I don’t knit. I’m not a parent that sews. When the fire detector goes off in my house, my two children will inevitably sing in unison “Mommy’s cooking again.”
And, they both can assure you that I don’t tie their hockey skates tight enough. But, as their mother, they mean everything to me and I’d do anything for them.
If I felt I had to, I’d even cut off my breasts for them. In fact, that is exactly what I did.
Recently I underwent a Skin-Sparing Bilateral Prophylactic Mastectomy using AlloDerm with Tissue Expanders. Operating time: seven hours. Appointments: Countless. Results: Priceless. Regret: Not a single second.
My journey, however, did not begin that way. When a genetic blood test informed me at the age of 29, that I had inherited the BRCA1 gene that substantially elevated my chance of developing breast and ovarian cancer, I tucked this information away to the far back of my mind. This is where it sat. For 10 years. I smugly pooh-poohed the recommendations of prophylactic surgery and merrily skipped through my 20’s and most of my 30’s in blissful denial.
My motives: Shame. Fear. Worry. I had seen the damage breast cancer inflicts, when as a young girl, I watched my mother grapple with breast cancer—twice. When I received the BRCA1 confirmation, I attempted to hide it alongside the old memories I had growing up in the shadow of my grandmother’s untimely death from ovarian cancer.
That is, until, one day, I myself became a mother. I could no longer ignore the compelling statistics, medical science and overwhelming desire to live my best, most prolonged life. I needed to get real. I needed to face the facts that the only proven method of helping me prevent cancer in my breasts was to remove them. I needed to accept the truth that I loved my life and children much more than my chest.
Thus began the multi-year process that has gradually and gracefully transformed far more than my physical appearance.
Despite the challenges of living in a rural location and long before the ‘Angelina Effect’, I began to learn, with the guidance and help of knowledgeable healthcare providers, that there were many possibilities available to BRCA1 patients. Some I recognized; others, I had no idea existed. One such option was breast removal with immediate reconstruction. The notion of awakening from double mastectomy surgery —with breasts, created using my own skin—was a paradigm shift for me. The slash scars I had seen on women a generation earlier did not have to be my fate.
Given the coordination of medical services, dedicated surgeons and cutting-edge advancements in reconstruction, the idea of proactively removing my breasts soon became palatable. But one nagging issue remained; even with reconstruction, removing the very body parts that embody my femininity seemed so radical. I ping-ponged for months: Take my chances? Fervently cross my fingers at every mammogram? Or undergo a double mastectomy with immediate reconstruction?
This surgical option became a vital part of my decision, for this reason: I had no clear idea of what this procedure would ultimately feel like. Thankfully, however, with immediate reconstruction, I could start to grasp what I would ultimately look like. If other women could love the look of their new chest, created within the same surgical procedure as their mastectomy, then maybe I could too? If I could carry on with the same quality of life I had pre-surgery, looking like the woman I am, without the BRCA1 cloud tick-tocking above my head, why wouldn’t I?
Led by experienced doctors whose uncompromising dedication and skills I respected, I was able to move forward with confidence. With the unyielding support of a husband who helped reassure me that my whole was greater than two of its parts, I underwent the operation. Today, I’ve never been happier! Am I less of a woman? No way. Among the many outcomes from this surgery has been the courage and strength to share.
I had begun this journey three years ago shrouded in secrecy and shame. Now, I could flash the world!
Thanks to immediate breast reconstruction, I have been able to recover and return to my life-after-surgery physically and emotionally intact. The prophylactic surgery and reconstruction I had once disregarded has in fact allowed me to embrace the life my grandmother would want me to lead - free of the invisible load of shame, fear and worry I had been toting around for over a decade. I realize now that I am one of the lucky ones.
As it stands, one in nine women will develop breast cancer in their lifetime and many are increasingly choosing immediate reconstruction after surgery. However, breast cancer survivors or those with an unenviable family history wishing to rebuild their bodies face many obstacles, including lack of information, timely access to reconstruction, and insufficient funding. Women who have received a cancer diagnosis or who are at high-risk are dependent upon the supply of operating rooms, surgical staff and funding through limited hospital budgets for their reconstruction.
There are attempts to change this. Pilot programs, like the one at The Ottawa Hospital are offering clinics where women who have made the decision to remove and reconstruct are operated on in one day. Side by side operating rooms allow for mastectomies followed by reconstruction by specialized plastic surgeons. Although this may not be the choice for everyone, it is a clear attempt to tailor our healthcare to the needs of the patients it serves. It is certainly a step in the right direction, but there is still a long way to go.
Sometimes, the most important decisions, like the one I made, are life-changing because they bring about a shift in your priorities and a transformation in your outlook. This same shift needs to take place in our healthcare system, where reconstructive breast surgery should absolutely be considered part of cancer treatment and/or preventative care.
All women, in any urban or rural location, undergoing the removal of her breasts from cancer or a predisposition to the disease, should have timely access and availability to all reconstruction options. At-risk women willing to use proactive, preventative health measures as opposed to treating the sickness down the road should be considered just as important of a patient. It will allow them, like me, an opportunity to define the rest of their lives, despite their current or imminent cancer status and come through to the other side, even better than before.
Now, thankfully, I can learn to tie skates tightly and maybe even learn to sew.