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Why I’m happy about having a double mastectomy without reconstruction (Guest post)

woman's chest with healing words

I have breast cancer in my right breast, and in a week I’m undergoing a double mastectomy without reconstruction. I couldn’t be happier. Here’s why.

For many woman dealing with breast cancer, the thought of losing one or both breasts is terrifying. Often our sense of femininity, attractiveness and sexuality is tied up in having breasts, and we don’t want to imagine life without them.

A few weeks before I found a lump in my right breast, I came across this article from the Wall Street Journal, which reported on what doctors are calling an alarming trend of women choosing to have both breasts removed after being diagnosed with cancer in one breast (dubbed the “Angelina Effect” after actor Angelina Jolie, who had a highly publicized double mastectomy in 2013 after discovering she carried a genetic mutation that increased her odds of developing breast cancer to 85%). Only a tiny fraction of breast cancer patients carry a genetic mutation for breast cancer, and with survival rates for lumpectomy-with-radiation matching those for mastectomy, there is a concern that women are undergoing drastic surgeries for no good medical reason.

I found the article interesting, but I also knew without a doubt that if I were ever diagnosed with breast cancer, I would want both breasts removed. (It just so happens that, according to the article, I fit the demographic that is most often making this choice: educated, middle-class white women.)

Little did I know, however, that sh!t was about to get real.

Two or three days before I was diagnosed with breast cancer, I watched the Netflix documentary Tig, about American comedian Tig Notaro. The documentary details her life in the year following her own breast cancer diagnosis.

Tig had cancer in both breasts, and a double mastectomy. She’s a small, slim lesbian with a boyish style, and as I watched the film I found myself envying her breastlessness. Knowing there was a possibility that I might have cancer myself, I thought about how great it would be to not have breasts anymore.

It was then that I decided that if my own breast biopsy came back positive, I would not only ask for a double mastectomy, but I would also forgo reconstruction (implanting artificial breasts in my chest). My biggest worry was that they would recommend a lumpectomy to try and preserve my right breast, which I didn’t want – or that they wouldn’t allow me to have a double mastectomy, leaving me stuck with one large breast and nothing on the other side.

I’ll be totally honest here: I’ve never really liked having breasts.

I’m a cis-gendered, heterosexual woman who loves being a woman, and enjoys being considered attractive and desirable… but for as long as I’ve had breasts, they’ve been really large. At age 12, they were 36C’s. A few months ago, before I started losing weight (on purpose, not due to my cancer), they were 36G’s. Do you know how hard it is to find bras that size? For years I’ve crammed my girls into 36D’s, with spillover at the top and sides that would make a bra fitter weep. The one time I did get a proper bra fitting, the store didn’t have any bras in stock in my size. Frustrating.

I became a teenager in 1980, when the ideal body in North America was Brooke Shields in a pair of Calvin Klein jeans. Shields was 15 at the time, and had a figure like a boy. Slim hips, flat chest. My 13-year-old-self felt like a freak by comparison, with rounded hips and full breasts.

This post isn’t about body bashing – as an adult woman I eventually learned to love and appreciate my curves – but about recognizing that I was living in a body that didn’t match the cultural ideal, and moreover felt limiting to me.

I danced a lot as a teenager – my high school even offered proper dance classes as an alternative to Phys. Ed. – and my large breasts needed extra support for all that leaping around. By university, when I took daily fitness classes at the university community centre and was trying to become a jogger, I resorted to wearing two bras at a time when I worked out, in order to keep my breasts from bouncing too much.

(This blog has published all sorts of posts about the challenge of finding good sports bras, here.)

Big breasts were a barrier to many of the physical activities I enjoyed. I was a lifeguard in my teens and early 20s, at a time when shelf bras in women’s Speedos were unheard of. I longed for small breasts that didn’t jiggle and bounce when I walked around the pool deck.

As I’ve aged, my breasts have headed south towards my waist, and actually ache when they aren’t bound by a bra, especially at night when I’m lying down and trying to sleep.

When I started aikido a year-and-a-half ago, I had to experiment with a number of bra configurations so that I could run without bouncing (we’re expected to move quickly when called upon in class), as well as roll and flip upside down without popping out the top of my bra.

I currently wear two bras at aikido – an underwire bra underneath, that separates my breasts and prevents “uni-boob”, along with an inexpensive, too-small sports bra on top, to keep everything motionless when I run on the mat, and safely contained when I flip upside down. (I’ve noticed with a thrill of recognition that Ronda Rousey and other female MMA fighters use a similar configuration when they’re working out and fighting.)

