Breast cancer and reconstruction – your body, your journey.

Recent figures suggest that 1 in 8 women will be diagnosed with breast cancer in Australia. The decision of whether to have a reconstruction or not, is merely an afterthought for most people. Just like any cancer diagnosis, the questions silently scream inside your head….What happens now? Will I need chemotherapy or radiation? How long do I have?

Not only are the technological advances in modern day medicine well equipped to deal with breast cancer, it is also well equipped to diagnose breast cancer in early stages via BreastScreen, and potentially pick up breast cancer genes via familial and genetic testing for those at higher risk of developing it. For most people, it’s a journey which starts off with fear and anxiety.

My mother and maternal aunt are both breast cancer survivors in my family. Whilst my aunt was lucky enough to undergo breast conserving surgery (ie. what is known as a lumpectomy these days), my mother was not so lucky. A mastectomy was required to clear her of the cancer, which conveniently traded her out of need for radiation therapy.

I sat there during her initial consultation with the resecting breast surgeon, and listened carefully as he explained where the tumour was located, the rationale behind the surgery, and what they needed to do with sampling the lymph nodes. I was only a junior doctor at the time, but hospital visits always become a big messy blur when things happen to your own family. It was clear to me from the very beginning that a breast reconstruction for her would be fraught with danger considering she had many other complex medical problems, and was also taking blood thinners.

“Now let’s not even consider breast reconstruction here….because it would be a bit complicated with your medical problems.”

And that sealed the deal for mum. It was clearly the correct decision. She hated (and still hates) going to hospital, and she certainly did not want to complicate an operation. So she settled right into a single side prosthesis – and yes there are some good ones out on the market these days. However, the next few years revealed a whole new level of struggle I never knew existed to breast cancer patients.

“You wouldn’t believe how much time I spent choosing the right top to wear today! All the other ones just showed off my lop-sidedness so badly!” She said jokingly at dinner.

“I really couldn’t bare wearing the prosthesis today, the weather was so hot!” She said to me as she sat down with me at a cafe with her arms crossed in front of her chest.

It is true that breast reconstruction is not for everyone. Whilst some patients simply do not want to bother with implants, extra scars, extra nights in hospital and extra clinic visits, complex medical co-morbidities and various external factors may also negatively affect reconstructive outcomes.

I believe, however, that everyone should have a fair chance to at least consider it. Breast reconstruction can drastically improve your quality of life and raise self-confidence through preserving femininity. Despite having very supportive partners, it is not uncommon for women to still worry about being less attractive to their partners without normal looking breasts. Prostheses can be expensive to buy and replace (with some, but limited government funding for cancer patients), and a size mismatch can still exist if the normal breast is particularly big and pendulous (there may not be a big enough prosthesis available on the market to match the normal breast).

The cancer and reconstructive journey from start to finish is a long one. It is up to each individual to consider – in conjunction with the treating surgeons – what options are available, and what possible outcomes can be achieved. Nonetheless, it is a unique journey for each patient.

Afterall, some of us would just like to leave the house on a daily basis without first spending half an hour trying ten different tops on.

Fair call, I say.



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