Facing a life-altering surgery such as mastectomy is never going to be easy, let’s face it.
Regardless of your age, your breasts have been a big part of your sexual identity, nurtured your children, and/or given your partner much delight (and hopefully you as well). If you are facing mastectomy because of breast cancer, the thought of losing one or both breasts is no doubt a huge shock.
There are many resources out there for you to help you make your decision – and more than a few on this website – but the purpose of today’s article is to share with you the merits of having a “breast wake” should you decide to go forward with mastectomy.
What is a Breast Wake?
The traditional wake, held when someone died, involved family members or friends who stayed awake with the body of the deceased to watch or guard it and/or have a prayer vigil until it was time for the church funeral and/or burial.
According to Wikipedia, a wake is often a social rite which highlights the idea that the loss is one of a social group and affects that group as a whole.
Why should the loss of a breast be any different? I have a friend who held a wake for a much-beloved dog. I really think that this kind of loss should be noted, either before or after the event, but preferable before and here’s why.
Why Have A Breast Wake?
When you have gathered your family and friends together to mourn the loss of your breast(s), this is an exceptional time to ask each of them to help you with that process, in some small way while you are recovering and even possibly after treatments begin (if any).
Whether it be cooking you a healthy meal and bringing it over, or just taking out your garbage, or occasionally scrubbing the sink, you will be surprised to discover how many people actually want to help you and are willing to do just that. And you will need their help at some point, I promise you.
Mourning the loss of a breast doesn’t have to be a solemn occasion. Put someone else in charge of all of this – your best friend, for example – if you don’t feel up to it. Pull the carpets back and dance if you want to. Have some great, healthy food with your friends and family. Cry and laugh with them. Propose a toast to your breast(s) and have others do the same. Serve cupcakes that look like breasts.
Instead of having a guest book where people list their names, have a blank book for people to write in – a few of their favorite inspirational quotes (ask them to bring them along when you invite them) because at some point during this journey you will feel overwhelmed, scared and depressed. Having a book like this to delve into can help you through these difficult times.
With regard to the people who offer to help you, either you or a friend with good handwriting can write down the name and phone number of each person who offers help, along with what it was they offered to do. Don’t be afraid to call them either!
Please do mark the occasion because it will help you in so many ways. It will help your friends too.
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Following on my series of articles about the different types of reconstruction surgery, today I’m discussing expander implants after mastectomy.
What Is Tissue Expansion?
A tissue expander is used widely in breast reconstruction when there is not enough skin to accommodate a permanent implant to restore a woman’s natural appearance.
A tissue expander is a temporary device that is placed on the chest wall under the pectoralis major muscle. This may be done immediately following a mastectomy, or it can be done later. The tissue expander’s purpose is to create a soft pocket to contain a permanent implant. Tissue expanders come in a variety of shapes and sizes.
According to PlasticSurgery.org tissue expansion is a “relatively straightforward procedure that enables the body to ‘grow’ extra skin for use in reconstructing almost any part of the body. A silicone balloon expander is inserted under the skin near the area to be repaired and then gradually filled with salt water over time, causing the skin to stretch and grow.” It is a staged approach.
Most expanders have a fill port that is built into the front of the device, and this is accessed with a needle through the skin. Expansion only takes about a minute, and the amount of fluid that is placed in it is limited by the tightness of the patient’s skin. A typical volume for each expansion procedure is 50 cc’s of saline (about 10 teaspoons).
Once Tissue Expansion Is Achieved…
Once expansion of your tissue is completed and you are cleared for another operation (about one month after finishing chemotherapy), the second stage of reconstruction is performed. This is an outpatient procedure that involves exchanging the expander for an implant, and creating a more refined breast shape. The initial tissue expander placement, and subsequent exchange for an implant, each take about 1 hour in the operating room.
Advantages and Disadvantages of Tissue Expanders
The good part about the procedure is that tissue expansion offers a very good to near-perfect match of color, texture, and hair-bearing qualities, also because the skin remains connected to the donor area’s blood and nerve supply, there is a smaller risk that it will die. In addition, because the skin doesn’t have to be moved from one area to another, as it does with the various flap surgeries I’ve written about lately, scars are often less apparent.
The disadvantage of the procedure is that it takes rather a long time to grow additional skin. Depending on the area to be reconstructed, tissue expansion can take as long as three to four months.
