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Every three minutes, a woman in the U.S. is diagnosed with breast cancer. Here is one survivor's story. By Vicki Mariner In 2000, when the young technician popped her head around the door after my mammogram, I assumed that she would tell me to button up and check out. Instead, she hemmed about "white sprinkles" on the x-ray. "Maybe talcum powder?" She wiped off my armpit for a second try. "O.K." she said," we've got it." I'm not a big worrier, but when I got home later and had a message from my doctor's office to call immediately, my heart sank. "Dang, this it." The second mammogram and my doc's call could only mean one thing: cancer . Still, I've always had an absurd faith in my ability to dodge truly bad luck. Maybe it wouldn't be so bad. The next day, my doctor saw me: "See these little white flecks? Calcified cells, possibly left by cancer." Next stop, my new surgeon's office to set up a biopsy. I surfed the web for biopsy images and was horrified. They looked like shish kabob skewers inserted crisscross through breasts! Still, I decided to approach the experience with so much confidence in medical technology that my mantra was, "Relax...breathe deep...don't look." Medical technology helped by being friendly, efficient, and totally reassuring. I felt nothing until I woke up with a little sore spot under a neat bandage on my left breast.
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During the week's wait for the results and a surgery consultation, I avoided wallowing in melodrama. Finally, the good news: It was a slow growing, not particularly invasive cancer. And, the bad news: It was not a lump, as in lumpectomy, but an area, as in modified radical mastectomy. I could say good-by to my left breast.
Then came a two-week wait to meet the surgeon. This was the worst part of my ordeal. I felt like I was on a toboggan teetering at the edge of a huge slide. When I finally met him, he discussed reconstruction and yet more surgeries. Yuk! I worried, too, about the other breast. Would I have to go through this again in a couple of years?
So Jim - my husband of nine years - and my best friend Sherry helped me through weeks of research and decision making. I discovered that during the past year two other acquaintances had faced breast cancer. Then Jim's sister called to say she had a lump and was scheduled for surgery and radiation. Yikes! It seemed like everyone I knew was headed to the oncologist.
When I told the surgeon that I wanted both breasts removed, he seemed to think I was overreacting. He emphasized that removing the cancer-free breast would not prevent a recurrence. I explained my logic: I was just over 50, didn't want reconstruction, didn't want an odd breast, and definitely didn't want to go through this again. I had consulted with a plastic surgeon, looked at all his pictures, and spent hours skimming other women's stories. What stood out was that to end up with a body I was comfortable with, I needed to take some control over what would happen.
I had seen pictures of post-surgery scars with puffs of skin around them. The surgeon would leave these extra "skin flaps" for later reconstruction. Most women go through one or more operations to rebuild a "breast" from thigh fat, and then have something that looks like a nipple attached. While I could appreciate the option of retaining symmetry, for me the price was too high. More surgery just filled me with dread.
If I had been younger, I would probably have chosen differently. But at this point another image of comfortable symmetry came into my head: bra-less summers! I weighed a future of retaining sensations in one breast (It is a major erogenous zone after all, and yes, there is sex after 50!) with a lifetime of fearing that breast would betray me. And, I didn't want to have to wear a bra and a weighted prosthesis to look normal. At a second consultation the surgeon accepted my decision.
The good-bye party
Once I felt clear about this, and had Jim's support, much of my dread and anxiety disappeared. I would do what needed to be done, but in my own way as much as possible. My close friends Sherry and Terry had heard about women making plaster casts of their breasts as part of a ritual to honor and say good-bye to that part of our female selves. Immediately, I embraced that idea.
We met at Terry's little counseling office with its big window overlooking a garden. Several friends wetted and wrapped plaster cast strips across my chest, leaving space in the back so we could slide it off after it hardened. Terry lit candles and we sat around the floor talking honestly about feelings. We laughed a lot. I'd always been quite pleased with my small breasts, so nicely proportioned. Part of me couldn't believe this mutilation was really going to happen. Yes, a part of me was grieving and horrified, but also thankful I wasn't in my twenties or thirties, fearing rejection and loss of "femininity" like so many young women might.
We remembered a wonderful poster of the poet Deena Metzger after her mastectomy. She had a curving tattoo, an ornate "Amazon dagger" created over the scar, and the poster shows her naked chest, arms proudly thrown wide, her smiling face reflecting the sun. This was exactly the image I wanted to keep in my mind.
Still, I had a nagging question. Would the scars be symmetrical and flat? My surgeon said he would do his best, but his job was to get the cancer. So, the day before the operation I began to panic and realized that I needed to talk again with the plastic surgeon. Kindly, he agreed to see me after his last patient. As his staff closed the office, he and his assistant measured and marked incision lines for balanced scars on either side of my chest. The next day, the operating surgeon was surprised by the lines, but fortunately he was a good sport. Later, he said that I was his first patient who had done that, but he was happy to follow the marker lines as much as possible.
Recovery without regrets
The operation and recovery were notable for me only in how quickly everything was over. There was a two week period of feeling like the Bride of Frankenstein with rubber tubes and drain bags hanging off my bandaged chest, but the healing was more uncomfortable than painful. I was lucky that Jim did some of the little nursing jobs that would have hard for me to do. Having imagined days of languishing in bed, I'd laid in a stack of light reading, but after only two days at home, I was raring to get out.
Once I was relieved of the bandages and drain tubes all I wanted was physical therapy and to get to a recovery exercise group. There was a longer scar on the left side where lymph nodes were removed, and I didn't want to lose range of motion in that arm. I was also afraid I wouldn't exercise enough on my own. So, I began calling breast cancer support organizations. All could tell me about getting fitted for prosthesis, special bras, and wigs for after chemo. There seemed to be a lot of sympathy for the "grief" process. Yes, they had heard that TMH offered a recovery exercise class, but they had no information. Finally I got a phone number from a department at Tallahassee Memorial Hospital, left my phone number, but never heard back. My HMO was willing to pay for a few physical therapy sessions, so I took their exercises and did them on my own. It worked fine.
In many ways, I had a best-case scenario. The oncologist did not think that radiation or chemotherapy would be necessary. The post surgery pathology report showed clear margins around the cancer, and lymph nodes were not involved. I also have a family that fully supported my choice without a moment's concern for others' thoughts.
Since then, a shocking number of friends have taken to wearing ball caps or bandanas for months at a time. My friend Sherry went through her own year-long ordeal just two years after helping me through mine. We all went through many of the same things, but each diagnosis and each experience was a unique individual challenge.
For a year or so after the scars healed, I toyed with getting a tattoo on my chest. Maybe a leafy vine with morning glories or butterflies? Celtic spirals! But tattoos are painful and expensive, and I couldn't really see myself walking around shirtless often enough to make it worthwhile. What does matter to me is that I can look at my chest in the mirror without regret. I was able to make my own deal with loss, and I can live with that.
Vicki Mariner is a very active community volunteer who lives in Wakulla County.
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