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

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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.

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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.

Breast cancer is turning me into a man. And I’m kind of okay with that. (Guest post)

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I was diagnosed with breast cancer this summer, and since then have had a double mastectomy and two courses of chemotherapy that have left me breastless and bald. For a woman who had large breasts and long hair, it’s been a big change. But I’m finding I’m strangely comfortable with my new appearance, shocking as it may be to others.

I’ve written on this blog about how I was really looking forward to my double mastectomy, and I followed up with this post after my surgery about how much I love my post-mastectomy body. The latest change in my appearance came from my chemo. My hair started falling out three weeks after my first treatment, and was a patchy mess when I went in for my second. Shortly afterwards I had a friend buzz my remaining hair off with barber’s clippers, leaving me bald.

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I thought I was ready for it (I’d had the same friend buzz my hair in a very short pixie cut before my chemo started), but it was still a shock. Bald heads are a sign of maleness in our culture; very few white women willingly go bald, and are considered outliers if they do. Long, thick, shiny, straight hair on women is prized by people of European descent. The few times in my life when I’ve purposefully cut my hair very short, I’ve been chastized for it, by both women and men. Bucking the cultural norm is definitely not okay, and even makes news.

And yet I really love my bald head. Many of my friends have commented that my skull is a nice shape. The artist in me thinks I’m more beautiful than I’ve ever been in my life, since going bald. I love looking at my head, and touching it. Part of me wishes I could keep it bald, even after my hair starts growing back. It’s so easy to care for, so minimalist.

My struggle has been going out in public since losing my hair. Until recently I was still working full-time, as a fundraiser for a nonprofit. I felt physically well, but didn’t want people to assume I was sick. (I figured they’d guess I had cancer as soon as they saw the bald head.) Before my first business meeting after my hair was gone, I vacillated: should I wear a scarf on my head? A hat? Did I need to explain my appearance? To be honest, most of the time I forget I look different – I still feel like the same old me on the inside.

(The business meeting? I wore a hat because it was cold out, but took it off as soon as I got inside. I explained that I was doing really well physically. It seemed to be a non-issue.)

Then one night I was passing by a mirror in my apartment, and caught sight of myself out of the corner of my eye. I was shocked – I really looked like a man. To be honest, I thought looked like my dad, who had been bald. My mom affirmed it when I posted this photo on Facebook.

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For many women going through breast cancer treatment, this part – losing the external signs of womanliness – can be very hard. At every step along my cancer journey, health care professionals have assumed that I wanted to mitigate this loss with prosthetics and wigs. And I’m not diminishing that need that some women may have. But I’ve been very clear with myself and others since my diagnosis: if anything, I want to be the poster girl for normalizing the realities of breast cancer treatment. I want it to be okay to be breastless and bald if you’re a woman. I want it to be okay to work through illness, if that’s what you want to do. I want it to be okay to be who and what you are, to be flexible in the moment, and do what you need to do to be well and whole (be it a take a nap, or go for a walk, or have a good cry.)

But I can’t deny it’s been fascinating – and a little disconcerting – to explore the emotional and spiritual landscape of ambiguous gender appearance. I feel like our culture has become more open to considering gender identity since celebrities like Chaz Bono, Laverne Cox and Caitlyn Jenner have shared their transgender experiences. But each of those celebrities seems to have settled on a gender appearance that puts them very squarely within the norms of their identified gender. I wonder if society is ready for people who are openly gender-ambiguous, even if only in appearance.

I guess what I’m trying to say is, I’m a woman and I love being a woman, but I’ve been wondering what it would be like to live the rest of my life in the No-Man’s (and No-Woman’s) Land of asexual appearance. Where I could be mistaken for a man (or transgender, or a lesbian) sometimes, and that would be fine.

I also wonder if I would feel differently if I were younger, or in a relationship with a conservative partner. Maybe part of my comfort with ambiguous gender appearance comes from being near menopause and single – and happy with both of those conditions. I was already knowingly entering a part of my life where my appearance and desirability were becoming less important. I’d heard from older women that you become invisible after “a certain age”. That didn’t seem like a bad thing to me. There’s a reason that contemplatives take a vow of celibacy – the pursuit of sex takes up a lot of energy. What if looking gender-ambiguous saves me from superficial and superfluous flirtations and drama? What if I can focus more time on my work and my creative projects? What if I can have more authentic relationships where people look past my exterior and value the person I am inside?

Part of me still worries about being labelled strange, however. About being ostracized for being different. If I were another 10 years older, I would laugh it off, because by then I’d be facing my 60s, and I know it really wouldn’t matter what I looked like. But I’m finding I’m thankful for activities like aikido, where everyone (male and female) dresses the same for practice.

Honestly? Breast cancer isn’t turning me into a man – it’s turning me into a pre-pubescent girl. (This will become even more true when I begin taking hormone-blocking drugs after my chemo.) And if I remember correctly, my 10-year-old self was pretty awesome. Who could complain about that?

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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.

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

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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

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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.