Juliet Fitzpatrick is a breast cancer survivor and patient advocate from the U.K. who chose aesthetic flat closure after breast cancer. She writes about her experience at Blooming Cancer, Living Flat and Recovery after Breast Cancer. In Episode 6: Living Flat after Breast Cancer, on the DiepCJourney podcast Juliet and I chat about her decision to remain flat.
She asked a lot of questions and did her research after her breast cancer diagnosis before making this choice. We chat about prosthesis, support groups, blogging, and of course, our combined interest in gardening. These are all on the list of things Juliet is doing since her diagnosis and through her continued recovery, finding the simple passions in life that are important to her.
The Breast Cancer Diagnosis
Juliet was diagnosed with breast cancer in her left breast after having the second routine mammogram she ever had in her life. She was only 54 at the time. The diagnosis took her quite by surprise. She was a large breasted woman with size GG breasts. She did not notice any changes in her breasts like a lump, dimpling, or redness. The tumor was at the bottom of her breast. She feels the size of her breasts may have contributed to the fact she didn’t notice anything since it was in a difficult location to notice anything.
She shares a funny story about the breast surgeon she went to. When she walked into the consult room, she noted the breast surgeon had on “the worst wig” she had ever seen. She thought how ironic many women in the waiting room were also wearing wigs due to their treatment from chemotherapy. He scheduled her to have a lumpectomy.
The Decision to Live Flat Begins to Unfold
Juliet had to go back to have another lumpectomy since they didn’t get clear margins during the first surgery. But what they also found out is the tumor had spread throughout her breasts. The new plan was to have a full mastectomy followed by chemotherapy. Since her tumor was HER2+ she would receive Herceptin. Now all she could think was, “I’m going to lose my hair and my breasts”.
The surgeon left rather quickly after delivering the news. However, a nurse came in after this and told her about the upcoming surgery and options after mastectomy. Juliet’s husband, Liam, was very supportive during a time when she felt afraid and vulnerable. When she saw videos of women after reconstruction, it seemed reasonable for her to have a DIEP flap since she was having a single mastectomy. Juliet did not feel an implant would be a wise idea given the size of her remaining breast. She knew it would also require a symmetry procedure to balance out the other larger breasts that might include a reduction or lift.
An assumption was made she would rebuild her breasts with no mention of flat closure. When she had time to go home and process the information, realizing how much she disliked surgery, knowing this would likely be more than one operation, she soon realized it wasn’t for her to have DIEP flap. There are women who choose not to have reconstruction for the same reason, a valid one and one respected at DiepCFoundation.
Becoming an Advocate for Living Flat Community
After she went through the compulsory visit to the psychologist to make sure she was making the correct decision, she had both breasts removed 18 months after her initial single mastectomy. Juliet found great support for her decision through the Flat Friends Facebook support group in the U.K.
Because her surgeon did not listen to Juliet’s wishes to have both breasts removed, she shares the story of the day “the penny dropped” and she opened his mind to how she was truly feeling. With her bare chest exposed, one large breast dropping down after her single mastectomy she looked at him and asked, “Why do you think I want to live like this?” It caught his attention and the communication between patient and surgeon changed. He respected her decision to move forward for flat closure.
Some key points Juliet shares from what she has learned and how she hopes to help others are:
- She had grown to prefer and accept her right flat side and knew removing both breasts would result in a more balanced body.
- It felt like a good decision because she was taking control of her own body.
- This decision felt like something positive to her after so many negative situations surrounding the breast cancer diagnosis.
- The informed consent she signed did not include all her options after mastectomy.
- She physically felt good about herself and the scars she had. She came to peace with her decision.
- Ask questions of your surgeon and think through your decisions. Shared decision-making conversations are important with your health care team.
- Women can still be whole with no breasts.
- Ask for photos of women who have had aesthetic flat closure.
Embracing Living Flat and Juliet’s Advocacy
She found a lovely friend and photographer to document her aesthetic flat closure. She wanted others to see what it looked like to live flat and reflect the happiness of her decision. We are all shapes and sizes, different ethnicity, and sexual preferences. We are real women with real decisions to make after diagnosed with breast cancer. We all have unique stories to share.
Juliet represents us well in her advocacy for flat closure. I am grateful for this lovely conversation. To this day Juliet and I “like” and “love” our messages about gardening on Instagram and Twitter. Enjoy Episode 6: Living Flat after Breast Cancer.