Tuesday, April 3, 2012

The Mastectomy Question

To mastectomy or not to mastectomy?  That is a difficult dilemma faced by many breast cancer patients.  And if you do, one or both? And do you want reconstruction? And if so, what kind of reconstruction? These are tough questions and I can't give you any clear answer, since each woman must decide what is right for her.  There have been several celebrities in the news recently who battled breast cancer and chose to have mastectomies.  I can only share my choice and my experience.

My surgeon very clearly explained my diagnosis and what things I should consider in making my decision.  I only had cancer in one breast (and lymph nodes), but was at high risk of the cancer recurring in the other breast.  I also had concerns that reconstruction might impede detection of possible future tumors, although the doctor assured me that would not be a problem.  It still haunted me that dense breasts had prevented earlier detection for several years.  I have also heard how painful the post-surgery "stretching process" is, and I felt that I was already going through enough suffering without adding to it, thank you very much.

I have never felt defined as a woman by my breasts.  I was only meagerly endowed anyway, so although it seemed like I got cheated when I lost what little I had, I still felt no less a woman.  I realize this is MUCH different than most women feel about mastectomies, but I also resented them since they contained the cancer that threatened the rest of my body.  Get rid of them!

So I chose to have a double mastectomy without reconstruction, and I have never regretted that decision. I never grieved the loss of my breasts or stood in front of the mirror and cried.  My husband was quietly hoping I'd choose the D-cup reconstruction, but he supported me in whatever I decided and agreed that my health was first and foremost.  God bless him!  At the "chemo lounge" I have gotten to know several other breast cancer patients and we discussed our choices.  A couple of them were young women, in their 30's, and had chosen reconstruction.  It had been painful and difficult for them; one was not successful.

I was always content as long as I could wear a comfortable prosthesis and look the same in my clothes.  "Comfortable" is the key word in that sentence.  If you have seen the silicone monstrosities and industrial strength bras they try to sell ....... ouch!  If you are prosthesis shopping, consider lightweight and comfortable.  You also want to be sure straps are not overly tight and constricting if lymphedema is a concern.

Most health insurance will pick up the tab for this and allow you to get new once a year or so -- be sure to check out your options and insurance requirements.

I should also mention that I have known several women who have NOT chosen mastectomies, but only had lumpectomies, and based on the aggressiveness of their particular type of cancer, it was the right decision for them.

I recently heard of a friend who, due to occurrence of cancer in her family, underwent BRCA gene testing to see if she was genetically predisposed to certain cancers.  Following positive test results, she has chosen to have a hysterectomy as well as a double mastectomy.  I have heard that many women are choosing to have prophylactic surgery like this and I applaud their courage in doing this!  I read an article on Medscape Today that told that those who test positive for the BRCA gene have an 85% risk of getting breast cancer sometime in their lifetime, but following a mastectomy their risk drops to 1%. However -- not all breast cancer is related to the BRCA gene (I tested negative, in spite of my own cancer and family history).

Keep fighting the good fight, ladies!  As always, I hope that sharing my experience helps someone out there!

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