Beauty and the Breast

Just a couple of years ago, I wrote about how I was feeling beautiful for almost the first time in my life, and wondered how long it would last. At the time, I concluded that losing beauty – or whatever claim to conventional beauty I currently have – might not affect my sense of self-worth any more than having money (and then not) had done a decade before.

While breast cancer does not immediately threaten any vital organs, it does go straight to the beauty / sex characteristics that are considered so very important in women: breasts and hair. If you’d asked me in the abstract, pre-diagnosis, I might have said (in fact, have said), that having large breasts has been a hassle and a distraction (to myself and others), and that my straight, fine hair was never my “crowning glory” anyway.

You won’t be surprised to hear that the real possibility of losing either has not been so easy to face.

During my first visit with Dr Traina, the surgeon who would later operate on me, she mentioned the possibility of total mastectomy. She didn’t seem enthusiastic about this option, and I was puzzled as to why it might be needed: the tumor was about 2.5cm on its longest axis, deeply buried within the volume of a G-cup breast. I said that I would strongly prefer to keep my breast, and to keep it looking and feeling as much the same as possible, nipple and all. (At that point, I already had two small, dimpled scars from the core needle biopsies that had been done.)

We agreed that we would discuss it again during our next, pre-surgery visit. In the meantime, I read further in Dr. Susan Love’s Breast Book, from which I understood that, while a full mastectomy was once considered (by both surgeons and patients) to be the “sure” option, a partial mastectomy (aka lumpectomy) followed by radiation had been found to be equally effective – and you get to keep your breast. At my next visit with Dr Traina, I said: “Given the size of the tumor, a mastectomy seems like overkill.” She immediately agreed, so we were settled on a lumpectomy.

I had no clear idea what to expect from a lumpectomy: how much would be taken out? What would my breast look like afterwards? Of course, there are lots of photos to be found on the Internet, some of which brought me to tears: scarred, twisted breasts with distorted or missing nipples. Still, if my breast ended up looking bad after surgery, many photos showed that it could probably be improved by cosmetic surgery later, and there was plenty of breast tissue to work with.

Lumpectomy

Nov 25: Had the surgery this morning at an outpatient surgery center. Prep started at 8:45. Among other things, I was asked three different times by three different people: “Do you know what you’re here for today?” “Lumpectomy/partial mastectomy in the right breast, and sentinel node biopsy.” The pre-op nurse also initialed the top of my right breast (my initials, not hers). She put an IV into the back of my left hand. I hate having needles in me that way. Always afraid that I will make a wrong move and the needle will come scything out, ripping open a vein and spraying blood everywhere.

Dr T arrived at 10am on the dot; I could hear her joking in the corridor: “What are you watching the clock for?” She poked her head in, said hello, went out. They wheelchaired me into the operating room. I was nonplussed to find it had a sunny view of the parking lot, but they reassured me that it was one-way glass (“We like having the sunshine.”). I got onto the table. My head fit into a cradle, my legs were raised on pillows. The room was very cold, but I’d been warned about that, and the nurse immediately put warm blankets on me. The anesthesiologist (Dr Mirza – once upon a time I studied the poetry of Mirza Ghalib in Urdu) put something into the IV feeder line saying “This will relax you.” That’s the last thing I remember. I awoke in a recovery room with the surgical nurse, who soon brought Brendan in. He had talked with Dr T while I was still non compos mentis. She had found one “interesting” node; that, and everything else she removed from me, has been sent for more study.

By the time I came around, my chest was swathed in elastic bandages to try to keep the breast still – not easy with so large and heavy a breast. Under that was a large pad of bandage and under that, I assumed, a wound closed with steri-strips. There was another wound, also covered, in my armpit where Dr T had removed three (or was it five?) lymph nodes.

They gave me percocet in the recovery room at 1pm, by 4:00 I felt sharp pain where the tumor used to be. Turns out that having largeish bits of you removed hurts like hell. Thankfully, percocet works fast and lasts a while.

Nov 26: Called the doctor about the underarm wound – wasn’t sure it was closed properly, and the steri-strips had come off (it’s hard to keep an underarm from getting damp). My friend M had come over to be with me, so we took the bandage off and she took a photo of it which we messaged to the doctor, who said it looked ok. Lots of bruising around the wound (to be expected), but the wound itself is closed. M and I went out for more gauze and tape to cover it over again.

Some pain, this time mostly in the axillary wound, enough to take a percocet at noon, and to be cranky with it in the evening. I don’t deal well with pain.

Nov 27: The great unveiling: I took off the ace bandage that had been wrapped around my chest since surgery, and took the gauze pad off the breast wound (ripping surgical tape off a nipple hurts a lot!). The steri-strips on the breast are still in place, there’s lots of nasty bruising, but the overall shape of my boob is not much changed. Maybe a little deflated right where the tumor used to be.

Afterwards

Three months on, my right breast has been through several phases. The surgery scars have faded to thin lines. After the first post-surgery swelling of the interior tissues went down, there seemed to be a hollow area beneath the breast scar, where tissue had been removed. Then that collapsed, and for a while there was a vertical indent, almost a fold, visible on the outside of the breast. Now, my breast looks much as it did before, though tissues are still settling inside – I get pain from time to time, deep down where the tumor used to be (I’ve asked: this is normal, can go on for months post surgery).

As for my hair… we’ll talk about that later.

Update, May 24: The tissue around the surgery site has continued to settle, with some episodes of residual pain. Now there’s a definite hollow in my breast where the tumor used to be, and noticeably less mass in that breast than the other one (they weren’t even to begin with – usually breasts are not – but I can’t remember which one used to be bigger).

Note: If you want to do something for me, I still have months of treatment to go, and can always use reading/view material. Here’s my Amazon wish list.


my breast cancer story (thus far)

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