Mastectomy in Breast Cancer

Mastectomy in Breast Cancer

For many women a diagnosis of breast cancer will lead to a mastectomy, sometimes single,
sometimes double. Whichever it is, it is an extreme step but, for many, a lifesaver.
The word sounds benign and almost refined, mas·tec·to·my [ma-stek-tuh-mee], noun,
plural -mies. Surgery. The operation of removing the breast or mamma.

It’s a word that is certainly polite enough for company, the subject of open discussion
among friends, acquaintances, colleagues with whom you might never have discussed your
breasts before (see “B Is for Breasts”). However, if I were to describe this procedure as an
amputation of the breast, it would probably make most people recoil. Having been through
one myself now, this is how I describe it. Something that was there is now gone, something
that protruded from my body is now “lopped” off. The words amputate or amputation
never came up when I was diagnosed with breast cancer. They still don’t. The first term
used was partial mastectomy, commonly known as lumpectomy. But soon it was clear that
there was more than one tumor and the only course of action was a mastectomy.

Mastectomy is a word that tens of thousands of women hear every year, and it is a
course of action they take. It is a brutal, violent thing to have happen to you, and it is
perfectly fine to feel that it is an amputation, and don’t let anyone tell you otherwise. For
me it was easier to cope with by thinking of it in that way. On those truly dark days when
you are in real pain, and you look down and the familiar landscape of your body is no
longer there, it is a humbling and mournful experience. In my case, one side had been
obliterated, in a process akin to mountaintop-removal mining, and there was a flat, stark,
scarred space where once had resided a soft, protruding manifestation of my femininity and
sexuality. At that moment, amputation seems a more accurate description of the procedure
than anything else.

At first blush you don’t give much thought to what a mastectomy means. Mastectomy is
a medical term you’ve heard a hundred times before. In that meeting with the breast
surgeon, the overwhelming thought is that there are cancer cells running rampant in your
breast and the only course of action is to remove the offending appendage before those
little buggers get comfortable and spread throughout your body and claim squatters’ rights.

Once they make themselves at home, it is always hard to throw squatters out! Get them out
of me by any means necessary. It is a visceral reaction. My house has been invaded.

Hurry, do it right away. Can we book the operating room soon? How about now? Well, it
turned out that we could, relatively quickly, send in the cavalry to throw those invaders out.

Ten days after being told that a mastectomy was my only option, I was under the knife,
and a few hours later I was down a breast.

I must confess, I’ve never been much of a boob person. I’ve always dressed modestly
and don’t like to show any cleavage. Spaghetti straps were not an option in my wardrobe,
let alone strapless. As I got older, I had even less desire to showcase my boobs. Gravity
and motherhood certainly took their toll. What miracle of engineering would hold up my
breasts without some extravagant superstructure? I wasn’t huge, just average, 36C, but
always conscious of my not very perky breasts.

So I didn’t love my breasts, but they were mine. I wouldn’t say I was particularly
attached to them or proud of them, but nothing quite prepared me for how awful I would
feel when I lost one. There is the physical awfulness, the flattening of your whole body
(see “P Is for Pillows”). There is also the bruising and the drains from the wound.

Immediately after the surgery you are bound up like an Egyptian mummy, a surgical bra
holding you together as drains protrude out of the sides and gunk collects in little containers
that you empty every day. You can barely raise your arm, and you need assistance to lift
yourself up in bed.

But there is something altogether more dispiriting. This is the worst physical
manifestation of the disease. It is there every day to remind you what you have been
through. I will admit that I could not look at my naked self in the mirror for months after
my mastectomy. I knew I would be having reconstruction, but that was going to be after I
was somewhat recovered from my chemo so that I would be strong enough to go through
reconstructive surgery. I knew I was misshapen. I knew I had a long horizontal scar across
my chest where I used to have a breast. I knew that I would get a new breast, that the
doctor would rebuild a nipple and tattoo the areola. I had seen pictures of his previous
surgeries. It was actually kind of amazing to see what he could do (see “R Is for
Reconstruction”). But I couldn’t look at myself. You are covered up, of course; nobody
can really tell unless they see you naked. The only people who saw my naked chest were
my husband and my doctors. I turned my back to the mirror every time I got out of the
shower. In hotels that had walls of mirrors, I never looked up until I had covered myself
with a towel.

This may seem like crazy, irrational behavior. In my mind it is the most normal reaction
to such a brutal act.

Of course, we are incredibly blessed that in the twenty-first century we are armed with
the tools not just to diagnose and remove the cancerous breast but also to reconstruct a
breast. For much of the twentieth century the only treatment for breast cancer was what
they called a “radical” mastectomy, which also removed the muscles attached to the chest
wall. It was a painful and disfiguring treatment. Those were the days before they
approached breast cancer as a holistic disease that requires drug treatment as well as
surgery. Nowadays, except in the most extreme cases, the muscles are kept in place and it
is possible to rebuild your pectoral strength. And of course, you can get a new breast. As
my brother reminded me, “You live in America; they have the power to rebuild you.”

True, but that’s a long haul. As you wait to get the perfect boobs, you are allowed to
mourn for the lost boobs. A part of your body that defines you as a woman, and maybe a
mother, has been removed because it is now host to a disease that could kill you. I can’t
help but feel that if we called it “an amputation” the rest of the world would get that too.