I saw this title in my newsfeed this morning and clicked on it with some trepidation but despite its lurid beginning it has some good information. I especially like how it contrasts the two women’s differences in pain perception, one woman describes not even taking any of the prescribed pain meds but just having a sensation of tightness post-mastectomy while another describes the pain as almost unbearable. I had the same experience as the first, aside from the horrid hangover from the anesthesia I had no pain at all and I wonder if the pain others speak of is sometimes from the placement of tissue expanders or implants under the muscle when they opt for reconstruction rather than from the mastectomy itself or if this is just an example of human variability. One of the women quoted also mentions the drains, (see second pic) those were the worst! Not actually having to deal with them but more like worrying about them every time I turned or moved for the ten days they were in place. Anyway, here’s Ann Marie’s article:
What It’s Like To Get A Mastectomy
After being diagnosed with breast cancer at age 40, Ann Marie Otis, now 44, had, as she says somewhat jarringly, her breasts “amputated.”It’s not a term most of us would choose to describe a double mastectomy, but she’s not wrong. After all, an amputation is the surgical removal of an extremity; a mastectomy is the surgical removal of a breast. Thinking of the two procedures as one in the same could drastically change our perception of breast cancer treatment. “A mastectomy is a big life change,” says Otis, who has documented much of her own healing—both physical and emotional—click to read more
Here is an article from the Fred Hutchinson Cancer Research Center’s Newsletter that focuses on Tina, me and the current trend in mastectomy tattoos. Yep, it is a trend. We met at her shop and photographer Robert Hood took a few shots of us together. Here is the picture of me. Click the link below to see a picture of Tina with me as the background. One of the other tattooists mentioned, Vyvyn Lazonga, runs the shop where Tina worked when we began our project.
Click here to read the full article: Fred Hutch
Facebook posts their new policy on mastectomy photos which states:
Does Facebook allow post-mastectomy photos?
Since Angelina Jolie’s news, I’ve seen several points repeated, so I’ll address them:
“She should have waited until she actually had cancer.”
This actually reflects several misunderstandings: of Cancer itself, a confusion between systemic and localized cancer, and a lack of knowledge about mastectomy procedures. She couldn’t have had the surgery she had if she had waited until she had cancer. What she had is a “skin-sparing prophylactic mastectomy” the point of which is to remove as much breast tissue as possible while giving a result that is not obtainable with reconstruction after cancer surgery. Compare the pix below:
Pretty big difference isn’t there? The first looks natural and the second is designed to look natural in clothing. The scars from biopsies and mastectomy really can’t be hidden that easily.
The other problem with actually waiting and relying on so-called early detection is that it assumes that a mastectomy could or should be done at that point when it is not always the best option. Cancers may be local or systemic and just because a cancer is small does not necessarily mean that it was caught early or that it will be easy to treat. A small cancer could be a very aggressive cancer with tendrils reaching into other organs that would need to be treated with radiation, chemotherapy or other treatments and skin that has been scarred and irradiated is not always capable of being stretched over an implant. Essentially, once you have a malignant tumor, you are no longer having a “prophylactic mastectomy” because breast cancer may be in other parts of your body besides your breasts as author Kelli and her sister, Fran, discover in this article, MY SISTER HAD A DOUBLE MASTECTOMY TOO, BUT SHE DIED OF BREAST CANCER ANYWAY.
This is similar to what happened to my mother. For those of you who haven’t read it before, Mom had breast cancer which was treated by lumpectomy and radiation. She had the requisite followups of mammograms and biopsies and when she was diagnosed with metastasized breast cancer in her lungs, liver and spine twenty years later, her breasts were clear of cancer. So if she had a so-called “prophylactic mastectomy” at the first sign of cancer, she would have had the same thing happen.
Obviously “preventive” means before cancer is diagnosed. If you want an approachable but still gratifyingly educational book about cancer, check out The Emperor of All Maladies by Siddhartha Mukherjee.
Here is another absurd yet oft’ repeated statement…
“No ethical doctor would ever remove a perfectly healthy set of testicles from a man who has no symptoms of testicular cancer, so how could a doctor do this?”
Here we have both medical ethics and sexism rolled into one question. The quote brings to mind all the tabloid scandals since the 60s from medically unnecessary hysterectomies, (the so-called Harlem appendectomy) to DES, from C-sections to prophylactic mastectomies… never mind that this time it is the women asking for the procedure. There are a couple of things that really irk me about this statement.
1. Testicles aren’t analogous to breasts, but to ovaries, and as important as these are women do get them removed much more cavalierly than they remove breasts. Breasts actually have little function aside from breastfeeding infants and Jolie and most other women who are in the age group to be considering this procedure have probably already done that.
2. Since cancers affect lungs, pancreases, stomachs, and plenty of organs that can’t be removed preemptively, does that mean that something that can be, shouldn’t be? These women are educated, can generally afford the procedures if not covered by insurance and are making their decisions with their doctors. Is that really different than any other elective procedure?
Bonus round: Right now, neither genetic testing nor prophylactic mastectomy is usually recommended by physicians but if Aetna’s policy posted online here is indicative, prophylactic mastectomy medically necessary for reduction of risk of breast cancer it may be recommended by insurance providers at some point.
I know this is controversial stuff, so please be thoughtful of others feelings when you comment.
Here is a link to a Daily Mail article about 4 young UK women who discuss their reasons for having this surgery.
Here is a link to an article by a woman who says she delayed having a prophylactic mastectomy and then did get cancer.
Skin sparing Mastectomy film on Youtube from Johns Hopkins
I was engrossed in making a presentation on the Part of Fortune for class this morning and completely missed Angelina Jolie’s announcement that she had had a prophylactic mastectomy until it was brought to my attention by a friend who asked if she could use a quote from me in light of it!
Once I looked the article up, I was thrilled that she had gone ahead with the surgery since I had thought about it back when she’d lost her mother to Ovarian Cancer, a related cancer. What shocked me was reading so many negative comments from people who don’t understand the context of a decision like hers. Sharon Osbourne received the same negative feedback when she made the same decision last year and it just amazes me how cruel and shallow people can be. I guess they are just proof that some people never really make it out of middle-school.
Their situations point up some differences between 1993, when I had my surgery, and 2013. In 1993, the BRCA gene test was new and no one was quite sure what percentage of cases it would account for, so I didn’t even have the test. We mostly discussed family medical histories. I had a traditional mastectomy which removed all breast tissue, leaving large scars. Reconstruction at a later time was offered but I preferred to stick with external prostheses and to cover the scars with tattoos. Angelina chose a skin sparing, immediate reconstruction option which she says left her with only small scars. Her cancer risk is slightly higher than mine but I am sure her results are more aesthetic than mine were pre-ink. Sharon had implants removed and I don’t know if she’s replaced them or not.
I’ll discuss why prophylaxis IS a reasonable way of dealing with cancer in another post, K?
Here is a link to Jolie’s New York Times piece.
And a link to Sharon Osbourne.
Amoena makes external breast prostheses.