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Will I have to have a mastectomy?
It really depends on how large the tumour is relative to
your breast and whether there is any spread. It may also depend
on how aggressive the tumour is. Your surgeon will recommend
what he thinks is beat. Most surgeons these days are relatively
conservative and will not recommend mastectomy unless they
think it is absolutely necessary, but if you are not sure,
get a second opinion.
Julie says:
I had to have a mastectomy. I was shocked and horrified at
first especially given I am a size 10D and dress size 8. But
when it came to the crunch, being alive was much more important.
And I always planned to have a reconstruction. Although interestingly
I still haven't got around to it yet.
What about my appearance?
If you have a lumpectomy or partial mastectomy, your breast
will not look quite the same. However,when you wear a bra,
it will look the same, unless you have a lump at the top of
your breast. You may need to wear some padding. And depending
on the amount of your breast affected, it may not look much
different to anyone but you when you undress. It could be
slightly smaller and your nipple may be a little higher or
lower than before.
If you have a mastectomy, you can normally have a breast
reconstruction at the time of the operation or later. There
are two types of reconstruction, one of which uses implants,
the other using skin and muscle or flesh from other parts
of your body. Some young women don't even bother and use a
prosthesis.
Julie says:
"Indeed this is a question I asked myself, probably
the most prominent actually. How was I going to feel and look
about myself after the mastectomy? I thought at first I would
never be able to survive it, I don't even know if I wanted
to. My appearance was very important to me, it still is and
after-all it is a big part of who I am. I've always had a
large chest. Before the mastectomy, I threw all my tops, bras
and bikinis out in the garbage cause I thought I'd never be
able to wear them again. I was so wrong! I wear now, all the
clothes I wore before with no exception!!"
Some thoughts:
- At first, the mastectomy will seem very daunting. Be patient.
- Wear a foam breast in your bra if you feel the need to
look normal under your clothes.
- Once the time comes, about three months after your mastectomy,
go and be fitted for a prosthesis. They come in different
shapes and sizes and even in different colours to suit your
skin type.
- Buy yourself some new bras that fit well and are comfortable.
- Treat yourself to a new top that looks good and that you
feel comfortable in.
- Hold your head high, you look perfectly normal on the
outside and remember…no one is looking.
Julie is still considering a breast reconstruction. This
is what she has been told about the two types of reconstruction:
Of taking some muscle from her
stomach- "The post-operative discomfort may be
much greater, but judging from the pictures I've seen of the
results of this operation, I think it'll be worth it. Because
I'm still quite young the scars will fade well too and of
course there's always the perk of having a consistently flat
tummy in the future"
Of breast implants- "I
was a size D cup before my mastectomy and therefore I now
have one breast still a size D cup. If I choose to have this
type of reconstruction (with tissue expansion), I will have
to have my natural breast reduced in size in order to match
the reconstructed one because the skin on my chest won't stretch
that much. I was told it may involve two operations, and will
take up to four to six months to complete. If I was smaller,
it might be a good option"
Will I have an early menopause?
Any form of ovarian treatment will bring on early menopause,
because it stops your ovaries making oestrogen. If you have
surgery or radiotherapy to your ovaries, this will be permanent.
If you have hormone implants, your ovaries will start working
again as soon as you stop having implants.
If you have chemotherapy you will have an early menopause.
It is usually temporary in young women, but can be permanent.
Julie says:
I was not given any indication that I would have an early
menopause because of my breast cancer. I had (Julie can you
explain what treatment you had please?).
Will I be able to have children?
Whether you will be able to conceive naturally after breast
cancer depends on what treatment is recommended. If you have
surgery or radiotherapy to your ovaries, you will have a permanent
early menopause and will not be able to conceive after this.
If you have hormone implants or if you have chemotherapy
you will have an early menopause which may reverse.
In either case you may want to have some eggs extracted and
frozen to be preserved in case you want to have children later.
A number of women who have had breast cancer have gone on
to have children later.
Julie says:
Yes, I can still have children! I was given the choice before
my operation to have some eggs taken and frozen to be preserved,
in case I might want to have children. This choice was given
to me because I might need chemotherapy and/or radiation therapy.
What about my sexuality?
Julie says:
At first it seemed to me that I would never be the same again
regarding my sexuality and relationships. I was used to going
out on dates and picking and choosing who was good for me
and who wasn't. When I was diagnosed I thought I'd never have
the option again…. that I'd be lucky to find someone
who would love me for who I am. But, some time after the operation
that changed. Eventually I begin to learn about who I really
and truly am and have been lucky enough to meet someone special
who truly love me for me.
Some tips Julie found useful:
- Sexuality is important.
- You need to feel comfortable with yourself
- If you have a partner, communication is very important
between the both of you and others for support.
- Contact the Cancer Council or the Breast Cancer Foundation
for information on relations with friends and family support.
- Become familiar with your own body again and accept yourself.
What will I feel?
Julie says:
"You may feel a little depressed at this time of your
life. You will feel better. From the moment I was told that
I needed a mastectomy, I had a hard time coming to terms with
the news.
The things that might go through your head (and certainly
went through mine!) are:
- I'll never look the same again
- I'll never be 'me' again
- I feel depressed
- How will I cope?
- I'll never meet anyone (if you are single)
- What will people think about it?"
There are many things that will help.
- You have options. If you want to look similar again, you
can have a reconstruction.
- Concentrate on eating well and looking after yourself.
- Accept your new image; get used to being the new you.
- You will be a 'better you' in the future with a positive
story to tell to others.
- Read about other people who have gone a similar situation
to you.
- You will survive your depression. You will be a stronger
person because of it.
- Talk to people, people truly want to help you through
your bad times
- You will cope with the help of others around you. Your
family, friends and therapy groups and people who have been
through a similar situation can all help.
- Contact the Cancer Council and the Cancer Foundation for
advice on what to do next.
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