[Comment From JT] 

You are pretty young to have breast cancer. Did you consider getting tested to see if you had the gene that causes it? My mother had it rather young, and it's something I think about doing from time to time.

We consulted with a number of physicians about this, all of whom said that getting tested was something we could do.  But given my age and a complete lack of any relevant family history, they thought it unlikely that my cancer was genetically caused.

[Comment From Sue] 

I know many women who decided not to get reconstructive surgery after the mastectomy. What made you decide to go that route.

I could not conceive of waking up without physical breasts (if I didn't have to) as I knew that my body image, femininity and sexual identity were already being put through the wringer--just anticipating the loss of the function of my breasts. If I had to lose the functions of my breasts, did I also have to lose the shape of my breasts? For me, that was not an option. A very personal decision which I would never begin to make or judge for someone else.

I think part of the answer, for anyone, depends on the reconstructive options available to you, and whether or not you are comfortable with them. Knowing that I was a candidate for skin sparing modified radical mastectomy and DIEP flap reconstruction made me think it was worthwhile to undergo the additional procedure and recovery. (And it is a very lengthy surgery and recovery.)

I knew that it would be difficult, if not psychologically impossible, for me to wake up without physical breasts. And because I was offered the option of reconstruction at the same time that the breast surgery took place (during my second and third opinion visits), I could have the reconstruction without multiple surgeries.

It might be worth mentioning that there is a lot of misinformation out there about reconstruction.  When we first started learning we heard from some people that immediate reconstruction was NOT an option and from others that waiting was not a good option.

And it is important when you get conflicting information like that to ask your health professional explicitly to explain the discrepancy in what you are hearing. Often that opens the door not only to learning about what the options are, and what the pros and cons of each mode of treatment are.

People often turn to the web for information about their illness/treatment options and it can be a very helpful resource.  One thing that many people are not prepared for are the photos of outcomes.  They can be pretty frightening, in part, because so many of the pictures that are posted are cases in which something went terribly wrong.  This can give patients the wrong expectations about what is likely to happen to them.

Comment From Lynn] 

So I'm embarrassed to ask this, but I know that I am not happy with my breast size. If I had to go through reconstruction I would change my size from A to C. Did you do that? Is that selfish?

No, that is not selfish at all. My doctor explained that with the DIEP flap procedure they will often make your breasts larger than they were originally, in part because if you need radiation treatment (as I ultimately did), the radiation can sometimes shrink the donor tissue. So, in my case the answer is yes, I am now one cup size larger. If you don't like the larger size after radiation is finished, they can always make them smaller with liposuction(!). 

When I went for the initial visit with my plastic surgeon, he was not sure whether I had sufficient abdominal fat for reconstructing two breasts--and that is necessary for DIEP reconstruction.  So for three weeks I ate as much as I could! Without sufficient abdominal fat, the other reconstructive option is implants.

My reconstructive (plastic) surgeon said that his hope was that I would feel as beautiful after this was over as I did before the cancer struck.

I think that any woman who has to lose her breasts to cancer is entitled to choose her cup size at the end of the day!