I have been thinking a lot about breasts lately. Ok, I know this doesn't distinguish me from guys, but I bet they never actually stop to ponder what these appendages actually represent. The truth is breasts have taken on much more than their mammary function, they represent femininity, sensuality, womanhood, and even sexuality. Breast are short hand for woman and everything that we are supposed to be--mother, lover, wet-dream, nourishment, tenderness, sustenance, life-giver, nurse. No wonder the "girls" fell ill under the pressure of their own iconography.
I must confess I had never had mixed feelings about my breasts until one fell ill with cancer. I had always been perfectly happy with them, though they have never actually defined me in any way--except perhaps as a Victory Secret junky. But when faced with a life or death decision, could I live without one? Either? Neither? One thing was clear: given the size of the tumor the left breast has to be removed in its entirety. What of the right one then? What's really at stake...just breasts or something deeper? How much of myself is wrapped in "the girls"?
Like the consummate pragmatists I went to the data first. For most things, with the exception of wisdom, youth is generally on your side. When it comes to cancer, however, youth is your undoing--it gives the cancer strength to reproduce and ample time to invade. The medical literature places a "normal" woman's chance of recurrence post-treatment at 0.5-1% change per year of life (as calculated according to approximate life expectancy). Ok, so what does all this mumbo-jumbo mean? Essentially that I have a 30-40% chance of cancer in the right breast (over the course of my life) should I decide to keep it. This, of course, is doubled if you are a BRCA 1 or BRCA 2 carrier. So depending on the genetics I have anywhere between 30% (best case) to 80% chance of a second cancer. I decided I'd wait for the genetic test results to make the final decision.
However, data only paints some of the picture. What about the possibility of breast feeding a future child? How comfortable am I with losing key erogenous zones? What are the physiological effects on my body and recovery? Never mind physical scars, how about emotional ones? What about my body image as a young single woman? Most importantly, what would allow me to sleep at night and prolong my peace of mind...in the loooong run? It seemed that most everyone around me was mostly focused on the very short term. But since I am not planning on dying young, I wanted to look well into the future and weight my options to make this impossible decision. As I worked through these scenarios and talked to survivors and doctors I started formulating my bottom line.
My friend Lisa helped solidify my initial thought that though being able to breast feed would be great, I'd first have to be ALIVE in order to give birth...so really, nursing was a minor detail at that point. Lisa also shared the less glamorous aspects of her experience. Given that, and the fact that generations of children have been successfully raised on formula, I eliminated this as a concern.
Now, what about intimacy? Many of the survivors I have been lucky to meet were graceful enough to open up about their post-mastectomy sex lives. In the immortal words of Joni Mitchell "you don't know what you got 'till it's gone;" thankfully these couples, who are living on borrowed time, have mostly strengthened their physical and emotional bond--reconstructed, implant or no breast...the fact that she's there at all is a gift in itself. The mere thread of losing a partner, then, is enough to appreciate her as a whole woman, rather than a sum of her parts. This set my mind at ease and gave me much insight into the kind of partner I hope to have once this ordeal is over. I know in my heart that this too will be my experience.
And so we come to the question of body image...every young woman's perennial torturer. It's hard enough negotiating a pudgy figure with the ultra-slender, curve-less, flat-stomached, toned, overly siliconed and botoxed ideal. Now I have to also figure out how to be a single girl with reconstructed breast? Isn't cancer torture enough? In truth, for its good parts and bad parts I have never really fully appreciated my body. I got my first wake up call when I blew out my knee and couldn't exercise for nearly a year. After a painful recovery I vowed never to spend another sunny Sunday laying on the coach. So I joined a triathlon team and learned to swim, bike, and run.
Now I realize how silly I have been--and how silly I am being to even add "body image" to my one boob/two boobs decision matrix. Any time that this body--whatever its shape--allows me to remain on the planet will be a gift, and one I will take full advantage of. I know mom is scared that no boy will want me after a radical double mastectomy/reconstruction. But if that is all they care about, then really, I am better off without them. So I am currently a recovering self-hater, and each day, though I am scared of the surgery's outcome, I tell my inner teenager, that whatever the result, I will be ALIVE--and THAT is my bottom line.
Once I came to this conclusion the genetic tests weren't back yet. There's a huge difference between 30% and 80%. Then I thought, 10 years ago women didn't have the luxury to find out their BRCA status; what if I take stock of my options and ignore genetics for a bit? How comfortable am I,
truly, with a 30%-40% chance of cancer later on? What if 10 years from now they realize that while I wasn't a BRCA carrier there is some other mutant gene that only affects Miami-raised-half-Colombian-half-Cuban-brown-eyed girls? What then? Ok, so that's silly, but so is banking entirely on a single test. Truthfully, I realized that any chance of this happening again was far too high (and far too high a price to pay) to keep a breast. And so, I signed over the girls to the scalpel and medical research, and have decided to have both breasts removed and reconstructed. New boobs and a new lease on life...now it's up to me to learn to love my new body.
PS: The genetic tests came back yesterday and I am NEGATIVE. Still, I am peaceful with my decision.
PPS: I decide to have a good-bye party for my boobs. Here are some pictures!
I cook Cuban food for everyone--but they have to help if they want to eat!
Everyone gathers before eating to hear me officially say good-bye to the ladies. Many boys offer to give the twins a proper good-bye, others demand that the girls make a personal appearance. With all decorum and solemnity I tell them to go to hell.
And finally, we eat a boob-shaped cake to drown our sorrow in luscious sugary goodness.
