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Patricia has had breast cancer four times since 1989 and has seen attitudes towards mastectomies change. However, she acknowledges there is still a prejudice against having mastectomies without reconstruction.
I grew up in a large family in which gender distinctions were irrelevant. We were ‘the children’: three sisters and two brothers.
My father had polio in 1911, when he was three. His immobility shaped our lives and made any talk of bodies and how they were meant to be, male or female, feel trivial. This was freeing while the concept of femininity from the fifties pressed in from outside.
Yet there were aspects of my adolescence that felt negative.
As a teenager, I was the largest in the whole family. My brothers were younger and smaller. My father had not grown to his full height and couldn’t stand up without his sticks and splints. I was red-faced and awkward and usually felt ‘too much’.
But my sense of self has never been bound up in my breasts or other signs of maturing womanhood. My breasts were small, my legs were long, and my physicality was expressed in swimming, singing, being good company.
In 1989, when I was 42, a hard lump appeared just below my left nipple. It was a few weeks before I referred myself to the doctor, and in that time I adjusted to the likelihood of a cancer diagnosis.
I wasn’t afraid. The lump was so obvious, almost outside my body, I believed it would easily be removed.
But when cancer was confirmed, another set of expectations surrounded me. I faced the disgust of male doctors and the worries of female staff, even though I didn’t feel that way.
Later, in 1996, I had a mastectomy after a recurrence. They gave me a morphine drip: a strong pain killer to help me accept both the fact of cancer and the loss of womanhood. This was the double burden of breast cancer. I felt that getting rid of my tumour became secondary to the assumed disaster of being single-breasted.
The surgeries I had for recurrences were superficial and I recovered quickly.
However, I did suffer from the Tamoxifen. It stimulated fibroids in my womb to grow till it felt like carrying a 2lb. bag of sugar between my legs. They would have remained insignificant otherwise, shrinking further after menopause.
When I had surgery in 1998, I also had a partial hysterectomy.
At that time, my surgeon told me about women who protected and hid any sign of their mastectomy by leaning forward and holding an arm across themselves. This would result in permanent stiffness, poor posture and inability to outstretch their arm.
I still feel ambivalent about my body, though I know that this has helped me keep the experience of breast cancer in proportion.
I have lived through four recurrences. This is the main thing. I am of course fortunate that the tumours growing inside me have stayed in the same place and that I haven’t so far had to face metastases.
My partner at the time shared the celebration of my living. The removal of my tumour and breast did not affect our sex life.
However, our culture still places a high value on breasts as central to a woman’s attractiveness and her character. Every woman has her own relationship to her body and breasts, which may or may not tally with powerful public messages.
It is a delight to see the Macmillan Cancer TV advertisement with the bright phoenix tattooed on the mastectomy scar of a young woman. Yet breast cancer is still written about and experienced as devastating. Survival is not enough to lift many women’s distress.
So much of breast cancer awareness and fundraising are done in the colour pink. I find this infantilising and girly. Even though it is meant to bring a lightness and comradeship to activities, it promotes a femininity that depends on a traditional view of what it means to be a woman, and implies that any changes to this would be disastrous.
Today, there are many ways to be a woman and sexually desirable.
Since I felt that hard lump under my left nipple, the only real shock I’ve had was when cancer returned in 2018, after a gap of 20 years. I was fearful, and the surgery was no longer merely superficial. I had to have a rib removed, which meant serious thoracic work then plastic surgery to put me back together again.
The doctors were glad I hadn’t had a reconstruction as this made the operation quicker and they had more of my own flesh to use.
I cannot speak for other women when it comes to mastectomies; all I can do is encourage them to feel that getting rid of a tumour is more important than the loss of a breast. And if they do feel defeminised by a mastectomy, to ask them: why? Where do the criticisms and insults come from? Where is the pressure coming from to think of yourself as mainly a pair of breasts?
Think about all the other parts of your body, mind and spirit, and how all these make up who you are.
You can hear more details of Patricia's story, read some of her other work, and purchase her book by visiting her website.
If you are struggling with your body image following breast cancer treatment, we have resources that could help.