January 15, 2021

#102 Lumpy, Flat, or Lopsided — How Do You Decide?

People have frequently asked me how I decided to have a double mastectomy vs. a lumpectomy or to have the diseased breast removed. It wasn’t an easy decision for me, but it was a quick one, and once I made it, I never looked back.

People have frequently asked me how I made the decision to have a double mastectomy vs. a lumpectomy or to just have the diseased breast removed. It wasn’t an easy decision for me, but it was a quick one, and once I made it, I never looked back.

For one thing, early on the doctor took lumpectomy off the table for me. Although I was a small D, they all (I had several doctors and opinions) felt that a lumpectomy was not an option for me. My frame is fairly small so they unanimously felt that a lumpectomy would leave my breast deformed and it would be very hard to get a good cosmetic outcome. So my only decision was a single mastectomy or a bilateral one (BMX). Like most of us, I did a lot of research, first turning to Dr. Google and then to breast cancer sites that run the gamut of “it was important to save my other breast” to “just take them both; I don’t need them anyway” to people who were just understandably distraught. It’s really a no-win situation, because no matter which you choose you aren’t going to look like yourself either way.

Ultimately, and it took me only one day to come to this decision, I chose to have the bilateral mastectomy. While I didn’t really want to lose my healthy breast, I had also read too many stories about the cancer coming back in the other breast. My focus all through treatment was to do everything I could to avoid being faced with this situation again. Although my daughters are young adults and my husband is just fine, I didn’t want to find myself standing at the kitchen sink doing dishes having just learned I had cancer in the other breast and I was about to go through this whole treatment regimen again. That I should have taken care of this the first time. I just don’t like regrets. Now I knew that particular scene would probably never occur because the chance of me standing in front of the sink doing dishes is really remote. But you get the idea. And, I must admit, I was worried about the cosmetic outcome because I didn’t really know what that meant. Was I going to be mutilated? Would I have to wear those silicone implants that look like chicken cutlets in my bra for the rest of my life? It was too much to contemplate at the time. But all that aside, what I knew for sure is that I didn’t ever want to go through this again.

So I chose the bilateral mastectomy. I’ve only second-guessed myself once and that’s when I had my first complication which occurred on what was my healthy breast—now, not so healthy. But I got through it and I don’t even think about it (much).

I know some people really wrestle with the decision and I feel bad because it’s a tough decision and once you make it, it’s done. I’m no expert so I don’t have any meaningful advice, but keep in mind what you’re trying to accomplish in the end. For me it was to never have to do this again, to live, and to have a “good cosmetic outcome”. So I did everything possible to achieve that. It’s about how much risk you are willing to take. I have a life insurance policy I’ve been paying on for years. I’ve probably already paid what my family would get out of it if something happened to me. But I’m willing to continue to make those payments than risk that something happens to me and they are left without the payout of that policy. That’s how this decision was for me; having a double mastectomy was a kind of insurance to minimize the risk that my family would ever need any of the life insurance payout—at least not because of breast cancer.


Valerie Novack

AUGUST 27, 2018 AT 3:11 AM

While not direct survivors, I’d love to know if the girls have weighed in on either your decision or ones of their own? My mother, a survivor, got breast cancer when I was in middle school. I had very little real attachment to my breast at that age. It didn’t take long to decide that I’d do the bilateral, even before they found cancer, if I could. I felt even more empowered when Angelina Jolie did just that. When I’ve talked to my sister she feels the same way. When your mother gets cancer at 37, you just accept that a days going to come when you have to make this choice. However, when we’ve had this discussion with my mother she’s bothered, maybe even hurt, at how cavalier we are towards it. I know a part of that has to be the hypothetical of the conversation, but I also think there is a shift when the person you love and admire most gets Breast Cancer. Suddenly, my breasts were bombs just waiting to go off, something to be watched and worried over. I tend to approach them less with love and more with apprehension, a relationship I know will eventually go bad. After what my mother feels she lost, I can understand why it makes her upset, but as a daughter I see less what is lost and more what could be taken away.