouldn’t be able to breastfeed (if and when I did have a baby) wound up being less important than symmetry and less stress. But this was definitely on the list of things I was considering.
To Nipple or not to Nipple?: Through research, I learned about nipple sparing mastectomies. It was something I requested and, because of the placement of my tumor, I was able to keep both nipples. The one on the cancer side looks a little different but I am still happy with the result. (As a side note, my keeping my nipples did not have anything to do with my recurrence. Sadly I had lymph node involvement as well, so the cancer had already escaped my ducts.) The process post-surgery was trying because, while they were able to spare the actual nipple, there was no guarantee my body would resume blood flow to that area. So even after surgery, I was at risk of losing them. I’m happy to say that I got to keep them both.