Why can’t I have a mastectomy?
If Angelina had her’s off and reduced her chance of breast cancer to a mere 3%, why aren’t they offering the choice of a mastectomy at diagnosis?
They offered me chemotherapy but when I asked for a mastectomy my oncologist said it wouldn’t help. I can’t help thinking that if I had no breast tissue, it might help to stop breast cancer coming back. (If you like, you can say that sentence with a rising intonation at the end, as I debated putting a question mark after it but decided to leave it up to you.) I understand them just removing the lump to start with, so that it can be analysed and decisions made accordingly, but having concluded it was an aggressive tumour with a 39% chance of recurrence, why isn’t lopping my tits off an option for me?
Money? Maybe, but I can’t see it. Chemotherapy must cost at least as much if not more than a mastectomy. Not only is the patient in hospital for a day every three weeks receiving a cocktail of expensive poisons into a main line vein, but they will also require the fitting of a PICC line (peripherally inserted central catheter), the weekly maintenance visit for said PICC, constant blood tests, an NHS wig, possible hospital admission for probable near-fatal infections, and that’s all before you even start on the amount of drugs given out at each chemo session to counter the extensive side effects. Surgeons get paid a lot, but they don’t just do one operation a day, so even with a couple of days in hospital and aftercare, I’d be surprised if surgery was the more expensive option.
Psychological trauma? Nate pointed out, while trying to reason with me about this last week, that had I been offered a mastectomy at the beginning, I would not have been making an informed decision. He reminded me of how disturbed my mental state was in those early months – how can women be expected to make that decision while trying to deal with a cancer diagnosis. Some women are told from the outset, due to the nature of their tumour, that they will need a mastectomy – even a double mastectomy. Some are told after the first surgery to remove the initial tumour that their margins weren’t clear – the tissue around the tumour was showing signs of pre-cancerous cells. They may need further excision at this point or a mastectomy. There is not really a choice in this, it’s probably wise to take the surgeon’s advice. I didn’t even think to ask the surgeon why I wasn’t having a mastectomy, he said I needed a Wide Local Excision, so in my mind, that was all I needed. I asked the clinical oncologist after surgery when I got the results, but her job is administering chemotherapy, so why would she propose a mastectomy as a preventative measure when she has access to all those wonderful cytotoxic drugs with which to fight cancer?
But I can’t help wondering – why can’t I have a mastectomy?
Don’t get me wrong, I have a new found affinity with my breasts, especially Bat Tit, which due to the removal of a cancerous lump, some healthy tissue and what amounted to a skin tuck is now perter. The extreme burns and skin removal during radiotherapy has now left me with baby-soft skin on that breast, as well as a nice healthy looking tan (unfortunately, only on my tit). I’ve started looking at them with a bit more respect and stopped saying ‘I hate my tits, I wish I could afford a boob job’ because there’s nothing like a bit of cancer to remind you that cosmetic surgery is just that: cosmetic. But I am also a tad intimidated by them. My breasts have the power to kill me. No one yet knows why one cell in one of them decided not to die and to start reproducing itself over and over again, taking over the healthy tissue and ducts in its attempt at total body domination.
So why can’t I have a mastectomy?