Fairness in Reporting, Breast Reconstruction
An on-line article was published on October 31, 2016, in The New York Times entitled, ‘Going Flat’ After Breast Cancer. This is my commentary on that article after having survived breast cancer twice and choosing to reconstruct my breasts with my own tissue. I want you to focus on the words “reconstruct my breasts”. They are my breasts. Every part of my breasts are me, my own tissue, my own blood source, my own skin, my own nipples. My own breasts that contained cancer cells have been removed through the skillful hands of a breast surgeon and rebuilt by the skillful hands of a microsurgeon.
The breasts that I had before breast cancer were mine. The breasts that I now have after breast cancer are mine. Once my breasts had cancer. Now, my breasts do not have cancer. Therefore, I respectfully disagree with the last part of the statement made just below the opening photo in the article, “…it’s not like we’re going to get our breasts back.” Again, I say, my breasts are back, 100% my own tissue, my own blood source, my own skin, and my own nipples.
This statement was made by a woman who chose not to have reconstruction. I respect her decision to remain flat. Each patient’s decision, man or woman, not to reconstruct their breasts after mastectomy is just that, their decision, their choice. But to say, “it’s not like we’re going to get our breasts back” was made in the context of not experiencing all the benefits of having your breasts back. I lived flat for seven months. I would not have made such a statement when I did not have my breasts, not knowing the true beauty and medical advancement of microsurgical, autologous breast reconstruction and what it did for me personally. I certainly would not make it now that I have my breasts back experiencing first-hand the benefits of breast reconstruction.
Fairness in Reporting
The entirety of the comment made below the opening photo in the New York Times article is as follows, “It’s a tremendous amount to put your body through, and it’s not like we’re going to get our breasts back.” I agree with the portion of this statement up to and including the word, “…. through”.
Going through any type of reconstruction, whether implant or autologous (using your own tissue), is an incredibly difficult decision and one that should be made with careful consideration. You will be left with varying degrees of scars, numbness and new feelings in a body that has been rebuilt after cancer. You must call on personal friends and family to help you through recovery which can be upwards of six weeks depending on the procedure. There is rarely one surgery involved and the process can take up to a year or more depending on individual circumstances.
As was the case for me, I had to ask others to travel to the place that I had reconstruction to assists with my two-week recovery away from my own home. There is a limited amount of board certified, highly qualified, microsurgeons who do DIEP flap, autologous-based, breast reconstruction. Choosing the best surgeon is paramount to the success and outcome of breast reconstruction so many must travel for any procedure they choose.
The passage of the Women’s Health and Cancer Rights Act of 1998 requires health plans to cover prosthetics and reconstructive procedures. However, you must be prepared to pay out of pocket for travel and lodging while you are away from home. Travel and lodging are considered medical tax deductions but not every patient can afford those out of pocket costs. There are resources and financial assistance programs available through the generous support of organizations like the AiRS Foundation, Angel flight, and The American Cancer Society.
Having breast cancer can be a financial drain on the patient whether they choose to have reconstruction or not. The brave and beautiful, Paulette Leaphart, featured in the New York Times article, walked topless from Biloxi, Mississippi to Washington this past summer to bring those financial struggles to Capitol Hill. Patients who choose to have breast reconstruction are aware of this and sadly, even those who would like to reconstruct, must sometimes forego the decision to do so because of lack of financial resources.
Fairness in Reporting
A portion of the article addressed a woman named Debbie Bowers who chose not to reconstruct because, “Having something foreign in my body after a cancer diagnosis is the last thing I wanted.”
Agreed! That’s why I chose DIEP flap surgery. I did not want anything foreign in my body either. DIEP flap is disconnecting skin, the underlying tissue (not the muscle as in TRAM) and the blood vessels and then reconnecting it to the chest wall. Those blood vessels are reattached to achieve a warm, soft, breast after the cancerous breasts are removed. It is a long involved surgery and many choose implants over autologous reconstruction because of the time involved in surgery and recovery. Again, that is a personal choice and respected. However, when patients do their research and find a qualified microsurgeon to perform autologous-based reconstruction the results can be life changing. They were for me and like many who choose autologous reconstruction, I have zero regrets.
