Second guessing personal medical decisions is common in the world of breast cancer. Is it wrong to rethink some of those choices?
Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. She is an avid photographer, freelance writer/blogger, wife, mother and grandmother.
Mastectomy. The big “M” word. It’s the word, besides “cancer” that no one ever wants to hear. There’s such finality in the huge, life-altering decision to have a mastectomy. It’s a decision that must be weighed carefully. It should never be entered into lightly. I wish I’d understood that concept before agreeing to have my breasts removed.
After I was diagnosed with breast cancer, my breast surgeon explained my choices. As I understood it, I had two choices. Option one: undergo chemotherapy followed by a lumpectomy and then radiation. Option two: have a mastectomy followed by radiation. If I picked option one, I’d be required to have a diagnostic mammogram performed every three months for the rest of my life. If I chose option two, I’d have my breasts removed. Then, after surgery, I’d go through seven weeks of radiation. There would be no need for a mammogram ever again. If lymph node involvement was discovered at the time of surgery, more medical procedures would be necessary. It seemed pretty cut and dry. The surgeon told me to go home and think about it and let her know my decision within a week.
I went home, but my head was spinning. I couldn’t process a single thought. I was overwhelmed. I sat and stared into space for an hour or more. I read the statistical information I’d been given. I tried to weigh the pros and cons of each decision, but it was still so difficult.
Thinking aloud, I heard myself say, “If I decide on a lumpectomy, I can keep my breast, but how much of it I can keep isn’t clear.” I imagined a huge chunk of my breast tissue would be removed leaving me with a disfigured breast. Although it would be disfigured, I assumed plastic surgery would be an option, but I wasn’t sure. My surgeon and I hadn’t discussed it. Choosing a lumpectomy didn’t guarantee that all of the cancer would be removed. I didn’t like the odds of this option. Just knowing one surgery might lead to another and another scared me. If I endured a lumpectomy and then, three months later, had to have more breast tissue removed, I might as well have chosen a mastectomy in the first place.
If I chose a mastectomy, I’d have my right breast completely removed. My right breast was the only one affected by cancer. This option would leave me lopsided. Of course, I could wear a prosthesis or have reconstructive surgery, but if I was going to choose mastectomy, I’d opt to have both breasts removed. I’d never want to remove one and then have to remove the other breast at a later date.
So I made my decision. I decided it would be best to have both breasts removed and not choose reconstructive surgery. I didn’t discuss my decision with my husband. I basically told him what my choice was going to be. He agreed to stand by my decision and assured me it was my choice to make.
The following morning, I called my breast surgeon’s office. I told her my decision. She said I’d made a wise choice. Surgery was scheduled a couple of weeks later. Everything went as planned, except cancer was found in my lymph nodes, too, so additional surgery was performed. That was three years ago.
Some days I wonder if I’d do it over again. That’s the big question. While I’ve thought about it many times over the past few years, I’ve never given myself much time to deeply ponder this question until today.
I’m an adult and I’ve always taken responsibility for decisions I’ve made. Taking time to research and gather as much information as possible has always been important to me as I’ve made my life choices, but I didn’t do that with my breast cancer. I have no idea why. In the past, I’d relied on the advice of those with more knowledge than I on a particular subject. Their input was extremely helpful. That’s why I felt comfortable making an informed decision when asked whether I’d prefer a lumpectomy or a mastectomy. I trusted my surgeon.
If I had it all to do over again, would I still choose mastectomy? I don’t think so. I would have probably asked if it was possible to use cryoablation, a tissue-freezing technique, to kill the cancer, or I may have decided to do nothing and just leave the cancer alone. With all the current medical information, it seems standard cancer treatments are changing constantly.
Mastectomies seem so barbaric. How can lopping off a breast be the best way to get rid of cancer? There has to be a better way to remove cancer from a breast. Needle aspiration, cryoablation, lithotripsy, medication or laser removal sound so much more appealing than mastectomy.
Although I probably would not repeat my mastectomies if given the chance to do so, I’m thankful to be currently cancer-free. Without the removal of my breasts, I might not have had the same outcome.
I wish I’d taken time to really think long and hard about my options. I also wish my breast surgeon had encouraged me to seek counseling, talk to other breast cancer survivors who’d endured mastectomies, watched surgical procedure videos, or done something else to help me understand the reality of the mastectomy choice but she did not.
Do I regret my decision to have both breasts removed? I’d have to honestly say, yes, I do. There are many reasons why I answered this way, but I won’t share them because they are personal.
My hope, for future women and men diagnosed with breast cancer, is that there will be mandatory counseling before surgery. This would help prepare patients to understand how a mastectomy might affect their future. It might also help a person take a little more time making their own decision and might keep them from rethinking their decision at a later date.