Bye Bye Boobies?

Two good things happened this past week. We finally finished our year-long home renovation project and, more importantly, I had my first appointment with an oncologist. I am so grateful that we aren’t in the middle of renovations for Operation: Kick Cancer’s Ass!

The oncologist I met with is a surgical oncologist; she is the surgeon who will remove my cancer. If I need radiation or chemo, I will need to meet with a medical oncologist who will develop that part of my treatment.

The surgical oncologist and her intern both examined my breast and nipple - my left boob has never been more popular – and noted that my Paget’s doesn’t look bad at all. She also reviewed all my tests to date and, because my cancer is still non-invasive (thank God!), she isn’t recommending radiation or chemo. However, since my cancer is multi-focal (i.e., it’s occurring in two places – the milk ducts and the nipple), I will need a mastectomy. She’s also offering me a bi-lateral mastectomy (bye bye to both boobies), if I want it. The reason for this is that my risk of breast cancer in my other ‘unremarkable’ breast will increase by 1% per year if it’s not removed. So, by the time I reach 60 or 70 years old, my risk will be quite high.

To help me make the decision, I’m being sent for an MRI, which will hopefully give us more information on how far the cancer has spread within the milk ducts in my left breast as well as catch any early cancer in my right breast. Even if there isn’t any cancer in my right breast, I’m still seriously considering the double mastectomy as this definitely isn’t a process I ever want to repeat.

The nurse who was there mentioned that this oncologist has done more breast cancer surgeries than anyone else in BC. I’m happy to know that someone with a lot of experience will be working on me. Apparently, there have been studies showing that the level of experience of the surgeon does have an impact on the outcome of not just the surgery, but the likelihood of recurrence as well.

So what happens when the cancer and boobies are gone? Reconstruction!  It sounds a lot like a renovation project – so I should be good at it (at least the design part!). When radiation and chemo are necessary, breast reconstruction is usually done months after the mastectomy, but when radiation and chemo aren’t required, reconstruction can happen immediately after the mastectomy, during the same surgery. This is what the oncologist is recommending for me.  So, I am being referred to a plastic surgeon to talk about my boobie renovation project.

For me, thinking about reconstruction has been difficult. I’ve never placed much importance on how my breasts looked and certainly never thought about plastic surgery to change them in any way. Now, faced with the prospect of a double mastectomy, I’m forced to think about my body image and how breasts, or the lack thereof, fit into that.

My early thinking on the topic is that I wouldn’t care what everyone thought when they saw my flat chest. I didn’t when I was a late-blooming teen and I certainly won’t now. Yet, I don’t want to be reminded that I had cancer every time I look at my chest, see myself in the mirror, try on clothes, or go swimming.

Second only to fear for my life when we didn’t know the extent of the cancer, grief and mourning for the end of my healthy, cancer-free life has been the most challenging emotion for me. I am still angry at the loss of my ‘invincibility’ at such a young age. So, if by reconstructing my breasts I can regain some of that feeling, forget that any of this happened and banish that damn black cloud forever, I think I will likely go for it.