Save The Tatas? NO!

It wouldn’t be October aka Pinktober aka Breast Cancer Awareness month if I didn’t write an obligatory “Save The Tatas” post.

So here it goes, my requisite post on “saving the tatas” or in my case literally having them amputated off of my chest wall.

For those of you who don’t know, which is probably most of you, many members of the breast cancer community are against this phrase. Furthermore, many members are against what they refer to as the pinkwashing that occurs every October. From what I have gleaned from Facebook support groups, pinkwashing is using the color pink and more specifically “breast cancer awareness” in order to increase sales, without necessarily giving much or any proceeds to actual breast cancer research.

Sounds pretty shitty, huh? Yeah, that’s why many breast cancer survivors are not a fan. On principle I am not a fan either, but I also just don’t have the energy to care that much about it. One can only have the energy to be riled up about so many things. And as I have mentioned before, I don’t always have the most energy.

Anyways, marketing ploys like “save the tatas” can be very upsetting and infuriating to survivors of breast cancer.

I get it. First off, it is inaccurate. Breast cancer treatment is not focused on saving or preserving the tatas, but instead it is focused on saving the person. Many times, to save the person, a trained breast surgeon has to remove a part of or the entirety of a breast. In some cases, like in mine, both breasts are removed.

My breasts were basically ticking time bombs. Spoiler alert – I was unable to neutralize the bomb before it blew up and I was diagnosed with breast cancer over a year ago. As a BRCA1 mutant I had an 87% lifetime risk of getting breast cancer. In mutants like myself, the recommendation is to remove both breasts after a diagnosis of breast cancer.

The medical recommendation I was given, prior to my breast cancer diagnosis, by multiple doctors was to have my children and breastfeed them and then to have my breasts removed. This is in addition to annual screening in the form of an annual mammogram/MRI of my breasts starting at the time of my diagnosis. I found out I had the BRCA1 mutation when I was 28 years old and did have screening, but this lapsed during my pregnancy, because screening mammograms and MRIs aren’t performed during pregnancy.

Let’s backtrack a little though. Did you notice the insanely high lifetime breast cancer risk that I had as a BRCA1 mutant with breasts. Did you also notice that the recommendation was to wait to breastfeed my future children and then have my breasts removed?

In all honesty, I thought this was a perfectly reasonable plan at the time. There was no family history of breast cancer in my family, at least that I knew of at the time, and of course as an educated millennial woman I was planning on breastfeeding my future children. You have to get as many of those IQ points for your future children as you can! Please note the sarcasm in that last sentence.

What the actual fuck!! In hindsight, this all seems ludicrous to me. I had an 87% lifetime risk of breast cancer and not one physician said get those breasts off of you now?!! In all fairness, I may not have followed that advice. A double mastectomy is extremely painful. Definitely the most painful surgery I have had to date. Fortunately, I have blocked the pain out from my memory, but I can tell you all that it was definitely the most painful recovery from a surgery that I have experienced. Oh, and then you have these drains sutured into your chest wall, which is it’s own kind of specific torture. I also liked my breasts and didn’t want to have to get them chopped off before it was really necessary to do so. Plus, I was an internal medicine resident at the time, and taking time off to have surgery didn’t sound appealing to me at all.

Anywho, back to the medical advice I was given. Now, when I look back and think about this in the greater context and in the political context (yes we are going there – don’t worry though just peripherally) I think that this is an example of prioritizing a woman’s health behind that of her offspring. I’m so sorry I am bringing abortion into this. I really am. But, I do see a similarity. Maybe it is a stretch, but I do think it is worth noticing and mentioning. In the simplest and plainest analysis, we put the health and IQ of my unborn child higher than my own. And in all fairness, I am included in this “we.”

OK, so I’m a rational and reasonable person and also a physician, so yes I can acknowledge that there is probably a lot of data saying that this is a reasonable recommendation. I’m sure for the aggregate BRCA1 mutant that it is completely appropriate to wait to remove one’s breasts until after breastfeeding. But, for me and many other women that I have met through support groups it wasn’t. It will probably cost me my life. If I could go back in time and make any change, it would be to have a preventative double mastectomy right when I learned I carried the BRCA1 mutation.

Unfortunately, just like breast cancer treatment, there have not been as many advancements in time travel as I would have hoped for. Don’t worry, I’m mostly just kidding. But, how cool would time travel be!

So, yeah, I think that the medical community has given me a disservice by not recommending all of my options to me when I first found out about my BRCA status. And, furthermore, by not strongly suggesting immediate preventative double mastectomy upon diagnosis of my BRCA status. Because, there is really no way to know when a person will develop breast cancer, and even with screening cancers can be missed. Maybe given a more complete set of options things would have turned out differently.

Well that was an upsetting detour. Let’s take another one! Hopefully, less upsetting, though. I can’t write a “save the tatas” post without acknowledging our society’s weird obsession with breasts. I’m not judging either, I am just as much of a part of the problem as anyone else.

For those of you who aren’t familiar, there are several options for reconstruction following a double mastectomy. Most women who opt to undergo reconstruction will have metal expanders placed either under or over their pectoralis muscles during the same surgery that the mastectomy is performed. This is what I opted for and I still have metal expanders that are under the muscle. Unfortunately I will probably have them until the day I die.

Why did I choose to opt for under the muscle expanders, which can be as painful as they sound? Well, you guessed it – I’m going to blame society again! I felt, that to be seen as a woman, even to feel like a woman, I needed to still have the classic curvature of a woman. I wanted to still have the classic silhouette that our society views as sexy, for lack of a better word.

How vain! But, you have to understand, at the time I was 30 years old. I wanted to still look and feel attractive after all this cancer nonsense was done, which at the time of my surgery was still the plan. I wanted my husband to still find me attractive!

This is in no way my husband’s fault, though. I did take his opinion into account, and he did agree that he wanted me to have reconstruction. But, again, society brainwashed us into thinking that is what makes a woman attractive! I have learned that it is not.

Ironically, neither of us even like my fake breasts. They are far from sexy or attractive. I had radiation to the right side of my chest, so my right fake boob is perky and somehow my left fake boob is saggy. I actually find it somewhat amusing – it looks like one is pointing up and one is pointing down.

I can’t do several exercises, like pushups or any pec muscle workouts because it is excruciatingly painful now. If I could go back and change the decision, I would opt for no reconstruction and to go flat. I think both my husband and I would learn to find the new me attractive. Plus, he has seen me look like a balding man, so he is clearly not in this for my looks at this point.

I am fortunate that I am not in chronic, excruciating pain, like many women who have under the muscle expanders are. How heartbreaking is that though? To go through all the trauma of breast cancer treatment and then have chronic pain from trying to maintain a sense of normalcy in one’s appearance.

I think that is another reason why many breast cancer warriors are over the pinkwashing as well as the sexualization of this disease. We are here fighting for our lives and companies are trying to make a profit off our suffering. Not cool! A lot of the times companies use pink promotions during October and give either none or a negligent amount of their profits to breast cancer research. Of course, there are many companies that do give a charitable contribution, but unless you ask you won’t know which is which!

So, no let’s not save those tatas, let’s save the women and men who are afflicted with breast cancer, because yes men can get breast cancer too. A woman’s worth is more than the size of her breasts and a woman can be attractive without any breasts at all. Again, I think that we are all more beautiful than we give ourselves credit for.

Love and light to you all. Until next time my dear readers.