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 Year of the Colorful Pants

The Year of the Colorful Pants.

I hereby designated 2010 "The Year of the Colorful Pants”.

I came by the above trio on a recent trip to a store named DELliAs, where my objective was to return a not-so-colorful Christmas gift from my husband, a “soft” and “fluffy” sweater that nearly swallowed me up. Not a shopper, I intended to accomplish the return in a matter of minutes, receive cash back, and put it to practical use. Call it an epiphany, foreshadowing, a sign from a higher power - I was actually seduced by a pile of colorful pants! Like a bee to honey. The "SALE" sign may as well have been flashing neon. In collusion, the fitting room mirror encouraged me along. A quickened heartbeat later, I exited the store as the proud owner of boldly colorful pants! It was the first week of January, and things were looking very bright.

Why on earth was I so emotionally charged by a few pairs of cotton pants? I found myself singing the whole car ride home! ("I can see clearly now, the rain has gone.....I can see all obstacles in my way................it's gonna be a bright, bright, bright, sunshiney day....)

I brought the pants home, tried them each on again, my husband serving as a very willing audience (smile). My son and daughter both looked surprised and nervous. What alien had taken their normally conservative mom and plunked down "Donna with the Amazing Technicolor Pants"? Had I made a mistake? Been intoxicated in the store by the overwhelming hue? No, no. The pants arrived in my life right on time. Life, I have learned, does put things in our path in very timely ways.

How wonderful, how metaphorical that these pants ended up in my closet, otherwise filled with tailored styles and safe, classic hues. The boldness, the infusion of color, felt like a celebration of joy for "living". These pants declare out loud what I am compelled to do - to inspire others affected by cancer to their best possible outcomes. On the days I wear them, I feel a little brighter. On the days that I wear them, sometimes consciously on days of self-doubt, I am reminded that change happens by engaging, doing, acting. "Go, girl, go," they say.

To understand how my life became color-deprived is to understand the psychological burden of breast cancer. You see, from the time I was diagnosed, a shadow hovered over me, a little dark cloud of anxiety that followed me like an unwanted friend.

For me, the bright spectrum of living did not return all at once, but in steps forward that helped me move entirely beyond a serious diagnosis to a state of normalcy. What helped me to move forward? First, the personal support of my oncology team, treating me and my family with compassion and individualized care. Then, participation in some social programs that got me thinking outside my “cancer” box. (Oncology social workers are truly unsung heroes in the universe of cancer care.) Yoga classes and a “Day of Beauty” offered at my cancer clinic, archery classes with my son, learning to play golf, playing my piano and violin - these activities helped my re-engage in "living", got me thinking forward again to a life full of possibilities. Breast cancer fundraising, advocacy and motivational speaking offered tremendous purpose to my days, delivered the rare gift of "meaning", and heralded my future.

Finally, breast reconstruction moved my post-cancer life a giant step forward, helping put the sun back high in my sky, and the color back in my rainbow.

The darkness, the draining of color from the lives of those affected by breast cancer is something I hope to address not only in this blog, but through actions and associations I hope will lead to a more holistic treatment of cancer patients. I feel compelled to help others like me move from grey back to colorful lives. Perhaps this starts with the donning of colorful pants! They certainly have inspired conversations, and dialogue is an important start.

I think I can, I think I can…life is again operating at full steam. The wheels stopped turning turning for awhile, but the engine has restarted. The schedule no longer controls me, I am the engineer. Cancer taught me that.

Yes, this is "The Year of the Colorful Pants".

MANGE VENTER MIG (Much Awaits Me)

Mange Venter Mig (Danish). Much Awaits Me. Self-confidence, possibility, faith, and hope – these unyielding elements have propelled me to achieve many things in my life about which I have been proud. Leadership of my high school class; first college degree in an extended second-generation American family; a distinguished graduate degree; a corporate career; the launch and successful management of a small business; civic leadership; elected public office; marriage; and the birth of two amazing children. All highlights in a forward life continuum. Striving, multi-tasking, and juggling were my lifestyle. Overachieving, I was driven by the belief that always there is a next step in life, more rewarding than the last. Ridiculous optimism? Perhaps. Innate determination? Most definitely. Foolish? Perhaps. Much awaited me, just around the next bend… and the next.

Practically from birth I was out to prove something – to the world, to anyone that doubted, and mostly to myself. I am woman. I can do it all. I can run a business full time with my beloved mom, while concurrently working in marketing for Alpha Software company, while maintaining a 4.0 GPA working full-time towards a Masters in Communications at Emerson College. Happy? I think. Tired? Extremely. Stopping to smell a single rose? Never. Much awaited me. I was a “mover”. My beautiful baby boy had captivated my heart, motherhood adding a new and amazing dimension to my complex and exciting life. What I did not realize then was that far too much, too many things that mattered, eluded my appreciation and understanding along the way. On I marched, projecting my future, laying out plans, acccelerating the spinning wheels in my personal “Habitrail”.

Then, cancer happened. It happened to me. It happened in the prime of my life, at just 34 years old. With a four-year-old marriage and an adorable three-year-old son, this was not supposed to happen to me. I was going forward, not staying still. Mange Venter Mig. This was not time for cancer. It was time for loving, learning, sowing, and growing. No, this was definitely not in the plan, this stopping to deal with cancer. I had no family history of cancer in my enormous, extended Italian family, nor in my extended Polish/Danish clan. I breastfed my son, I was not overweight, I did not smoke or drink. No time for this. I’m going places.

