Ruffles and Roses and Life Without Breasts

Having survived early stage breast cancer and a lumpectomy at the age of 34, I marched forward with my life.  Assured by my beloved late breast surgeon, Dr. Yvedt Matory, that the result of two consecutive surgeries had, in fact, removed all the cancer cells in my right breast, I re-boarded the train of my life, destined again for great places, wonderful vistas, and friendships along the way.  

The removal of the lower third of my small (but perky) breasts did pose some interesting challenges.  But, all in all, the cancer removal had little impact on my life.  Try getting an underwire bra to stay "under" when there's no breast "fold" to keep the wire from sliding up.  Alas, aside from the elimination of popular underwire bras from my lingerie possibilities, I rarely thought about my disfigurement.   Padded bras helped fill in the missing contour quite nicely, and, well, I still had my wonderful nipples! 

Four years later, things changed.  I discovered a lump, wound up in the operating room again, and....yada, yada, yada.....the biopsy revealed breast cancer again.  This time, the prognosis was much more grim.  (I shall describe the emotional and slightly humorous instance and circumstances of this diagnosis in a later blog.)   With infiltrating invasive breast cancer, my "choice" of having a mastetomy was clearly the best course of action.  The removal of the contra-lateral left breast was optional, but given my history, the agressiveness of my cancer, and my desire to "never have to deal with this again" I signed up for bilateral mastectomies.   This was my second time around, and I was anxious to get the *@**##!  cancer out!

Back to the operating room again at Brigham and Women's Hospital in Boston, this time for  major and literally life-saving surgery.  

On the recommendation of my surgeon, I had a consult with a plastic surgeon prior to surgery.   This, of course, SHOULD be standard practice, as all possible aesthetic outcomes should be considered before the treatment and surgery plans are devised.   Did you know that according to the American Society of Plastic Surgeons less than half of all women diagnosed with breast cancer in this country are afforded breast reconstruction information?  Unacceptable!   Well, my plastic surgoen presented me with the option of having immediate breast reconstruction performed during my breast removal surgery.  I would wake up without my real breasts and with some scarring and loss of sensation, but with perfect silicone-filled substitutes. 

Well, that was not to be.

The cancer was very extensive, five underarm  lymph nodes were also cancerous, and a nasty infection had taken hold in the breast as well.  Not good.  The reconstruction was not possible.  And, a year-long treatment plan was put in place involving chemotherapy and tissue-damaging chest radiation. 

I woke up from surgery with no breasts at all.  Not a mound, not a nipple.  I was beyond just flat, with a concave contour where my lovely curves once resided.

Breastless is how I spent the next 4 1/2 years of my life. 

With the support of my family, my husband, and friends, I made the best of my LWB (life without breasts).  I approached this period of my life with humour and determination, although the smiles often hid the emotional suffering this disfigurement truly caused me.   I determined to keep wearing the same fitted styles I always enjoyed, my GAP tees, fitted sweaters and the like.

Among the many sentiments people sent me during my period of recovery, the Hallmark Fresh Ink card sent by my cousin Dolores and depicted above is my absolute favorite.  It about sums up how I felt, how my breastlessness affected my self-esteem.  She really GOT it, and that validation made me laugh hysterically (still does) and cry.   "I think the ruffle really makes a difference, don't you?"....as though the little fringe at the bottom of the bathing suit could really mask the low self-esteem obviated by the depicted woman's body language.  "I think the ruffle really makes it."  Ha.

On so many levels, I related to the cartoon on the card.  Tiny hair (that's what my then 3-year-old daughter called my newly re-growing hair after chemo), concave body, and a weirdly fitting girls bathing suit.  I think the flowers really make a difference, don't you?  Perhaps I should have chosen ruffles? (smile)

My grandmother and others, truly "ruffled" by my diagnosis,  tried to "restore" me to my former self.  I adore fitted clothing, knits, body hugging styles.  That's me.   I battled a new malady - the invasion of the ruffles!  In the years ensuing my mastectomies my closet became half-full of interesting gifts:  crazy ruffle-front shirts that look like they were taken off pirate ships, tops with "gathers" to "fill me out", crazy prints deigned to "trick the eye", and coordinating rose pins that nearly screamed out my flatness.   All well intentioned from giving folks that love me.  Did I mention I come from a gigantic extened family of Italians, Polish and Danes?  These "style tricks" could not take away the reality that a primal part of my female identity, my "curves", had been taken away.  Forever.

My life without breasts hurt in more ways than one.   Ways that one untouched by cancer might never consider.

My breasts represented many things to me:  my identity as a woman; a source of intimacy and vital physical pleasure for both me and my husband; the sentimental symbol of my breastfed babies; a certain female power that comes from atrractiveness to the opposite gender; a required contour for beautiful lingerie and clothing made for women.  All gone in a single surgery that preserved my life.