So when I met with my surgeon after my diagnosis, my only worry was about whether she would entertain my double-mastectomy wishes. In the end, a double mastectomy actually makes medical sense for me. Turns out lumpectomy is not a medically recommended option for my cancer. Thankfully my left breast is currently clear, but the cancer in my right breast is such an unusual presentation (with a possible genetic mutation like Angelina Jolie’s, which I’ll be tested for later this year) that my surgeon tells me I’m at higher risk of getting cancer in my left breast. This makes preventive mastectomy of my left breast a sensible choice. If I wanted to keep my left breast, I’d be facing annual MRIs and the increased worry of a recurrence for the rest of my life.

I don’t have a partner to consider. I’m at an age where breastfeeding is not in my future. And while I love being a woman, I’m not afraid to look boyish. I’ve had 36 years of being voluptuous, and an eye-magnet for men and women who like large breasts. I’m ready for freedom from that kind of gaze and attention, and freedom to move my body the way I want to move my body. I anticipate “living flat” for the rest of my life, and likely going without prosthetics, too.

One of the benefits of forgoing reconstructive surgery is that my recovery should be much faster than if I’d chosen reconstruction at the time of mastectomy. I’m looking forward to getting back to my regular life as soon as humanly possible.

My only hesitation is that I feel guilty for not wanting my breasts anymore. I feel like I’m betraying a part of myself. So I’ve been spending a lot of time during my breasts’ final days trying to celebrate them. I’ve also been preparing myself for the huge visual change there will soon be in my figure whenever I look in the mirror. While my femininity isn’t tied to my breasts, I recognize that it may be for others. So I’m making plans to cut and colour my hair in a “pretty” style, and wear clothes and jewelry after surgery that make me feel and look feminine.

But honestly? I’m so excited about my upcoming breast removal. And the interesting thing is, whenever I’ve talked about it with other naturally large-breasted women, they totally get it, and tell me they would make the same choice.

This is the second of a three-part series on breast cancer, sports and body image.
Part 1: What martial arts taught me about fighting breast cancer
Part 3: My pre-surgery boudoir photo shoot

___

You may also be interested in these blog posts by Michelle about her breast cancer experience:

Michelle Lynne Goodfellow works in nonprofit and small business communications by day, and also enjoys writing, taking photographs, making art and doing aikido. You can find more of her work at michellelynnegoodfellow.com. Michelle has also written about her breast cancer journey on her blog, Kitchen Sink Wisdom.

17 thoughts on “Why I’m happy about having a double mastectomy without reconstruction (Guest post)

  1. I have also entertained the thought of a double mastectomy without reconstruction (I don’t have breast cancer, but my mother died from metastatic breast cancer and my younger sister has had two recurrences of breast cancer jn various body parts, so I’m at risk). If I didn’t have a husband, I would do it in a heartbeat–my guess is that he would not be pleased, but I find them more annoying than anything else. I hate bras and I won’t wear them unless I have to, and I don’t often have to. I’m 51, have breastfed two kids, and they are droopy and I don’t care; I only wear bras when I exercise.

    Coincidentally, last night we watched Tig Notaro’s “Boyish Girl Interrupted.” Partway through her stand-up, she removes her shirt and does the rest of the set topless. I was impressed by her ability to stand in front of all of those people topless.

    I wish you all the best with your surgery and recovery.

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    1. Thanks Cathy. I’m 48, and I have the feeling that our attitude is more common in middle-aged and elderly women. I know the daughter of a friend, when diagnosed with breast cancer in her late 20s, was anxious to save her breasts and opted for lumpectomy. Unfortunately the disease metasticized, and she passed away over a year ago.

      I’ve heard about Tig’s set when she went topless, and would like to see Boyish Girl Interrupted. She’s amazing, and an inspiration to me. I suspect that if I hadn’t seen her living example of a breast cancer survivor at that crucial time right before my own diagnosis, I might have been a little more anxious about everything than I am.

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  2. I personally can’t imagine being comfortable with my body without my breasts (though that may change after I’m older, who knows). Though I often wish for some sort of magic where I could have breasts except when it was time to workout, I am growing to hate sports bras so much. I find myself often thinking of getting in a quick workout and then thinking “do I really feel like putting on a sports bra though?” I wear a 38D. Not large enough that I have any back pain from them, and not small enough that I can comfortably forgo sports bras during workouts.
    There definitely do seem to be practical benefits to not having breasts.

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    1. Yes, I hate sports bras too. The ones I wear right now for aikido are very snug, and pulling them over my head (and taking them off after class, when I’m physically exhausted) is a huge pain.

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  3. I SO get this right now. I’ve been having an issue with my ribs that’s been causing chest pain especially where my bra band hits. I’ve been wearing my loosest sports bra, but earlier in my healing having my boobs unsupported also pulled on my chest causing a different kind of pain. What I wouldn’t give not to have boobs right now! I think I would make your same choice if I could convince my doctors/insurance (if I got breast cancer).

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    1. I’m finding there are a lot of women out there who feel exactly the same way. I hope your rib pain gets better soon – I had many bruised ribs when I first started aikido and didn’t know how to roll properly, and I know how much they can affect your life.

