This is one of the more interesting parts of my journey I think. Two words are used a lot, lumpectomy or mastectomy. A lumpectomy does as it says on the tin, removal of the lump and a bit more to make sure the bugger is gone. A mastectomy is total removal of the breast tissue. The only option for me was mastectomy due to having multiple tumours and actually because I was a teeny A cup, more tissue would need to be removed than would remain so a lumpectomy wasn’t a viable option. The second time I saw my initial consultant / surgeon she told me -‘You have lots of little cancers….We will perform a simple mastectomy…this is how we reconstruct….’ All crammed into one 15-20 minute appointment.
I would like to reiterate at this point that I am sharing my personal experience. This may not be true of everyone in the world. Although unfortunately it is a common occurrence in the UK I am told that we are pushed towards reconstruction.
‘I don’t want to reconstruct’
'Samantha (cue a USG) don’t you realise that there is evidence to show that a woman’s quality of life is drastically increased with reconstruction? (errr which woman did you quiz on this exactly??) Someone at your age really should be considering reconstruction. There is evidence shown to increase confidence blah blah blah...'’ (by the way is there any evidence to suggest that free choice regardless of what choice that is, is of detriment to someone’s mental health and state of wellbeing?)
Let me tell you something. When I first came to title this blog, BOOBLESS just came to me. In calculator font. There was a reason for this. When I was a young girl I was made fun of for what felt like a long time / the brunt of jokes stemming around the fact I was a late developer and was very flat chested. I was tall, very slim and very long bodied. This was an asset in my classical ballet training – I can’t say the same for my feet though -however among my peers I was the subject to much mockery. I would have class mates leave their calculators on my desk with BOOBLESS typed into their calculators. This just became my norm. I started joining in and mocking myself as a way of unknowingly managing the taunts. BOOBLESS kind of became my thing. By the way I had a fun great childhood and these ‘ribbings’ however cruel they were, were just part of my practical resilience training. Kids can be cruel. As I probably was on occasions. Empathy and kindness is all part of our learning and speak to anyone about their childhood and they will be able to recall their reality of isolation in some form.
This didn’t stop after puberty. As a professional dancer, a grown woman, I was still made to stand in front of my peers on a film set in India and have the director gesture at me asking why I had no boobs. ‘Get the girl some boob pads!’ In public it was like water off a duck’s back although the fact I can recall it 15 years later makes me now think differently. Even post biopsies in the mammogram room, the mammographer (I just made that role up-I don’t know what the lady’s called who performs mammograms) smiled as I took off my bra saying that the wound dressing was bigger than my ‘tiny’ breasts, and when standing awkwardly having being man handled and manipulated (can you tell I’m a fan of these procedures) restrained in the crushing perspex walls she calls out from behind her safety glass ‘Aren’t you skinny?’. That is a rhetorical question right? Or sorry did you want an answer?
To wrap that up, I have never had breasts. My breasts fed my two children well and I unashamedly admit that I loved being able to do this. They served me well. But now they were working against me.
With all aspects of this journey I took on board all of the information and options and went away and did my own research. There was part of me initially that thought that this may be my opportunity to have C cups…I could actually have BREASTS!!! Proper ones!!!! This excitement (which was actually the little girl inside me who had daily reminders in calculator form of her lack) waned quickly when I actually realised that having reconstruction would mean a)having foreign material in her body b)that would need replacing every 10 years c)not being able to do push-ups anymore for fear of displacement (I did not want a tit up in my shoulder girdle-that is a joke-I am aware that anatomically that is IMPOSSIBLE) d)would have six months of tissue expanders before implants to stretch my skin out and e)much longer recovery and chance of complications. It was a no brainer for me.
‘Quality of life’ is different for EVERYONE. I do not judge anyone on their choices. I have not walked in their shoes. I have no concept of their internal dialogue and most importantly it’s none of my business. My quality of life is not defined or impacted by my breasts or how I am perceived with or without them. I may be telling a different story had I always be a bustier woman. For my consultant to place a certain amount of pressure on me to reconstruct made me frustrated. I understand that it is common practice to reconstruct. But regardless, who is anyone to judge whether a stranger's quality of life would be impacted negatively or positievly from such a personal change. Just because there are statistics to back up that more often than not someone’s quality of life is increased post mastectomy. Well I should bloody well hope so after a pissing cancer diagnosis. Anything is going to better after that. And would you have it doctor but my quality of life is far better now I don’t have cancer in my breast. Duh.
For me my quality of life is defined by my freedom, my emotional freedom and my physical freedom. Being able to move limitlessly. To be able to cartwheel. And to not live in fear about what other people might think just because I choose not to have boobs.
When you are losing something that has personally never defined you, something purely functional and something that in truth had been a source of sadness for many of my younger identity forming years and although I joke it has always been the part of me I would change if I could, it takes on a different narrative to someone who has loved their breasts as a part of them.
I say all of this because I want to reiterate that this was my choice. I could have chosen to reconstruct. I have had people question and even challenge my decision. I have felt the need to justify those decisions. Which is what I suppose I am doing here. But it is more than that. It is to acknowledge that it is OK to go against the masses. What is not OK is to follow someone else’s path when you know instinctively it is not your path but you are afraid to turn the other way. Most people have been supportive but there has also been a proportion of people who have assumed that I will reconstruct later on are incredulous as to why I wouldn’t.
The surgeons need to know if you are planning immediate or potential delayed reconstruction. This alters the way they make the incisions and therefore the scars. Also they can sometimes save the nipple and some breast tissue for reconstruction. So if I had wanted delayed reconstruction at some point they would have made diagonal scars. Instead I have horizontal ones.
Should I have wanted to reconstruct, the only option for me were implants. However for larger ladies there is an option for something called a DIEP flap which is when they take skin and fat from the abdomen and use it to recreate breast tissue. I had some really funny conversations when I told friends this as they processed what they meant and decided they would prove their friendships by offering their tummies for the sake of my new breasts. I would laugh and they would get really serious, lean in close and say ‘No Sam I mean it… you can have mine…’
So anyway I didn’t reconstruct. I have no breasts. However…that’s not to say that forever I shall be flat. I have had prosthesis fittings. I have my knitted knockers. And I have worn them out and about on occasions. For a few reasons a) to avoid an awkward conversation with strangers b)so people don’t pity me c)because it suits what I am wearing d)because I want to fit in or more aptly I don’t want to stand out and e)because it feels good. I know my feelings around wearing them are likely to fluctuate and develop as I learn more about myself but to have the option is incredible. I also write this in the height of winter so it is easier to cover up should I wish. I love the summer months and I have a salsa weekend in Majorca in April coming up so I am sure other feelings will arise then. I am yet to struggle with clothes but I am sure those challenges will come also. But just because I chose not to have reconstruction does not mean I am never allowed to wear a body con dress with breast forms or a prosthesis in a bikini on the beach. It is a choice.
The bottom line is I am comfortable in my skin. I am comfortable and very at peace with the decisions I have made. I don’t judge anyone on their choices as it’s not my business and I am grateful I had and still have a choice. Flat, B cups or mega Es should I wish.