Also, the procedure requires repeated visits to the surgeon for injection of the salt water that inflates the balloon. And from what I’ve learned from those enduring this procedure, IT’S DAMNED UNCOMFORTABLE, I don’t care what the surgeons say. I’ve heard the complaints – they discuss the discomfort of having these foreign objects in their chests that are regularly inflated so that it feels like their breasts are going to explode, the necessity for sleeping in a recliner chair because they can’t roll onto their sides or stomachs for at least two months, the drains going from the surgical sites drive them nuts, healing sometimes takes a long time…
I’m not saying don’t have this – just be aware of the pitfalls. Make sure you discuss this procedure thoroughly with your surgeon and ensure it’s the best one for you and your particular needs before you proceed.
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Prophylactic Mastectomy, Thoughts Shared By A Cancer Coach
In my last article, I promised to share some information about prophylactic mastectomy, which is the removal of a single breast or both breasts, disease-free, to reduce the risk of developing breast cancer. My own personal opinion (which may or may not count with anyone) is that this sort of surgery is happening far too frequently these days, especially in younger women. While there are certainly situations when prophylactic mastectomy might make sense, they are few and far between. If your doctor has suggested prophylactic mastectomy for you, please read this article.
While the following is not an exhaustive list, these 7 situations are most frequently the basis for a recommendation of prophylactic mastectomy.
The 7 Situations When Your Doctor May Recommend Prophylactic Mastectomy:
When you have a strong family history of breast cancer.
When you have a personal history of breast cancer – the thinking here is that this your likelihood of developing a new cancer in the opposite breast than someone who has never had breast cancer.
When you’ve tested positive for the BRCA1 or BRCA2 gene mutations, which some feel increases the risk of breast cancer.
When you have been diagnosed with lobular carcinoma in situ (LCIS), which has been shown to increase the risk of developing invasive breast cancer.
When you’ve had radiation therapy to the chest before age 30, which appears to increase the risk of breast cancer throughout your life.
When you have widely spread breast microcalcifications (very tiny deposits of calcium in the breast tissue) sometimes this means cancer can be present, certainly not always.
Some doctors are even recommending prophylactic mastectomy for women with dense breasts. The thinking here is that it can be difficult for doctors to diagnose breast abnormalities which sometimes requires the removal of tissue samples to study under a microscope (biopsy). If this happens too many times, the scar tissue that is created can cause problems for mammography screening.
My Answers To Those 7 Situations
Using the above numbering system, I would like to go out on a limb and offer a new way of thinking. Again I remind you that this is simply my opinion (and everyone, as you know, has one!) I have years of mind-body research, a background in natural medicine, years of experience as a breast cancer coach, I fought the disease myself, and I am continually reading the latest research.
1. If your doctor recommends prophylactic mastectomy because you have a strong family history, get a new doctor. That is practicing fear-based medicine at its worst. I had a strong family history – both my mother and her mother died from breast cancer. And even though I did get it as well, I learned that there are many causes of breast cancer, it is a multi-factorial disease. I learned what those causes are and limited my exposure, I learned not to be afraid of cancer and how to take my healing into my own hands, and now I teach these things to others.
2. If you have a personal history of breast cancer, it doesn’t mean that just because you got it in one breast, you will get it in the other. It’s not too late to change your life by taking some positive steps towards health and wellness. If you need more information about this, sign up for my free newsletters on the right side of this page and you’ll get my two free e-books as well.
3. Ah, the BRCA1 and BRCA2 genes. Would you be interested in knowing that the ONE single company that tests for these genes (and charges thousands of dollars for doing so, thank you very much) is presently trying to take out a PATENT on the genes? Would they be doing this if there weren’t a lot of money involved here? Read my article on the BRCA1 and BRCA2 genes. Read also the web page of Breast Cancer Action, an organization that opposes gene patenting.
4. If you have had LCIS then you might have an increased risk of developing invasive breast cancer. But as I said in paragraph 2, it’s not too late to change your prospects by being very proactive with body and mind and immune system. Find out what things will take you back to a state of extreme good health.
5. If you have had radiation therapy before the age of 30 but you still have healthy breasts, there are things you can do to minimize whatever damage that might exist. Don’t undergo needless mastectomy if you have healthy breasts.
6. Microcalcifications in the breast do not mean that cancer is present. Again, there are things you can do to minimize any possible problems.
7. On Aug 20, 2012, in the Journal of the National Cancer Institute, researchers reported that high breast density does not increase the risk of death among breast cancer patients. If you have dense breasts and your doctor recommends prophylactic mastectomy, get a new doctor.
Here’s what I recommend if you’re on the fence about prophylactic mastectomy. If you have healthy breasts, you have time to make your decision. Subscribe to my newsletter series because I’m all about being proactive with your health, both body and mind. I have lots of top quality information based on actual research in my newsletters, and they won’t cost you a thing.
