Giving Voice to Canadians Concerned About Breast Cancer

helping you understand your surgical options

SurgeryGuide

Mastectomy

A mastectomy is the surgical removal of an entire breast. If you have a mastectomy you may choose to use a prosthetic to replace the breast that was removed; you may want to have some type of reconstruction to replace the breast; or you may choose to have neither and live flat or asymmetrical. The information below will help you learn more about each option so that you can decide what’s best for you.  

Options After a Mastectomy

  • Living Flat or Asymmetrical 

    If you don’t want additional surgery

    • If reconstruction isn’t an option
    • If there are complications as a result of reconstruction
    • If you find wearing a prosthetic uncomfortable
    • If the cost of a prosthetic is unaffordable – view community programs that can help with the cost.
    • If a long surgery and recovery is overwhelming
    • More information at: Flat & Fabulous or Flat in Canada

    Something to consider: Going asymmetrical with a large breast size often isn’t possible due to the long term risks on your spine. When a breast is removed the weight on one side of your body is no longer even. This can cause curvature of the spine and lead to back pain and issues with balance.

    I love being able to go flat, to lie on my stomach at night, to jog without bouncing, no hot boobs in the summer. I don't mind the scars, because to me it's like looking at an old, interesting gnarled and knotted tree. It shows life and strength and survival. Honestly, being flat is better than the original issue!”
    ~anonymous~

    I chose a single mastectomy with delayed reconstruction because I knew I would require radiation. Now that I am finished active treatment, it feels much more important to focus on recovering my stamina and strength. I may consider meeting with a plastic surgeon and get my options for reconstruction in a few years after I have had some time where I am strong. I need to feel physically and emotionally ready to attempt such a huge surgery. For now, it is enough that I am here cancer-free. My scar is a reminder every day to appreciate my life”
    ~Andrea~

    After my mastectomy I made the decision to go flat for about two years. I loved the feeling of not having to wear a bra. I found it extremely uncomfortable to wear prosthetic forms in a bra. Before cancer I had large breasts, but highly desired smaller ones, so my new figure was a welcomed change. I found adorable tops that were flattering and disguised a flat chest” 
    ~Trisha~

    I was very active and did not want my muscles cut into in order to create a breast. I was concerned about missing recurrences because of reconstruction and I basically had no issues about my body image with or without breasts. Women are very different on this topic and you need to consider the whole person and their attitude."
    ~anonymous~

  • Prosthetic 

    Artificial breast form made from a variety of materials

    • Can be used directly against your skin or in a special pocket in bra or swimsuit
    • May be sweaty and sticky if it’s directly against your skin; using a mastectomy bra with a built in pocket can help with this
    • Can be replaced if it gets worn out or damaged, but cost may be something to consider as programs and insurance may have a certain amount of coverage for prosthetics
    • Weight changes can occur as a result of cancer treatment, multiple size prosthetics can be used if you had a single mastectomy and your other breast size changes
    • Can be used after radiation once the skin has had time to heal. Knitted Knockers often work well to bridge the gap while your skin is healing.
    • Most prosthetics don’t hold up well in chlorinated pools, there are special swimming prosthetics that can be used for swimming in chlorinated pools.

    The more modern materials give a more natural look and feel. No one will even know if they bump into you that you are wearing this”
    ~Andrea~

  • Reconstruction 

    Surgery performed after a mastectomy/lumpectomy  

    • Permanently rebuilds breast shape
    • May be done immediately after mastectomy or delayed and done months or years later
    • Options include using your own tissue, using implants or using both
    • No need for an external prosthesis
    • Often requires more than one surgery to get the required results

    I chose to have immediate implant-based reconstruction for a number of reasons. I was 53 at the time of my diagnosis, was in good physical shape and proud of my appearance. My mother had a mastectomy at an early age and I always remembered her covering up in change rooms, and losing her silicon prosthetic at inconvenient times; for example, while swimming. I did not want to feel self-conscious and it was important for me to be able to wear a bathing suit or low-cut dress and appear natural. I felt it was critical to my self-esteem. Had I not been able to have an immediate reconstruction, I might not have agreed to more surgery later. I was glad the expanders could be inserted right after the mastectomy. Unfortunately, a lot of women are not able to have immediate reconstruction because of the difficulty of scheduling time in the operating room with the oncological surgeon and the plastic surgeon together. A word of advice: You will never look like you did pre-mastectomy; I still do not feel comfortable parading around naked except in front of my husband.”
    ~Karen~

    After two years of living flat I made the decision to undergo breast reconstruction. It wasn’t a decision that I took lightly, and I made sure that I was physically and emotionally ready.”
    ~Trisha~

    I think people need to be realistic in their expectations of reconstruction. What is your goal in doing it. A mastectomy takes away a part of who we are as a woman, both physically and psychologically. Getting back to feeling confident with or without reconstruction is a lot of work. Acceptance of the new you to start key. I know I felt I had no choice but to move forward with figuring it out. My breast was gone there was no grey area around that. Also knowing that reconstruction is not a simple procedure but can be painful at times but the end result worth it. I know many women who have not had reconstruction and they have found their sense of self as well.”
    ~Sondria~