I was talking to a breast cancer buddy the other day -- one of the lucky ones who found her cancer at Stage 0 and got away with a minor lumpectomy -- and was amazed and horrified at something she told me.
Apparently, while she was still learning about the staging of her disease, a handful of her friends told her they thought breast cancer was a great opportunity to improve her boobs (my friend's always been small-breasted). As in, "You should totally do a double mastectomy and then get the boobs of your dreams."
As someone who's not only had a double mastectomy but is also currently researching reconstruction, I'd like to offer a little insight into this idea that breast cancer is a convenient way to "upgrade" your girls.
Mastectomies suck. Obviously, finding out that you have to have your breasts taken from you is horrific. I had two tumors in each of my girls, spaced far enough apart that lumpectomy wasn't an option. Both of my boobs had to go (although I was able to keep my nipples). While I had a great surgeon, I now have scars on the outside of each "breast-ette." I also have adhesions, areas where the skin is firmly stuck to the chest wall as well as knots of scar tissue that can be painful (it can also limit movement in some women). My chest wall hurts most days, probably from the heavy scraping it experienced during surgery. And speaking of surgery, after mine I came home with plastic tubing under my skin that wrapped around my breast area and drained bloody fluid into two plastic "hand grenades" that I had to empty out -- and measure -- twice a day for about three weeks. Not a good time. Also not fun, having to strap on a "sandbag" bra that chafes against my chest and armpits every day. Or wearing all of my V-neck shirts backwards because I don't want people (particularly men - I'm single) to see my prominent ribs and realize there's something funky going on with my front. Or looking in the mirror as I'm washing my hands or putting on makeup and seeing a gnarled and knotted chest looking back. Some women skip the fake boobs and rock their flat chests and I say more power to them. But for those who think breast cancer is a convenient way to get those double Ds they've always wanted, just remember that you have to live with nothing but scars and stares (imaginary and otherwise) for awhile first. Sometimes a very long while.
Kiss sensation goodbye. I did my research before surgery so I knew that loss of feeling was part of the process, but apparently not all women are aware of the fact that along with your fatty breast tissue -- and whatever cancer -- the surgeon removes all of your nerves during mastectomy. Which means you're left with a Dead Zone where your breasts used to be. I could probably put a cigarette out on my skin and not feel it, at least not until the ember made its way through to my chest wall. I've certainly looked down to find cat scratches that I have no memory of. This lack of feeling has been one of the worst thing I've had to adjust to post-surgery. I'm a sexual person -- there I've said it -- and my girls have always been two very important players on the team. Now those players are permanently on the disabled list. A man could stroke my breasts -- even stroke my nipples -- all day long and the only thing I would feel is frustration. That delightful tingle I used to feel -- the same thing most of us experience when someone nuzzles our neck -- is gone, most likely forever. Some women claim they get some feeling back as their nerve endings regenerate, but I haven't experienced anything like that. Many women never do.
Reconstruction isn't immediate. While some women can get their breasts reconstructed at the time of surgery (usually women who opt for prophylactic mastectomies due to a genetic predisposition for breast cancer), others have to wait. I lobbied hard to have immediate reconstruction, using tissue expanders (or TEs) which would be placed behind my chest wall, filled with saline over the course a few weeks and then swapped out for implants. But thanks to the nature and number of my tumors, I had to wait for the pathology report. And that report determined that in addition to the double mastectomy, I needed further treatment. At this point in the process, I've been without boobs for a year and a quarter. Why the long delay? First I had to have chemo and you can't really deal with that and surgery at the same time (it's too much for your body to handle, plus chemo compromises your immune system so you can't heal). Then I had to have radiation, something else that doesn't mix well with reconstructive surgery, since radiation messes with the structure of your skin. Even women who do opt for immediate reconstruction sometimes have to stop the whole process -- or have their TEs removed -- when their doctors discover they need additional treatment. Breast reconstruction isn't cosmetic surgery. It's also not easy or painless or even an option for every woman who gets this lousy disease. If you have a friend who's been diagnosed with breast cancer, spend a few minutes doing some research on treatment and reconstruction options before you start throwing out silver linings -- or supersized lingerie -- that may not be in the cards for them.
Shit happens. When I first started treatment, I was told I'd have to wait at least six months after radiation before I could even start thinking about getting new girls. Since then, I've been told that I won't be able to have the "easy" TE/implant type of reconstruction on my irradiated left side since my skin can no longer stretch enough to accommodate either a tissue expander or an implant. This means I'll probably have to have a more complicated "flap" procedure on that side, a reconstruction technique where they nip a bit of muscle and flesh from one part of your body (like your stomach or your back) and tuck it into your breast in order to accommodate an implant (or a chunk of tissue). These are major surgeries that take major recovery time (we're talking weeks). And instead of just having scars on your breasts, you're left with scars on other parts of your bodies, large scars that can look like somebody tried to saw you in half. As a BC buddy who had a stomach flap procedure on her irradiated breast and a TE/implant done on the other one told me, "I've got boobs now, but my body looks like a patchwork quilt." But having a body that's crisscrossed with surgery and reconstruction scars is just the start. Some women get post-surgery infections or hematomas; others have to have their implants removed because of capsular contraction, a process where the body's immune response creates a hard shell around the implant which is not only painful but can make those "bigger, better boobs" end up looking like something out of a bad Playboy cartoon. And the list of complications goes on (some of my BC buddies have even had problems from the general anesthesia used during reconstruction).
I understand trying to put a positive spin on breast cancer. I'm the queen of "fake it 'til you make it." What I don't understand are women (and men) who think breast reconstruction and breast augmentation are somehow synonymous. Or think that "milking" breast cancer for all it's worth, i.e., using a diagnosis -- or a cancer scare -- to lop off those old girls and get boobs that are bigger or perkier or just bright, shiny and new is smart and acceptable and something that should be encouraged.
I'm not saying that losing your breasts is the end of the world. Double mastectomies are survivable; ditto for reconstruction. But I wouldn't wish this surgery on my worst enemy. And I certainly wouldn't wish it on a good friend.
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Seattle journalist and author Diane Mapes was diagnosed with breast cancer in February 2011, at age 52, and has been writing about it ever since -- for msnbc.com as well as on her blog, www.doublewhammied.com. Follow her on Twitter @double_whammied.