In some recent speeches I gave on the subject of breast reconstruction, I challenged every man in the audience to consider what a "comparable" loss might mean in terms of their "masculinity".   Picture lots of crossed legs and flushing faces.  The fact of the matter, and the reason for my awareness crusading, is that breast loss undermines women's well-being in ways that pervasively impact her life.   

Ruffles and roses, humorous cards, loving family and friends all helped me in their way.  But, it was the flourish, the bloom, and the joy I re-discovered in ME that helped me emotionally recover and get on with my life.  My breast reconstruction surgery helped finally put the train back on the track.

The Abercrombie Bag and A Modest Hope

An Abercrombie bag. A wholesome young model. A pie. A friend. The sum of these ingredients comprised a recipe that lead to my restoration . You could say, I suppose, that from that day forward, my hopes for a renewed life after breast cancer were "in the bag".

It was Easter of 2007. I graciously offered to host my entire immediate family, all 17 of us, at our home for Easter dinner. My husband and I enjoy these occasions, our house filled with good food and love. It is times like this that I cannot contain my deep appreciation for being so very much alive. The beautiful sight, the cacophony of chatter around the table, magnified my post-cancer joy, dampening my cheeks with silent, salty rivulets of escaping happy tears. Generations of our Italian ancestors before us lived for days like this, when family and good food fostered love. This was a good day. Never mind that I had spent 30 minutes that morning pondering my closet in hopes of locating a single blouse or sweater that would look normal on my post-mastectomy body. Forget that most of my tops, purchased when I enjoyed being an "A" kind of girl, now gathered dust. (I imagined my tops complaining about not ever being chosen and accusing me of neglect.) Our son and daughter, nieces and nephews, and extended family deserved a holiday where wonderful memories would be made. There was work to be done, food to prepare. No time for a personal pity party for one.

Fortunately, my mom and husband make up for my domestic deficits. Our collaboration in the kitchen that Easter added to the holiday fun. My mom brought some side dishes I do not remember, and an apple pie I recall being exceptional, all delivered to me in a recycled Abercrombie bag, pictured above. The annual InDelicato Easter Egg hunt commenced, the hungry hunters counting retrieved eggs, receiving their prizes, and joining the table for our feast. And feast we did. When the binging was over and the last coffee served, hugs were exchanged and the guests departed. I traded my masquerading ruffle-front blouse for an old sweatshirt, and got down to the pleasing task of returning our home to order. The aforementioned bag, still in good shape, got filed away with other recyclable totes.

A few weeks later, our daughter's Montessori school held their annual end-of-year picnic. The bittersweet commemoration of another school year was held outdoors at a local park, "pot-luck" style. I brought my "famous" chocolate chip cookies in...the saved Abercrombie bag. After depositing the cookies in the "dessert buffet", I grabbed a piece of lawn near my friend Lynn, the mother of my then five-year-old daughter's "best friend ever". I adore and respect Lynn. We laughed and talked, enjoyed each other's company as best we could while vigilantly keeping track of our children in a crowded public place. As older and oh-so-appreciative moms, Lynn and I tend to be extremely (okay, overly) protective of our precious progeny. As was typical at such public events, my concave post-mastectomy chest elicited unwanted sympathy, shading my interpersonal interactions. "So, how are you feeling?" people would inquire. "How are YOU feeling?" I felt like snipping back.

You see, despite having completed my cancer treatment over three years prior, despite being entirely cancer free, having my long hair grown back, being extremely healthy and active.....in spite of all that, when people saw my concave, breastless profile they continued to define me as "suffering" from cancer. I suppose in some ways, they were right - I was still suffering emotionally from the physical scars my mastectomies left behind. Still, sympathy was the very LAST thing I ever wanted.

Anyway, at the picnic, the subject turned to the upcoming bathing suit season, and my struggles with finding a suit that worked. Our "swimsuit season" here in New England being especially short, I wondered out loud if the shopping would be worth the trauma. My dear sympathetic friend conferred. Then it happened. The image of the Abercrombie model on the now-empty bag looked at me. Or so it seemed. I picked the bag up for a closer look. "Why can't I have THAT," I said out loud to my friend. "That's all I want to be happy," I added while deep in thought. "Yeah, don't we all!" came the response. "What?" "Oh!" We both laughed a good cleansing laugh. The image on the opposite side of the bag, the one facing her, was pure beef - a topless young stud of a twenty-something man! I laid the bag down. The young woman pictured was lovely. The model's barely-there "AA" contour, the minimal curve in her shirt, seemed so wonderfully feminine to me. Bumps.....that's all I really wanted.

Why was this very modest wish not possible? I had been told by three well-established plastic surgeons that my small frame, the amount of tissue taken during my life-saving mastectomy surgery, and the radiation treatment damage precluded me from any kind of breast reconstruction. Each time I was told this it was harder to take. With all the advances in medicine, wound repair, and science, this lack of possibility was difficult for me, a highly educated and tenacious person, to accept.

The bag's place was elevated from the recyclable totes heap to a place in my closet, where the Abercrombie model continued to look through a camera lens right at me.