When I first met my mother-in-law, in 1972, she had recently recovered from her second mastectomy. She was only 46 at the time. She’d had her prior mastectomy at age 31. Reconstruction wasn’t an option back then. I remember feeling sorry for her, but also marveling at her positive attitude. She looked great — she wore breast forms and, had I not known about her surgery, I never would have guessed she’d had both breasts removed. And I never imagined that one day I would be in her shoes.
I was diagnosed with breast cancer in 2003, when I was 54 years old. By then, both my mother and grandmother had been diagnosed with breast cancer, so I knew my risk was high. Still, it was a shock to hear the words, “You have invasive breast cancer.” Nevertheless, I counted myself lucky that my cancer was found at an early stage and that I didn’t need chemotherapy. After a lumpectomy and radiation, I began taking tamoxifen. By the time a year had passed, I felt fully recovered and my fears of recurrence had receded to an occasional anxious twinge.
Then, three years after my diagnosis, a new primary cancer was discovered in my other breast. Again, I knew I was fortunate — the diagnosis was DCIS, the earliest possible stage. But my breast surgeon told me that this time a lumpectomy wouldn’t suffice. The DCIS was extensive and I would need a mastectomy of the affected breast. I wanted to do everything possible to reduce the possibility of a third cancer diagnosis, so I asked for a bilateral mastectomy. Although I don’t carry a BRCA gene mutation, given my family history and the fact that I’d already had two cancers, my doctors supported my request.
Next came a big decision — whether or not to have reconstruction. While reconstruction isn’t considered cosmetic surgery, it is elective. I could choose to do it or not. My doctors didn’t push me in either direction. I’ve since learned that many doctors advocate reconstruction and even assume their patients will have it, sometimes without informing them that non-reconstruction is also an option.
My breast surgeon offered me some helpful advice — she suggested that if I definitely wanted reconstruction, I should have it done at the same time as my mastectomy, but that if I felt any doubts, I should postpone my decision about reconstruction. She went on to say that the most unhappy patients she’d had were those who went ahead with immediate reconstruction despite feeling ambivalent and later regretted it.
I consulted with a plastic surgeon. None of the reconstruction options he offered seemed appealing. I had a gut feeling that reconstruction wasn’t right for me. Knowing that I could change my mind later and have delayed reconstruction gave me the courage to move ahead with plans for a simple mastectomy. I asked my breast surgeon to give me the best cosmetic result possible — symmetrical incisions, no extra skin. I knew that if I had unsightly folds of skin, I might get depressed about that and regret not having reconstruction. To give non-reconstruction a fair chance, I wanted to look as good as possible with no breasts.
When I saw my chest after surgery, I felt relieved. I thought I looked fine and, happily, so did my husband. While the decision about whether or not to reconstruct was mine alone, my husband’s love and support helped me immeasurably. And the fact I had seen my mother-in-law living a full life without breasts reassured me that I could feel whole and happy without reconstruction.
My mother-in-law herself confessed surprise that I chose not to have reconstruction, given all the options currently available. But once she realized I had made a positive choice to live breast-free, she, too, embraced my decision. Non-reconstruction isn’t right for everyone, but it has been for me. Over seven years have passed since my bilateral mastectomy and I’m still enjoying my breast-free life.
Have you faced a similar decision about whether or not to have reconstruction? What helped you decide?