The diagnosis stunned me. It hurt my loved ones, and reflected their sorrow back to me tenfold. Relief came; the cancer was early stage. The first surgery was unsuccessful, leaving some cancer cells behind. The next surgery, weeks later, got all the cancer and left me with 1 2/3 breasts. (I shall share in a later post the humor and the challenges of having two thirds of a breast). My surgeon, God rest her beautiful soul, advised that since so much tissue had been removed I may not need radiation therapy. If cancer were to return to that breast (she noted I had about a 35% chance of recurrence over the first few years following the surgery), I would be unable to have radiation treatment to the same area later. So, the decision was made against radiation treatment. Would this have prevented my recurrence? I suppose I will never know.
Forward. Think forward. No looking back. Self-confidence returned and my crazy optimism. The faithful “Donna” engine was refueled, the determined little engine that propels me over the hills and valleys of my life.

The “cancer” chapter was over, or so we thought.

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.

A Rude Sales Clerk Saved My Life

Yes, a rude salesperson at a Marshall's store unwittingly helped save my life.

For the four years following my mastectomies, one of my greatest challenges involved shopping for bathing suits. Let's face it, no woman really enjoys this affair. For, we are at our most exposed point, most vulnerable in terms of our self-image, when staring at ourselves under the harsh fluorescent lighting in bare fitting room cells. What I saw reflected back to me in that mirror reminded me of my cancer, and made me feel more than physically reduced.

Over the years after the removal of my cancer (and my breasts) I had the pleasure of numerous strange and unsuccessful trips to department stores, attempting to find a bathing suit that "worked" for my "two-dimensional" post-mastectomy body. My beloved mom and daughter normally accompanied me on these annual, dreaded trips to the bathing suit sections of various retail establishments. We would start in the juniors department, and inevitably end up in the little girls area, searching for a suit that would fit my flat chest. You see, my concave chest gave new meaning to the term "pear shaped body", with normal adult-woman hips and an abnormal "blank" chest. At 5'2 and 105 lbs., I was lucky. The girls size 16 suits I often ended up with assumed the wearer had a pre-pubescent body, but also reflected the color and fabric choices enjoyed by little girls. (Picture multi-colored hearts and cheesy plastic trims).

These trips would begin with a deep inhale of resolve before entering the store, and exchanged "here we go" glances between the three generations of women. We would take armfuls of bathing suits into the fitting room, where I would put on a pathetic (sometimes comically theatrical) fashion show to my hopeful loving audience. Other fitting room comrades would lend quick sideways glances; their expressions, though fleeting, would ask more than they would reveal. Often, the absurdity of these sessions would evoke a range of emotions, exploding into laughter or ending with me fighting back tears.

I had tried prosthetic bathing suits. Companies like Lands End do offer women some suits that accommodate a breast prosthetic. (Thank you Lands End!) Unfortunately, most of these have an "older" or "larger" woman in mind. I'd rather the bows and hearts than the matronly cruisewear-style swimsuit. Also, the prosthetics have a tendency to "escape" from the suit at exactly the wrong time. (Picture my coyly chasing my bobbing fake boob floating in a public pool.) Additionally, the shifting wet prosthetic, coupled with the wet suit rubbed horribly against my scarred chest. The chafing was, well, certainly not worth the contour.

Well, in the summer of year four I had finally, I thought, found a woman's bathing suit that would work! Of course, this suit had been settled on after another emotional outing. When I got it home, and modeled it for my equally hopeful husband, we both realized that the "empty" spots on the top just would not do. I also realized that, with no breast contour to hold the suit in place, it rose up my chest every time I lifted my arms up. Hmm. Too bad...I liked it.

Two weeks later the three girls (me, my mom, and my young daughter) returned to the Marshall's store from where I purchased that suit. The plan was to exchange it, but there were no other viable choices. There was a long line at the return desk. This is where the rude clerk saved my life! I had removed the tag from the garment, and she absolutely refused to take it back. I quietly explained the circumstances, still no effect. Well, this was a watershed moment for me, I guess. Four years of suppressed emotion came pouring out. I burst into tears, left the store (followed by my consoling child), and realized at that moment how very much (despite my convincing myself otherwise) I really missed my breasts.

You see, my life had been saved by a year of cancer treatments. But, my "life", had been sorely affected. The scars ripping across my chest healed, but had left much deeper emotional ones.

Two other things happened within weeks of that incident that set me on the path to my reconstruction and "resurrection." I will explain more in my next post.

Breast Cancer and Hope

My name is Donna Bramante InDelicato. I live in Windham, NH. At just 34 years old, I was diagnosed with early stage breast cancer. A partial mastectomy later, I thought I was cured. But, that was not to be. Four years later, I was again diagnosed. This time, the diagnosis was devastating: Stage III cancer, aggressive, and traveling outside my breast. With a bright future, a husband, two beautiful young children, and a wonderful extended family, I had everything to live for. I underwent a year of cancer treatment including several surgeries, chemotherapy, and radiation. When the treatments finally ended, I was thrilled to be alive. But, the effect that stayed with me the longest and pervasively affected my life was the absence of my breasts, a deformity I lived with for 4 1/2 prime years of my life.Several times over those "breast-less" years I visited plastic surgeons seeking the hope of breast reconstruction. Each time, the answer was no. I was too thin, had too much tissue removed, and the radiation damage was too extensive. Finally, through serendipity, I landed in the office of Dr. Karl Breuing, a pioneer of a breast reconstruction procedure that utilizes donor tissue matrix (known as AlloDerm) and implants to recreate breasts. The results have been remarkable, not only in how this procedure restored my appearance, but, more importantly, how breast reconstruction helped restore my life.This blog will chronicle my journey, what I have learned, my collaborations with others, and how, in many ways "Cancer cured me."