Prophylactic Mastectomy: No Guarantee
Although prophylactic mastectomy is shown to greatly reduce your chances of developing breast cancer, it is not a guarantee. For one thing, it is almost impossible to remove all the breast tissue. Cancer can still develop in the tissue that is left on the chest wall or underarm area.
The latest paleoanthropological research shows that cancer was virtually nonexistent before pollution and poor diet became the norm.
Science is still no closer to finding out what causes cancer because I think they’re looking in the wrong place. Cancer is a man-made disease. It’s going to require us getting VERY proactive with our food and nutrition, our environment, our body products, and our minds to rid ourselves of cancer.
Sign up for my free e-newsletters on the right, or “like” me on Facebook (Marnie Clark Breast Health Coach) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
Disclaimer: The information provided in this blog is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional. You should not use the information on this site for diagnosis or treatment of any health problem and please be sure to consult your health care professional when making decisions about your health.
While I was doing my research for yesterday’s article, I came across an article concerning needless mastectomy, a matter of which I was blissfully unaware. Today I’m sharing that with you because you need to know.
Women are often enduring mastectomies for no good reason.
I’m not saying it’s always the case, but by the time you’ve finished this article, hopefully you’ll know the best reasons for having a mastectomy and when you should go after a second opinion.
On October 27, 2012, Nicholas Regush of ABC News wrote “While we hear news almost daily of the need for women to have mammograms and to inspect their breasts for changes that could suggest breast cancer, the actual treatment for breast cancer that many women receive, especially poor ones, is often outrageously out-of-date, if not bordering on the criminal.” Here’s a link to the full article.
The article goes on to state, “In Texas, for example, a study of breast cancer treatment at one large urban hospital revealed that 84 percent of the women with early stage breast cancer had mastectomies and only 16 percent had lumpectomies. The women who lost their breasts were mostly poor.”
Mr Regush referenced an article written by Diana Zuckerman, President of the Washington, DC-based National Research Center for Women and Families. The article was published in the Journal of the American Medical Women’s Association. Despite much digging, I wasn’t able to get hold of a copy of that article, but I did discover that Ms Zuckerman has been extremely proactive with the Breast Cancer Public Education Campaign.
Because many women diagnosed with breast cancer do not have all the facts they need to get the treatment that is best for them, the National Research Center has been working to raise awareness of this issue.
What I discovered from some of the online articles I read was that if a doctor was trained before 1981, his patient is much more likely to have a mastectomy. Apparently, old medical habits are hard to break.
Research is clear that lumpectomies are as safe as a mastectomy for most women with early stage disease.
Back in my grandmother’s day, nearly every woman who was diagnosed with breast cancer underwent mastectomy, often while under anesthesia for the biopsy itself with no participation in a discussion about treatment options. How fortunate we are that this is no longer the case.
However, tens of thousands of women with breast cancer are losing a breast (sometimes both) unnecessarily each year. Many women are getting their breasts removed for no good reason — meaning that such decisions are often not based on sound medical judgment but more on the basis of other factors such as her income (it’s cheaper to perform a mastectomy than lumpectomy followed by expensive radiation treatments), the training of her doctor, the age of her doctor, and where she lives. Sometimes it’s based purely on fear of the return of the disease.
There is absolutely no data that mastectomy (either single or bilateral) in a breast cancer patient improved survival rates or helped them live longer. It appears that many women are doing this in panic mode.
Mastectomy vs Lumpectomy
Presuming you have already found a breast lump and your doctor has told you it’s malignant, you will need to make the decision between a mastectomy and lumpectomy.
There’s a helpful article in www.breastcancer.org titled Mastectomy vs Lumpectomy. Please read the article, it references the deciding factors, advantages and disadvantages, and there’s no need for me to reiterate it here.
When Mastectomy Makes Sense
If the tumor is big and, after the lumpectomy, very little breast tissue would remain
If there are multiple tumors in more than one quadrant of the breast
If you do not want to undergo radiation therapy after the surgery (and you don’t have to – I chose against radiation after my lumpectomy but I was very proactive in my health care and chose something else)
If you believe you will have less anxiety about a recurrence of breast cancer with a mastectomy
There is an alarming trend of more and more women removing healthy breasts because they are panicked or in fear of breast cancer returning or migrating to the other breast. In some cases, doctors recommend prophylactic mastectomy, which is surgery that is performed to reduce your breast cancer risk. That is a whole, huge topic unto itself and the subject of my next article.
While I can’t tell you what to do, I do want you to be aware that YOU HAVE CHOICES. Please don’t choose mastectomy purely out of fear. Sign up for my newsletters (use the colored box on the right) and allow my experience to gently help you through this process. It is my honor to walk with you on this journey.
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