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Interesting that this discussion has ranged into so many aspects of reconstruction, and also that most of us have related NOT having reconstruction. I know that there are lots of women who are totally happy with their reconstructed breasts. They should report in, to balance this topic.
What bothers me about this issue is that often the decision is made in the heat of the diagnosis-moment. In one breath, the surgeon may be making recommendations for (truly) life-saving surgery, and in the next breath, discussing the plastic surgeon referral. I think that women are not in a good state at that time to sift out the fact that reconstruction has nothing to do with cancer treatment. On the other hand, for some, immediate reconstruction seems to make a big difference in their attitude about their losses to cancer. It's a hard, and very individual question.We can relate what worked (or not) for us individually but each person will have a different "right" answer for themselves.
I didn't have reconstruction after bilateral mastectomies, wanting to get on with treatment as quickly as possible. But at the time of diagnosis, I thought that eventually I would consider reconstruction. Like many of you have said, I found that I did not like being a patient, and more surgery that was not medically essential did not appeal at all.
In addition, I found that I could not wear my prostheses. I tried. Lovely bra, comfortable little things - I'd put them on but they never made it out of the bedroom. To me (me only), they made me feel costumed. They were foreign things on my body that were there only for my vanity or my desire not to shock or offend. At first it was very weird to go flat. It felt so obvious, so deformed, and somewhat exhibitionist. But over time I realized that: 1) no one else was really noticing - at 50 and never pretty nor slim - it was only me who seemed to notice, except maybe at the beach or gym. 2) my loss was not my fault and I owed no one an apology nor camouflage 3) I've always valued function over form and this flatness fit with that approach (my closet floor has only birkies, water shoes, and hiking boots - function and comfort above all).
So I reasoned that if it felt weird to have these "things" on my chest - reconstruction would not feel much different to me. It's true of course that I miss the presence of breasts, but even more, it I miss the sensation of them which would not be restored with reconstruction.
In conclusion (finally!), I'd say that I'm content with my decisions, but I don't think I will ever say that I'm happy with my flatness. On the big scale, flatness is WAY down there in importance but still - I do miss my breasts - don't we all?
One more thing - recommending for or against reconstruction is far outside the scope of an oncologist - I think it was wrong for Jade's oncologist to weigh in on this topic, especially with such a strong opinion. We look to our providers for expert, EVIDENCED advice. There is no evidence to support his theory. It IS an interesting theory, although what I've heard is that surgery (not the anesthetic) can release growth factors that could promote growth or metastasis. This theory would relate to any surgery, including the one for primary disease. Definitely an interesting topic for a separate discussion thread. The idea about suppressing the immune system lacks logic. If the immune system worked on its own to stop cancer, we wouldn't have to be tricking it with vaccines so that it could help. Lots of cancer probably IS eradicated by our immune systems every day - the unsuccessful cancers. The successful ones succeed in part because they evade detection by the immune system and/or actually harness the immune system to help them in their growth and travels. It's not a weakness of our immunity but a cleverness of our cancer.
When I was at Project LEAD in Seattle, Nora Disis from UOW was one of the instructors. An article appeared on the wire services that week about stress weakening the immune system and "allowing" cancer. We asked her about it - I think her reply was "that's crap", and she graciously proceeded to enlighten us during an impromptu lunch chat.
Debbie Laxague
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