Chapter 5: Going for a Double or a Single?

We get some good news.  The scans are clear.  There is no cancer anywhere else in my body.  We hug, we breathe.

We look for a plastic surgeon.

It’s a good day when your cancer appointments takes take you somewhere other than the Cancer Center or the hospital.  I'm not knocking the NYU Cancer Center.  It is lovely.  I always think my of sister (alias Mary Poppins) when I walk in.  She is addicted to caring for people and her favorite color is purple.  She would get plenty of both here.  There are purple pens, purple signs, purple clipboards, and purple plants (not really, but there should be).  My favorite purple touches are the Thank You Cards they hand you after every procedure.  They’re a little weird, and it’s a little weird when I say “You’re so welcome!  It was my absolute pleasure to come up here today!”  But I appreciate the gesture. 

They are, however, seriously lacking in one department.  Kleenex.  Would it kill them to put some tissue boxes in the lobby?  And the waiting rooms?  And generally in every room that a person is going to be in.  I know it would be an added expense, especially if they all had to be purple.  But are they on a tight budget?  Maybe.  It’s not like they’re in a booming business like…. cancer.

Where was I?  Oh right, not The Cancer Center.  I was heading to the spa, which is where you might think you are when you walk into a plastic surgeon’s office.  Bright, calming, relaxing, and…optimistic.  A boob job is optimism incarnate.  It means you are going to be around for a while and you may as well spend your remaining time on earth with some new knockers.  So for someone like me, who missed her growth spurt in the chest area, the day is pretty significant.  I am, as my friend Yael puts it, getting my legitimate boob job. 

For a spot of entertainment on the topic, here is a clip from our show Naked in a Fishbowl, where "Bonnie" and "Sophie" discuss the very topic.  It is disturbingly prophetic.

 

When I meet the surgeon for the first time, he may have been thrown and confused by me since I look like I've already had a mastectomy.  He says to me “Well, this will be great!  You’ll finally have some breasts!”  Though he says he won’t take me above a B.  For fear that I would fall over, I suppose.  He doesn’t offer me any breasts to try on and select.  Instead he tells me we’ll be working together every week to watch my new boobs “grow” and I'll get to decide what size I’d like to be.  And what shape I’d like to be.  He’ll put in “tissue expanders” which we can fill every week until I say stop.  When I do, he’ll take the tissue expanders out and put the implants in.  The long and the short of our visit is that the plastic surgeon can do anything.  He can match my existing breast or he doesn’t have to put implants in at all.  It is all up to me.

But I don’t like it when things are all up to me.  It means I am responsible for my own decision and I can’t blame anyone later.

And speaking of decisions, there is still one more to make: whether or not to have both breasts removed, as a precaution.  Now you would be right if you said, “But your poor right breast has done nothing wrong and you’re going to punish her, too?!”  And I would say to you that, yes, some women choose to have both breast removed to reduce the risk of having to go through this again.  I have spent the past couple of weeks very solidly in both camps, because apparently I am bipolar when it comes to breast cancer.  For a time, I was resolutely focused on keeping at least one natural breast if I could.  A week later I was resolutely focused on making sure I stayed alive for as long as I could.  This week, after another sit-down with Doc, I’m leaning heavily towards saving the right breast again.

Bilateral mastectomies reduce the risk of recurring breast cancer by 90-95%.  Some women who have had both breasts removed do have the cancer return in the surrounding areas of the breast, the chest wall, the tissue under the armpits, and even as low as the abdomen.  So removing both is not a guarantee against recurrence, but it greatly reduces the risk.

But I am not in a high-risk category.  I do not carry the Breast Cancer Genes (BRCA1 and BRCA2), there is no significant history of breast cancer in the family, and the cancer that I currently have is non-invasive.  The chances of cancer occurring in my right breast is 15% over 40 years.  Which, not for nothing, is only 3% higher than your chances, if you are a woman who has never had breast cancer at all.

Also, Doc told me yesterday that the recovery process of having one breast removed, on a scale of 1 to 10, is 1.  For having both breasts removed, the recovery is a 10.  So that is something to consider as well.  And “consider” is what I will do for the next six days, before I go in for surgery.  It's going to be such a fun week!