Surgery and all that stuff.

As if just having cancer isn’t enough, there are chemo treatments, surgery, radiation and more drugs. Each cancer patient’s treatment plan is different. Sometimes you do chemo before surgery but sometimes after. You may just do radiation and have a less invasive surgery. You may never have to do surgery. It all depends on your diagnoses. For me, my treatment plan involves chemo, surgery, radiation, and hormonal drugs for years to come and in that order. But this surgery bit, that was a lot to work through. And now that I know I have the BRCA2 gene mutation, my ovaries come into play. And there isn’t one easy solution to any of the madness.

My diagnosis; Stage 3, Grade 2, ER+, Invasive Ductal Breast Carcinoma which simply means that the cancer traveled outside of the milk ducts in my breasts, where it originated from, to my lymph nodes and was growing at a 5% rate while being feed by estrogen (ER+). Being a women who has had two children, my estrogen levels have been extremely high. Funny thing about that is I have always heard that breastfeeding can decrease your chances of getting breast cancer. Well, that’s certainly not the case for me. My general surgeon told me that this cancer had probably been present for 3-5 years and when I started having children the estrogen fueled it. So I was damned if I did… and damned if I didn’t. In addition to the lymph nodes, there was tumor found by the mammogram and ultrasound both, which was a big surprise to me given it was in addition to the two swollen lymph nodes I had found myself. With all the information we had, we had a lot of thoughts to work through and decide upon.

• Lumpectomy, remove just the lymph nodes and tumor but nothing else. Given I have the BRCA2 gene mutation that increases my chances of cancer returning in either breast.
• Mastectomy, removal of just the one breast where the tumor is along with removing the lymph nodes but nothing else. Given I have the BRCA2 gene mutation that increases my chances of cancer returning in one breast.
• Bi-Lateral Mastectomy, removal of both breast (but with 5% of tissue still remaining (skin and nipple)) to minimize the chances of cancer returning in both breast in addition to removing the infected lymph nodes.
• Reconstruction, having your breasts reconstructed after the tissue is removed to look like your original boobs but with implants.
  • With implants brings other questions such as what type of implants do you want? Saline? Silicone? How large do you want them to be? Smaller than you are now or larger? If you decide to go with implants, these things called expanders are placed in your breast during your initial surgery. They are filled over a period of months with saline using a needle and once you are comfortable with the size the filling sessions will stop. Then the expanders are removed during another procedure and your implants are placed inside your breast.
• You also have the option to just go flat. This is also called being a ‘flattie’ which entails having all of your breast tissue removed and nothing added back such as implants. Therefore, no tissue will be there to appear like breasts. I certainly flirted A LOT with this idea. I even asked if I could just have the mastectomy done and come back later to do implants if I ‘missed’ my boobs. Unfortunately, since I will be doing radiation that wasn’t an option for me. I had to make the decision to have boobs or no boobs. I flirted with the ‘flattie’ idea mainly because of all the things that could go wrong with implants such as leakage, my body rejecting the implants. Some women have stated that implants have made their overall health deteriorate over the years. And yes, that could be so. In years past, there have been cases of implants slowly leaking out into the body. Some of those cases were linked to rippled implants verses smooth and sometimes it wasn’t the implant but rather just the body not accepting them. Same goes for someone who has had a hip replacement or pacemaker procedure or any other foreign object being placed in your body. Sometimes your body just doesn’t like what you have placed inside of it. Believe me… if I had the choice to have my original breast, I would but then I would slowly begin to die from the cancer. And we ain’t doing that! Haha. And to note, a couple of positives to being a ‘flattie’ means no bras and no THO. How awesome! No bras ever! No titty hard on! What lady couldn’t get used to that!
• And one of the last options is to do a flap procedure which is simply taking skin/fat from other areas on your body and placing it on your chest. Many have done this but it does require a longer healing period. It is also a more invasive surgery with more pain. And unfortunately, the procedure doesn’t always take and the skin/fat dies.
• Then you have nipple sparing; leaving the nipples as they are and not removing them from the breast. Some don’t get to make this decision though. Sometimes the tumor is so close to the nipple that the nipple has to be removed. But I had the choice. I could keep them or have them removed. And if I had them removed the nipples could still be tattooed on by some amazing tattoo artists! Yeah, that’s a thing. But for me, this was hard. Really hard. As you’ve read prior, being pregnant and then having children was a dream of mine. Nursing my children was such an accomplishment and big dream of mine, too. My nipples are what gave my girls life for years. My nipples connected me to my girls in a way other things don’t and never will. My nipples are a part of me. And without them I felt I’d just have two, firm, perky, tan balls sitting on chest. Two firm, perky, tan balls with no sensation ever again due to the nerves being removed during surgery. No blood flow. So why take my nipples? At least they provide some form of normalcy when looking at them. A fun fact: Once you have a mastectomy with reconstruction you can shine a light through your new boobs and they will glow. So bizarre but somewhat humorous!

I cried about it, prayed about it, discussed it with my husband, and asked more question during doctor visits. Once we felt comfortable, we decided to go with a nipple sparing, bi-lateral mastectomy with reconstruction to decrease my chances of breast cancer returning. Meeting with three different plastic surgeons, reviewing their work through confidential patient photos, getting a good feel for their bedside manner, and of course their reviews online and through word of mouth, I was able to make my decision and was more than comfortable about it. I knew I would be in great hands.

Just like being diagnosed with cancer, losing your breasts is too a grieving process. I have lost my hair, lost time with my husband, children, family and friends, lost my appetite and still don’t crave some things like I did before. I lost days and nights due to the chemo side effects where I could have been playing or laughing. But what I have gained is courage, compassion, patience, faith, hope, wisdom, love, friends, deeper conversations with my husband, and yet again, a new identity. My breasts will no longer be what I was given at birth. They will be artificial. But they will be a part of the new me. The new lady that sees life differently, who has fought to be here and will soon be a survivor.