body image · Guest Post

Thriving after double mastectomy for breast cancer without breast reconstruction (Guest post)


Sam recently forwarded this New York Times article to me, about the increasing numbers of women who are choosing to “live flat” after mastectomy, forgoing the reconstructive surgery that would give them artificial breasts. I’ve talked here and here about my own choice to live flat after a double mastectomy for breast cancer, and I continue to be completely comfortable – even enthusiastic – with “life after breasts.”

What boggles my mind is that the health professionals – including surgeons, oncologists and nurse practitioners – helping women through breast cancer treatment don’t see seem to realize that for some, the choice to live without breasts can be an incredibly satisfying one.

That’s certainly been my experience.

I love not having breasts anymore. I’ve never for one moment regretted my decision to have a prophylactic (preventive) mastectomy of my left breast at the same time that my right breast was removed for breast cancer. I feel sure that I would have been very, very unhappy with only one breast – or with reconstruction of one or both breasts.

In my case, I just didn’t like my breasts. They’d been quite large for most of my life, and I was uncomfortable with the way my body moved and felt with large breasts, as well as how I looked. If you’d come up to me 20 or 30 years ago and told me that I was going to get breast cancer, and asked if I wanted to have my breasts removed, I would have jumped at the chance even back then. I loved (and still love) being a woman; I just didn’t like having large breasts.

Lucky for me, I did get breast cancer, which came with a complimentary breast removal.

I love the way my body looks now. (With clothes on. Without clothes, I obviously have two huge scars across my chest, and a lot of the subcutaneous fat was removed on the right side where my cancer was, so that side of my chest is a little sunken. But I’m okay with how I look naked.)

I love how it feels to move through the world without 5 pounds of tissue hanging from my chest. Sports (running, calisthenics, martial arts) feel so much freer now. Before my surgery, I was always conscious of that weight bouncing uncomfortably up and down whenever I ran or jumped. I struggled to find sports bras I liked, and struggled even more to find sports bras that were easy to get on and off.

Not having breasts is fantastic. I wear tank tops under my shirts most of the time, just to keep my scars from being visible when I bend over in a low-cut top. The straps are also a visual clue to people that I’m a woman, which I found especially helpful during my chemo, when I was bald and looked very masculine. (I have never worn breast prosthetics, BTW – the idea of having fake breasts just doesn’t appeal to me at all.)

My mom met a woman my age at the cancer clinic one day, and this woman had had a single mastectomy when she’d wanted a double (without reconstruction). She was psychologically quite traumatized about her situation, and angry at her surgeon for refusing to remove her second breast.

I’ve also met another woman like me, who chose to have a double mastectomy and is living flat, and like me totally loving it. I wish I could counsel other women who are facing this choice, and let them know that not only can you live healthily with no breasts, but you can actually thrive – feel better than you did before.


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 Michelle has also written about her breast cancer journey on her blog, Kitchen Sink Wisdom.

9 thoughts on “Thriving after double mastectomy for breast cancer without breast reconstruction (Guest post)

  1. You might want to join the beast cancer section of Team Inspire. I have been a participant in the brain cancer section for several years, and have follwed and participated in many very helpful, open conversations. It’s basically just a place for patients and caregivers to share their experiences, positive and negative.

    My mother also decided to skip reconstruction after her 2 separate breastfeeding cancer mastectomies. As far as I know, she was fortunate in that no one challenged her choice. My sister, who had a prophylactic double mastectomy in her early 30s after a biopsy turned up a tiny LCIS, did have reconstruction. I really appreciate living in a place where both choices have been respected, have been recognized for precisely what they are: the patient’s, and only the patient’s to make.

    1. Thanks for the suggestion, Winnie. I’ll follow up on the Team Inspire referral.

  2. What a great post ! My mother had stage one cancer and had a double mastectomy 5 years ago. She thought about reconstruction but the process as it was explained to us sounded horrific and way more painful than the actual double mastectomy. Like you she had large beasts and now wears breast prosthetics and loves every minute of it.
    I was told by her surgeon that OHIP would cover a radical double mastectomy for me because of our family’s extensive history of cancer. I am 29 and have thought about these issues a lot.

    1. Thanks for sharing your story and your mother’s story, Lina. The decision to have a prophylactic mastectomy is a huge one, and I sympathize with you. If you haven’t already had genetic counselling, I might recommend it – I had genetic counselling myself (after my surgery), and discovered that I was BRCA1 & 2 negative, or not at a higher risk for the breast cancer / ovarian cancer combo. But even if I had had my results before my surgery, I would have made the same choice to get my second breast removed.

      It’s a really personal choice, and part of the dilemma is removing one of society’s signs of femininity and desirability. I know I asked myself many times before my surgery if it would make a difference in my future sexual relationships (I was single at the time). In the end, I cared more about my own comfort with my body than how somebody else would see me. But that was just my choice.

  3. I think a lot of people, both men and women, are offended by women that do not have “large” breasts…or have no breasts.

    I had almost first hand experience with this.

    My fiancee (no mastectomy) dressed like you describe–tight shirt under a loose shirt–even when we would run 10-15 miles. Even with the ear studs (she was going to be a pediatrician and big ear rings don’t work out well with small kids), her short hair, tallness, thinness an no obvious breasts caused many people to be confused about her gender. Her voice was awesome and when she spoke, it would end the confusion, but then a large number of people would act irritated at her for their confusion.

    Her mom was the worst offender. “For God’s sake, grow your hair out. With your figure and *that* hair, you look like a boy. Don’t you want to attract a man?” or “Since you’re going to be a doctor, you, of all people, should know there are other doctors out there that can give you a little something up top. You should look into that. It might help your social life. Don’t you want to attract a man?”

    Those comments were insulting on so many levels and to both of us, but when I’d start to say something, I’d get “the look” and I’d quiet down. She explained that it wasn’t worth the fight, especially since our future plans were of such a nature (moving to a tiny town) that her (NYC is too small for me) mom would never be around.

    A few months after we were engaged, my fiancee was diagnosed with ovarian cancer 🙁 After the surgery to remove her ovaries, her mom pops in and after noticing the emotions going through both of us, “I don’t know why you are so upset. It’s not like you ever wanted to be a girl anyway.”

    I politely asked “mom” outside and…my dad said he hadn’t heard such comments from anyone since he was in Marine Corps boot camp in the 1930s.

    1. Thanks for sharing your story, @53old. I’m really sorry to hear about the criticism and judgement that your wife faced. I would agree with you – some people seem to find it very disconcerting for a heterosexual woman to look “unfeminine”. I struggled at times in my life (even when I had large breasts), when I chose to cut my hair very short, and some friends and family really didn’t like it and weren’t shy about telling me. I’m glad you were there for your wife as an ally.

      I hope your wife is doing well now.

  4. We need to make the best decision for our own health–psychologically and for physical comfort. That’s great Michelle you’re at peace with yours.

    Society does (terribly) over-emphasize breasts as part of a woman’s sexual desirability. I cannot even begin to tell you like some small-breasted women, it took me time to get past the embarrassment (yes, really) I had to buy teen bra-sizes for myself over @35 yrs. Then I started to read the difficulty of women practically squashing their largish boobs in sports bras or wearing 2 of them..

    There is a whole experience of small-breasted to naturally flat women, who reach a time in life, don’t think about their boobs at all when exercising. We realize that most men don’t even pay attention to us…because of our near flatness….but true, it is incredibly freeing.

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