Fairness in Reporting
Another portion of the article states:
While plastic surgeons and oncologists aggressively promote breast reconstruction as a way for women to “feel whole again,” some doctors say they are beginning to see resistance to the surgery. Patients like Ms. Bowers are choosing to defy medical advice and social convention and remain breastless after breast cancer.
No one, not my oncologist, my breast surgeon or my plastic surgeon “aggressively promoted breast reconstruction”. No one on my health care team did. No one! They explained it to me as an option. A member of your breast cancer team who “aggressively promotes breast reconstruction” should not be on your team. Find someone else. End of comment.
Fairness in Reporting
Ms. Leaphart, the brave women mentioned earlier who traveled to Washington to raise awareness about the financial struggles of breast cancer, chose not to have breast reconstruction because of a clotting disorder. My respect for her runs deep. She made this statement in the article. “Breasts aren’t what make us a woman.” I’m not sure how to interpret that and don’t pretend to know the thoughts behind the comment. I suspect it has something to do with the commercialization and marketing of women’s breasts. If this is the case I, I certainly see her point.
However, in a true and literal sense, breasts are what makes us women, just as much as a penis is what makes a man. It is a body part. Just as a soldier, who unwilling loses an arm or leg in battle chooses to replace it with another arm or leg through reconstructive surgery, so too, patients who have had cancer choose to replace a body part lost to cancer through reconstructive surgery. The fireman, Patrick Hardison, who lost his face in a fire and chose to have it rebuilt through reconstructive surgery, chose to reconstruct a body part.
Body parts do define who we are. When they are lost to disease they can be replaced by the marvels and progress in modern medicine. If, as the article states, “Some women say physicians pressured them to get implants,”, walk away. Go to a plastic surgeon who listens, gives you all options, explains the risks of the surgery and makes you feel that you are in a shared decision making process about deciding which reconstruction option is best for you and if it is even right for you. No one should be pressured into making this decision. It is a personal choice to reconstruct or to stay flat and each choice should be respected by family, friends and the physicians who serve these patients, both men and women. Cancer does not discriminate and yes, men can opt to have reconstruction too with fat grafting.
Support in Our Communities both Flat and Reconstructed
Yet another woman in the article, Kate Cloudsparks, found great comfort and solace in connecting with the Flat and Fabulous community because, “Finally, I had an opportunity to talk about what it’s been like to live as a woman without breasts.” I am so happy for Kate that she found this group. Connecting with others who have been through the process and having made the choices they made give strength, validation and comfort.
I have administered a closed/private Facebook support group for over a year. Members included both male and female breast cancer patients. They are implant patients, BRCA patients who have chosen prophylactic mastectomies to reduce the high chance of getting breast cancer and those who choose to do autologous based breast reconstruction. The members in this group give strength, validation and comfort to each other, no matter what decision is made for reconstruction.
There is fear. There is healing. There is an enormous amount of research and planning. Not one of the patients in this group who have made the choice to reconstruct went into it without a great deal of time and thought put into the decision. A recent thread of discussion in the group in response to a woman who is having fears as her DIEP flap breast reconstruction surgery nears was given these words of encouragement by other members of the group who had completed their reconstruction.
- It was a good thing for me.
- I am healing and feeling great.
- I had zero problems. I wish you well and hope you don’t back out.
- I love mine one year later. Feel it’s well worth it.
- It’s a personal decision. It is not an easy path but the results are great.
- I would do it again without hesitation
- It will be worth it!
- DIEP surgery is tough in the first year then gets easier for most.
- I love my DIEP. It’s my own tissue.
- Sending you wishes for finding peace with your decision and the courage to forge on! You can do this…we’re all here to walk with you on your journey.
Fairness in reporting
I read the New York Times article this morning and truly want to understand what “Fairness in reporting” means to those in the media. I am not in that profession so I turned to an article I found from the ethics handbook on the NPR website. It states:
In all our stories, especially matters of controversy, we strive to consider the strongest arguments we can find on all sides, seeking to deliver both nuance and clarity. Our goal is not to please those whom we report on or to produce stories that create the appearance of balance, but to seek the truth.
I wanted to take the opportunity to present my truth. I wanted others to consider a strong argument in favor of breast reconstruction after cancer since this article presents the argument of “Going Flat” after breast reconstruction. I do respect the choice to reconstruct or go flat but please…