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  4. Best wishes for good recovery with your surgery.
    I realize the strength of your feelings re breasts which other strangers might notice first than the inner you. Somehow one can’t help believe, that it will be a different feeling with double mascetomy.

    Many small breasted women as they age, to me, just sort of forget their breasts as long as bra covers them up. I look completely flat with my cycling jacket. ….I haven’t cared for last few years.

    Your health is much more important. 🙂
    Enjoy lying on your stomach one day. Most likely you will have to completely rethink the size of T-shirts, etc. : smaller, slimmer fit at top, less open neckline; A lot of medium round cut or even V necklines don’t fit me, looks terrible and crumpled….because it’s meant for women broader bone structure, boobs, etc. in terms of upper body width. You may be incredibly surprised….

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    1. Thanks Jean. I have a degree in Clothing, Textiles and Design, so I’ve been thinking a lot about my clothes after surgery, especially since I have many tops that are cut to accentuate my large breasts, and of course they will be completely unwearable after surgery. I’m really excited about this part of it, though – time for a wardrobe change (and I can sew anything I can’t find in the stores).

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  5. What an inspiring post! I think it’s awesome that you have such a positive outlook on it – it really can be a chance for you to start a whole new life… without boobs! My husband and I just finished watching Tig Notaro’s special – absolutely amazing. I am so glad to see our society starting to move past gender norms. Women don’t have to have boobs to be attractive. They don’t have to wear makeup. They don’t have to be demure. We come in many different varieties, and that’s the fun of it. Best of luck to you with your surgery!

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  6. I am a fellow Flattie, I too love it. I didn’t like my breasts either. They limited my ability to connect with myself. I love being female, I don’t want to feel compelled to be anything other than true myself. I don’t want to wear forms. I love my body more than ever before. Thank you for participating and being flat out! And, please google my name! I added your story to my Flattie Pinterest board too.

    Liked by 1 person

    1. Thanks for your comment, Melly. I’ve had a chance to look through your Pinterest board and your website – love your work! I think we have a lot in common. I studied design and visual art, and am really comfortable with a gender ambiguous look right now. Glad to see that there are others out there who love living flat. I would love to see it be a desirable option for more women. Thankfully my surgeon didn’t question my choice at all, unlike your experience.

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  7. Michelle, what a great post – thanks for sharing your thought process and your feelings about forgoing reconstructive surgery. I’m 4 months post-op and looking forward to hanging around the pool this summer topless. I hope your post will pop up whenever someone looking at breast cancer options types in “mastectomy no reconstruction.” It’s good to have such a positive and clear-eyed view of what seems to me to be the simplest (and for some the best) option for early stage breast cancer. I wrote about my decision-making process at http://queerfit.org/2015/11/30/my-breasts/, and will someday follow it up with a post about how it’s turned out (quite well!). I hope you do the same – I look forward to an update!

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    1. Thanks KungLi. Best of luck with your healing – although I know that mine didn’t take very long, so I imagine that you’re doing quite well by now. I can relate to wanting to sunbathe topless! That’s also on my wish list for the summer. I enjoyed reading the blog post you shared… you might also want to read this one that I wrote about my feelings about having a more masculine appearance: https://fitisafeministissue.com/2015/12/21/breast-cancer-is-turning-me-into-a-man-and-im-kind-of-okay-with-that-guest-post/

      I’m cis-gendered, so I’m at home in my woman’s body, but it’s been interesting to be now living in a more gender ambiguous body. I don’t have the clean scars that F2M transgender men get when they have their breasts removed, but I love that I can see my pecs through my t-shirts. I’m doing bodyweight training (push-ups, etc.) and my arms and shoulders are naturally muscular. I love the new silhouette that I’ve got in my upper body.

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  8. I am with you lady friend i had a double mastectomy 4 weeks ago with tissue expander placed in the time of surgery they hurt so bad, now 4 weeks into this 1 of my expanders is actually coming out through my stitches and because of my insurace pardon my french but my asshole plastic surgeon says he will take them out but doesnt want to work on me again i am in a kinda state of depression because i feel like i wouldnt be want by a man and the thoughts of looking dike-ish but im trying to get through this my expanders come out in 2 days and the feeling of know im going to feel 90% better without them gives me some kind of comfort i will probably try prosthesis but only to go out and feel pretty hey listen good luck to i enjoyed reading your story

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    1. I’m sorry to hear you’ve had so many problems with the reconstruction process. I’m still really happy with my decision to not have reconstruction – I healed in 2 weeks from my surgery and was back to full physical activity (lifting, aikido, etc.)

      I can understand your fears about not having breasts and not appearing feminine. My hair is still very short (it fell out during my chemo), and without breasts I appear very butch. But I can also do things with make-up and jewellery and pretty clothes with gathers and ruffles that make me look more feminine when I want to. And I have a beautiful wig to wear if I don’t want to attract attention as a cancer survivor.

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