Breastless After Breast Cancer

Going flat is the new choice for many survivors

Immediately following the trauma of a breast cancer diagnosis, mastectomy, chemotherapy and/or radiation treatment, many female breast cancer survivors face another challenge: the decision to have or forgo reconstructive breast surgery.

For some women, the next stage of their recovery seems obvious, and they decide to get breast implants soon after their mastectomies or months later when their bodies are healthy enough for another procedure. But for many other breast cancer survivors—and an increasing number of them—the choice is just as clear to reject the option for breast reconstruction and “go flat,” as it’s called in the breast cancer community.

Why do some women choose to go flat?

“Contrary to what patients might assume, breast reconstruction following mastectomy isn’t a simple procedure like it can be for women without cancer who opt for breast augmentation,” said Alejandra Perez, M.D., breast program director at the Sylvester Comprehensive Cancer Center. “The reconstruction itself may involve multiple surgeries. And the recovery process can be complicated, with risks for infection or loss of sensation or range of motion.”

A woman’s decision to forgo breast reconstruction can be based on many personal factors, including:

• The severity of the cancer demands more of her body’s resources for survival
• Other medical conditions: significant heart disease, medication usage, smoking or a systemic medical condition
• She doesn’t want to undergo additional surgeries following the physical and emotional trauma of a mastectomy
• She doesn’t need breasts to feel attractive or feminine
• She doesn’t want unnatural breasts
• She doesn’t want breasts that lack physical sensation or nipples
• She doesn’t want any level of risk associated with reconstruction (including infection or other complications)
• She needs to return to daily activities as quickly as possible
• She is concerned about losing muscle strength from autologous (or flap) reconstruction, even though some procedures can avoid cutting muscle at the flap donor site
• She is worried about the financial cost of reconstructive surgeries or lacks insurance coverage

“The decision to take advantage of or reject the option for breast reconstruction is a very personal one,” said Dr. Perez. “The best thing I can do as an oncologist in these situations is fully inform my patients of their options as well as the potential benefits and risks.”

“Beyond medical professionals like myself, there’s a whole community of breast cancer survivors and their partners who have been through this and are going through this together. I tell my patients to reach out to these groups on social media and in the local community to hear their stories and even see their physical scars. There’s so much to be learned from the experiences of other women who have lived through this unique situation and have reached the other side feeling healthy, happy and beautiful.”

Dana Kantrowitz is a contributing writer for the UMiami Health News Blog.

Originally published on: May 17, 2018

Tags: breast cancer, Breast Program Director, cancer treatment, Dr. Alejandra Perez, mastectomy