Big breasts run in my family. My maternal grandmother, my mother, my sister, and I all had very large breasts. As a teen in the 1970s, I wasn't able to wear the cool halter tops and tube tops all my friends wore. I was the only one in a modest one-piece when all my friends wore bikinis. My D-size breasts were always in the way — they made me feel fat and matronly. I spent a lot of my teenage years trying to accept myself but hating my enormous breasts. Even when I married and had kids, I chose not to breast feed, despite what I knew about the health benefits for children, because the absolute last thing I wanted to do was expose my breasts in public.
Breast cancer was always a part of my life. My paternal grandfather died of it well before I was born. His sister had two radical mastectomies which were only discussed in whispers back in the sixties. In 1997, at the age of 55, my mother was diagnosed with breast cancer. She had a mastectomy and underwent chemotherapy. She decided against reconstructive surgery. On her 60th birthday, a mammogram revealed a lump in her remaining breast. She was devastated but took on the battle a second time and survived.
I have memories of my mother flipping through the Jodee catalog from JCPenney for the expensive prosthetic devices that were available at the time. She wore those prostheses all the time and, if you didn't know her history, you wouldn't have guessed she was wearing them. She had a wicked sense of humor and I recall her frequently taking one out at the end of the day and tossing it to whomever she might want to horrify, usually one of my brothers. For years, I never saw her without a bra and her prostheses.
Sadly, soon after her 65th birthday my mother was diagnosed with metastatic lung cancer. She passed away peacefully at home on Christmas Eve, 2002. My sister and I cared for her during her last months. We bathed and dressed her and had the opportunity to see the scars from her surgeries. They were asymmetrical, having been done five years apart by two different surgeons, but certainly not disturbing or horrifying. Bottom line — she was my mother, with or without breasts.
Given my family history, I was admittedly a little paranoid about breast cancer. The fact that, at 42, I was the oldest living member of my family didn't help. Then on Friday evening, October 13, 2006, I noticed my right breast was leaking a watery, bloody fluid. I went right to the Internet. After extended research, I diagnosed myself as having an intraductal papilloma, which is benign more than 90 percent of the time. Still, I knew I wouldn't sleep well until I had a mammogram.
I was on a mission. I had a mammogram and made an appointment with the Director of the Lynn Sage Breast Cancer center at Northwestern, who was renowned for her surgical prowess and her ongoing research. More tests (ultrasound, MRI) were done and came up negative. I also had genetic testing. My results came back negative for BRCA 1 and 2. There was some relief in that, although the test currently accounts for only 80 percent of genetic cases.
In December, 2006, after a biopsy of my right breast, the diagnosis of a benign intraductal papilloma was confirmed. I was told I had a 42 percent lifetime risk of breast cancer. That was unnerving, but according to the doctor it would only require that I be categorized as "high risk" and return for six-month checkups rather than annual ones. I could also consider taking Tamoxifen, to which I was personally opposed due to the side effects I had witnessed in my mother. Or I could have a prophylactic bilateral mastectomy, which the doctor regarded as an extreme and currently unnecessary option.
Maybe the 42 percent figure kept me from hearing anything else that afternoon. Also, despite the benign diagnosis, I had experienced post-biopsy bleeding and had found that traumatic. I knew I couldn't live with my odds and the prospect of future biopsies. I decided to have a prophylactic bilateral mastectomy. I knew right away that I wouldn't have reconstructive surgery.
I never had doubts about the bilateral mastectomy. I had three young kids and I wanted to live as long as possible for them. And I still had a lot I wanted to accomplish for myself. My doubts were more about why I DIDN'T want reconstruction. My surgeon referred me to a second plastic surgeon and delayed my surgery a week to ensure I considered all my options and didn't make a hasty decision. The more I read and investigated, looked at pictures, and talked to plastic surgeons, the more my decision not to have reconstruction solidified. But I still had a few nagging concerns. What did this choice say about me as a woman? Why weren't my looks, my female looks, important to me? What message would I be sending my then 11-year-old daughter?
Finally, I called my best friend from high school and voiced these worries out loud. With one question, he calmed and affirmed me — "And since when have you been like every other woman?"
Almost everyone I told seemed flabbergasted by my decision not to have reconstruction and tried to talk me out of it. My female friends and family members were vocal and opinionated about my choice, many assuming that reconstruction would take place and then arguing for it when I explained it would not. However, my husband told me he would support my decision and he has. He's not a man of many words. Despite two years of prodding him for deeper emotional insights, I've come to accept that he meant what he said and truly just cares that I'm alive and sharing in the joys and challenges of our daily family life.
The week after surgery, I returned to have my drains removed. My doctor walked into the room, took me by the hands and said, "Never mistrust your intuition." She shared my pathology — I had DCIS in both breasts, one small, one microscopic. I probably would have had a similar cancer trajectory to my mother — one breast diagnosed sooner, one breast diagnosed later. But now I was cancer free, my surgery was my treatment, and my lifetime risk for a recurrence has been reduced to one percent.
The scars have healed. Because I had large breasts and I'm overweight, there is still some extra flesh and what I call a "booblet" under my right arm. It's not ugly. It's not beautiful. It's me.
It's sure nice not to have to wear a bra, not to sweat underneath my breasts in the summer, and not to have to deal with gravity as I age! I purchased prostheses, but I don't wear them. I tried. Sometimes I'll still try with certain outfits, just because women's clothes tend to hang funny without breasts. But two years later, I don't want reconstruction. I don't want the anesthetics, the surgeries, the worries over the chances of the silicone or saline implants rupturing or needing to be replaced.
I don't want to be judged by my breast size or shape. I want to be myself and myself today is breast-free.