Dr. Susan Love Research Foundation | Breast Cancer

Right modified radical mastectomy and immediate TRAM-flap reconstruction, chest wall radiation

Age 38 at diagnosis (1990)

Age 45 in photo (1997)

Between November, 1990, and March, 1991, I had a right biopsy which was positive for malignancy—diagnosis, intraductal carcinoma; a left biopsy which was negative; a right modified radical mastectomy followed by reconstruction with unilateral TRAM-flap, performed at the same time. The pathology report was intraductal carcinoma in situ with positive deep margins of resection. I had radiation therapy to my reconstructed breast and chest wall—4500 rads in 25 daily fractions over five weeks. In August, 1993, I developed lymphedema in my right arm and hand.

On my own I searched medical journals and found outdated photographs of mastectomies and reconstruction slightly similar to the one I was considering. Based on these I expected my body to look funky, perhaps even traumatized, but not vulgar or grotesque. I feel that my body is beautiful despite any alteration made by man or nature.

One of my concerns—trivial when compared to eliminating my cancer threat—was the certain loss of sensation in my right breast and nipple due to a mastectomy and the possible loss of sensation in my left breast due to a biopsy. For me, this sensation enhances love making and orgasm. Denny and I discussed this concern. We decided we would search for new pleasure sensations after the crisis was over. But I remained concerned. I did not discuss this with my doctors.

After surgery my body looks better to me than I had expected. My scars are much lighter now, except for the one resulting from a benign cyst removal from my chest, which still appears red after two years. I can wear athletic bras and you can't notice the absence of a nipple. After healing I found I had normal sensation in my left breast and this is enough to satisfy any sexual urges.

The transplanted tissue from my abdomen to my breast area has no feeling; however, it stays as warm as the rest of my body and is just as smooth. I am content with my body image except for one quirky thing—my navel is not centered. I can't believe this bothers me, but it does. Perhaps if I had known it would be off center I would have prepared myself mentally and it would not bother me now. Deep down I'm hurt that it was not discussed in advance. My advice to you is, if you want a centered navel, ask for it in advance. But, as you can see by my picture, I have not had my navel moved to my center; I am content even with my funky navel!

Partner's observations:

If I had been asked about concerns regarding my wife's physical appearance in the weeks prior to surgery I think I would have said something like...I don't care, just make sure she survives this horror. I did do one thing regarding her physical appearance. The night before the operation I asked my wife if we could videotape her nude from the waist up while she talked about the forthcoming operation and her expectations. We did this in our bedroom.

The camera—my accomplice in capturing a bittersweet image—the intimate form of my beautiful wife of 20 years, my high school sweetheart, my best friend, innocently putting the best light on a painful time to come both physically and emotionally.

As I write this, it is six years after the operation. Regarding my wife's physical appearance, my strongest memories are of

…our mostly fruitless search for photos and descriptions of what to expect the reconstruction to look like if things went well or if things went badly. Some people want to know, some don't. We wanted to know everything.

…the first look at the results of the surgery; watching the doctor peel back the bandages; the coarse, black stitches against her pale skin; the little mid breast stitch we couldn't explain: 'What happened there, doctor, did you make a mistake?' 'No, that used to be her belly button.' Absolutely incredible.

…the fading of the scars and the emotional pain; the angry red scars have faded and so has my anger and fear; anger at a world in which the very best blessings in our lives can be unfairly assaulted; fear that we will lose those very best aspects of our lives and we will be lost.

…waiting over five years to look at the video tape. I knew my motives included capturing an image of her perfect form before the operation. So if I viewed the tape to see her as she was before the operation it would be like saying those were the days when life was good. And that's not true. Life is good now.

Francoise: Right modified radical mastectomy and immediate TRAM-flap reconstruction, chest wall radiation