I Have One Breast: Life Without Reconstruction

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PHOTO: Abigail Toribio

Once upon a time, I had two breasts. They were full, perky, nubile, all that. They aroused appreciative stares from men and envious glares from women. They were beautiful; they were perfect. And then, without warning, one of them went rogue and tried to kill me.

Getting diagnosed with breast cancer at age 38 was a complete surprise. When it happened, I was terrified at the prospect of chemotherapy and radiation and metastasis and death. Fear of  losing my breasts barely registered on the radar screen.

As the date for my mastectomy surgery approached, I remained surprisingly calm. I covered my bald chemo head with a ridiculous “Beyonce” wig and had my best friend snap topless shots. I wore low-cut shirts and push-up bras in celebration of cleavage. I looked at myself in the mirror a lot. I wondered what life would be like without them.

My surgeon told me the week before my scheduled operation that she thought I might be a candidate for a lumpectomy instead of a mastectomy, as the chemotherapy had effectively shrunk my baseball-sized tumor to the approximate size of a walnut. I balked – I’d originally wanted a bilateral (double) mastectomy to protect my body from more cancer, but my surgeon had convinced me that getting rid of both breasts wasn’t really any safer than just getting rid of the cancerous one. And now she was telling me that I might be able to get away with just losing a small part of one breast.

My first thought about a lumpectomy was ABSOLUTELY NOT. The cancer had already metastasized to my lymph nodes, and leaving even one little tiny cancerous breast cell would greatly increase the chances of the cancer spreading further. But my surgeon was persuasive: the lumpectomy was a much more minor surgery, she explained, and post-surgery pathology would clearly show whether or not we’d achieved the intended tumor-free result of “clean margins.”

After lots of internal debate and conversations with my “cancer friends,” I reluctantly decided I’d give the lumpectomy a try.

The surgery was a breeze, and when I removed the bandages, I was relieved and overjoyed to see a tiny, pea-sized indentation that only made my perfect breast very slightly imperfect. Huzzah! I’d made the right decision. My cleavage was intact. I’d come out the other side of treatment as two-breasted cancer warrior with only a small scar to evidence the deadly breast invader.

But it wasn’t long before my surgeon called to tell me that she hadn’t gotten clean margins. I would have to have a mastectomy after all, she told me, and I should plan on having the surgery the following week.

This time, awaiting the surgery date, I was a little more scared, and a lot more angry. I had a week to watch my incision heal, to watch my breast become almost perfectly beautiful again, to think about the cancer cells that were still in there along those dirty little margins.

The mastectomy surgery was uneventful. The anesthesiologist was young and extremely handsome and I apparently said some racy things about him while under the influence of surgical drugs, and gave all the nurses a good laugh. I told funny stories to my cousins who visited my hospital room. I dropped a $300 anti-emetic pill on the floor of the recovery room and a nurse assured me it was no big deal, giving me a new version of the look I’d gotten used to during chemo, the empathetic stare I translated as oh, poor young cancer patient. The post-op look clearly meant, this poor, young, pretty girl only has one breast.

Two-and-a-half years after my mastectomy, my hair has grown back, my color has returned, and people who see me with clothes on have no idea that I’ve had breast cancer. I have a funny little plastic “foobie” ordered especially for me, which approximates the size and shape of my missing breast. It fits in a little pocket inside my mastectomy bra.

My friends ask me when I’m getting reconstruction, and I tell them I don’t know. But I do know: I’m never going to. Not because I like having one breast – I don’t like it, not at all – but because getting another one isn’t so simple.

Reconstruction is a complicated issue. Some women can get reconstruction surgery at the same time as a mastectomy, but I’m not one of those women. Since my cancer was so advanced, I had to get massive amounts of radiation after my surgery, and I couldn’t get that kind of radiation with an implant in the way. Because of the cancer cells remaining in my breast after the lumpectomy, my mastectomy surgery involved the removal of an extensive amount of tissue – all the way up to my collarbone and around the side to my back. All this meant that the only reconstructive option for me was a very serious deal. I’d have to be in intensive care for a few days, inpatient for at least a week, in bed for a month, and unable to lift or work for 6 months. No dice.

But more than 6 months of missed work, I think about the weeks, the months of missed life as usual. If cancer’s taught me anything, it’s that life is short, and I don’t want to spend any more of it than I absolutely must in a hospital, or in bed, or on narcotics, changing drainage tubes.

Sometimes I look in the mirror from a side-view, admiring the silhouette of my good side, my side-with-a-breast. The skin on my mastectomy side is puckered, jagged, scarred. There is no fat or muscle in between my skin and my ribs, and the radiation burns and scarring have left the area nervy in some places and without any feeling in others, alternating spaces of numbness and sensitivity.

That’s really the perfect metaphor for cancer survival: alternating spaces of numbness and sensitivity. Sometimes I can forget about it, but sometimes something touches me just so and I’m jolted back into pain and fear. So I breathe, I meditate. I burn sweet-smelling candles, and I order dessert. I splurge on silly useless things; I live. I focus on the good sides – the side of my body with the perfect breast, and the side my life after cancer treatment, the side of my life as a survivor.