What would you do?

This is actually something I wrote awhile ago but never did anything with.

I just read an article that was heartwrenching and insightful. It was about a woman, age 33, who is dealing with a possible preventive mastectomy. The article went through the whole process of her decision and what she has had to deal with. She is one of the 25,000 women who test positive for a gene mutation that indicates they have a 60-90 percent chance of developing breast cancer and/or ovarian cancer. I have heard about this before but to read an article with first person perspective makes it seem more real.

Having no kids, yet, she has to make the very difficult decision whether to have her breasts removed and all natural tissue with no hope of ever breastfeeding. But on the flip side, with her breasts removed, she has the same probability of everyone else of developing another cancer and may live to be an old woman – cancer free. She can be assured that she won’t develop breast cancer and have to deal with the cancer, radiation and chemo, and a possible mastectomy anyway. She is torn by her decision as family members don’t understand her “self-mutilation” when she has not yet developed cancer. She opts for the surgery and reconstruction but has to fly from her Iowa home to Chicago to have it done. Her mother, a breast cancer survivor, accompanies her on her trip and can understand why her youngest daughter has made this decision but wasn’t immediately on board. Her mother didn’t develop her cancer until the age of 48 and her mother (the woman’s grandmother) didn’t develop her cancer until her 70’s. Having already had children, the decision for her mother to have the mastectomy was an easy one. For her daughter, she couldn’t give her approval right away. It took her daughter encouraging her to investigate at what age other women in the family developed their cancer. With other family members developing cancer at ages 33, 34, and 35, it was clear her risk was higher.

Would I do the same thing? Would I have a voluntary mastectomy if I knew I could possibly develop cancer at some time in my life? I don’t know. Nothing is certain. Having already had children the answer is mostly clear; I want to see my children grow up.

It made me start to think about how our identity, as women, is tied to having breasts. We have them, men and children do not. It is the one thing that makes us unique as adult women and we are “bound” by them. Men obsess over them, advertisers make money because of them, products abound on the marketplace because of them… It is one part of our bodies that is almost always obvious to everyone. Nobody knows how big your liver is, for example. For us, they are present and accounted for all the time. As teenagers, we learn to manage them when body image is such a big deal. Many try to minimize their appearance because of embarrassment and teasing; while others flaunt them like they’re going out of style. It is often a difficult transition from embarrassment to acceptance.

It also got me thinking about my own self image. I am conscious of my chest size and my feelings about it. My chest has never been something I was particularly proud or fond of but as it (seemingly) disappears… it makes me sad. Having an outward symbol of still being a woman is important. I never realized it until they got smaller. When I was breastfeeding, they were gigantic (for me) and very uncomfortable. Now, because of diet and exercise, they are the smallest they have ever been. A glance in the mirror shows the breasts of a much younger (and probably thinner) woman. I admit, it is much easier to manage them for sports and triathlons when they’re smaller. There are tons of women who wish they had my issues. But I no longer fill out dresses, shirts, and some bras. And to make matters worse, they are saggy. No longer perky, breastfeeding has made them droopy. My husband says he likes their size, but there’s hardly anything there. It makes me wonder, how much smaller can they get? Will they disappear, leaving only saggy skin behind?

I’m not sure why this struck such a chord with me today. I guess I’m in an insightful mood. It’s something I’ve thought about before when I’ve seen mastectomy swimsuits in catalogs but never really gave it a whole lot of thought. It is a difficult topic for most women as we often take our breasts for granted, never giving them a second thought. We assume that we will always have them and we won’t be one of the ones that develops breast cancer. Although heart disease is the number one killer of women, of all ages, breast cancer is much more talked about. Maybe it’s a fear thing because deep down we all know our identity is tied to our breasts. We don’t know how to act with the thought of not having them and sympathize with those that have been affected.

What would you do if you knew there was a 60-90% chance you could develop breast cancer? Would you have them removed? Would you go through painful reconstructive surgery to regain that identity? It is a difficult decision, even if you’ve already had children. We are tied to our breasts, whether we like it or not.