If you have read Diagnosed at 36, you know the emotional state I was in when I met with my cancer team at Dorothy Schneider Cancer Center on the Monday after my diagnosis. So much was going through my head….I was at a cancer center… Chemo!… Radiation!… I never thought this would be me. It was all too much to process and everything was happening way too quickly.
Yet, I maintained a plan. I had always joked, “If I ever get breast cancer, I am just going to have them cut off and get brand new ones”. When it came down to that though… I was scared. I didn’t realize there were other options that didn’t include putting silicone or some sort of liquid in your body. I am the type who will focus on the what-if forever if I have something unnatural in my body. So, after talking to my husband, Scott, I made the decision to have one or both removed completely. Whatever insurance was willing to pay for. I never wanted breast cancer again and if I didn’t have breasts, I couldn’t get breast cancer. I later found out that this is actually almost true…
So, I went into the cancer center to visit with my surgeon and the first thing she said was, “I don’t know if you are the luckiest woman in the world or what but, your cancer is very small, it is rarely caught at this point”… She then informed me that because of this, I had all options available. I didn’t really know what that meant so I quickly asked “So, I can have them both removed?” She said yes and I think that guided her in the conversation because she quickly skipped through a lumpectomy which is where they remove only the lump. She did explain that with a lumpectomy, I would have an 8-10% chance of getting breast cancer again given the fact that I have had it and my age. Also, with a lumpectomy, I would have to go through several weeks of radiation along with chemo.
Then we started the mastectomy options, the entire time in my mind I was thinking that I just wanted the mastectomy… no fake boobs! Well… she explained how I could have a mastectomy and then they could use expanders to expand my pectoral muscles and eventually insert silicone into them once they were expanded enough. This in my mind, sounded absolutely awful. Awful. I’m not going to lie… I despise working out… and this sounded like it was going to hurt more than the worst workout ever. Not that the choice I made won’t… My other problem with this though, was the silicone… I can’t bear the idea of something non-natural being in my body. I am still weirded out by the idea that I have the titanium marker in my lump.
Next, my surgeon explained something I had never heard of. A Double (Bilateral) Mastectomy with DIEP Flap Reconstruction. When she started talking about it, I had no idea what she meant. She explained that instead of inserting something non-natural into my body, they would do the mastectomy and instead of inserting silicone, they would move my stomach fat (thank heavens for stomach fat!) into my breasts. She explained that they would reconnect the arteries from my stomach into the arteries where my breast tissue had previously been attached. She explained that in the end, I would have new breasts, made from my own body and coincidentally, a flat stomach. She explained that unlike silicone implants, these new breasts would be warm to the touch because they would have blood flow and if I lost or gained weight, so would they. This sounded like an option, right up my alley! While it is the option that requires the most surgery, it also leaves me the most natural in the end.
I still wasn’t 100% sold though so, I started asking her about percentages. She explained that with the lumpectomy as mentioned above, that I would have an 8-10% chance of getting breast cancer again. This being due to my age and the fact that I had, had it at all. She explained that with the mastectomy regardless of what choice I made, I would have a 1-2% chance of getting it again.
The following image is taken from the National Cancer Institute Fact Sheet.
So, I began considering where I was, I am 36… so let’s use the percentage chance of getting breast cancer at age 40… 1 in 68! That meant my original chance of having breast cancer was little to none. Now, if I have a lumpectomy done, that leaves me a 1 in 10 chance of getting it again. If I choose the mastectomy, I have a 1 in 50 chance of getting it again. These numbers are obviously not factual but this is how my mind was processing.
So, I chose the Double Mastectomy with DIEP Flap Reconstruction. You can read more about the details of this particular surgery at breastcancer.org.
I also saw an oncologist and radiologist that day. The oncologist explained that regardless of surgery choice, there was no trade off for chemo. I would still go through chemo but, with the double mastectomy, I would just do 4 rounds in 3 week intervals. He explained that I would probably be sick a day or so after chemo treatments and that I shouldn’t drive after chemo. He explained that I would probably lose my hair after the 2nd treatment. When I saw the radiologist, he was very quick and explained that since I was choosing the double mastectomy, radiation would not be necessary. I didn’t understand why at that point but, later learned that radiation is actually done on the exact location of your cancer and since I was having the whole location removed, that is why.
A few days later, I got to meet with my plastic surgeon who would actually be in charge of my reconstruction. He and my cancer surgeon will work together the day of my surgery. He explained how my surgery would go and showed me lots of before and after pictures. In the end, I left almost excited… I mean as excited as you can be when your body is fighting cancer. In the end, I will have a prettier body that is actually less likely to get cancer than the general population. So I guess it is a win.
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