I never thought that a campaign for nipple preservation would be a thing, but it is.
Even though I’m practically qualified as a consultant oncologist after the last two years’ hands-on training, the whole process of my cancer diagnosis has been completely new territory. My husband had had several scans and described them to me in detail (well, basically, he said he’d just lain on his back and waited – much as he’d done in certain other aspects of our marriage, come to that,) but I was surprised to find that my MRI scanner was set up like a massage table, with a hole for my face so I could lie on my front, and two incredibly optimistically-sized buckets in which to place each breast. I actually laughed as I tried to stretch them widely enough apart to place enough flesh in each hole.
Before I went for my results, I started to hatch a plan. Maybe, just maybe, if I ask for some different treatment – chemo, even – those two tumours might shrink enough to let the surgeon just snip them out one by one, and I won’t lose my breast. I mean, really. Who the fuck asks for chemo? Me. I’m not frightened of it. My husband was on and off it for two years, and it’s only at its worst when there’s no hope left at all. I know this. I saw it, lived with it, and with huge sadness had to support the decision to eventually quit. I’m not in the terminal category – this would be a means to an end, and I’d rather temporarily lose my hair than permanently lose my breast. I can’t lose my breast. Not now. It’s too soon. Losing a husband and a breast in the space of six months, well – it’s verging on carelessness. (I already felt bad that I’d had my husband cremated and our dog castrated within the same week, but this seemed to be a punishment too far.) Chemo would at least give me some time to think, and maybe get some counselling. What do I deal with first? The loss, or – well, the other loss? But don’t just drag me into hospital and take off my tit before I’ve even come to terms with losing my husband. Please. It’s the last fucking straw.
Two of my dearest friends had come along to my appointment. We’d all met at NCT antenatal classes eleven years ago, and we were the only three couples who weren’t a bit weird, or unprepared to stuff our children full of chips and Haribo from time to time. Our entire friendship had been built around frank discussions about vaginas, breasts, and our awful bloody children, so they seemed like a safe bet. There’s very little we don’t know about each other’s intimate regions, but barely know each other’s kids because we sacked off meetings in soft play centres for child-free evenings of Thai food and Prosecco years ago. Team Tits ‘n’ Fanny held hands and we all looked anxiously at the two ladies in lanyards who had come back into the little side room to give me my scan results, and who smiled. Politely.
There are three tumours. Not two. Well done, me. What an achievement. There’s no way, with my minuscule mammaries, that they can do anything other than take away the majority of the left one to make sure everything’s gone away. There’s no other way of doing it, and chemo isn’t generally very effective on the type of cancer I’ve got, anyway. I’ll be on Tamoxifen for five to ten years, which will bring on the menopause but keep the disease at bay… but won’t ever shrink it down enough to do anything other than take off my breast. So, no option. I need the mastectomy. So sorry, they said.
It took a while to sink in. They explained the procedure. They told me that they’ll scoop out my breast like a pumpkin, and reconstruct with some material taken from a cow. I think that was meant to make me feel better. I wondered if I should shove a candle in my bra and sit in the window on Hallowe’en. Some surgeons prefer the sort of reconstructive material that’s taken from a pig, they added, but at my local hospital they prefer to use the product from a cow. I couldn’t really give a flying fuck, I thought, as long as I don’t start mooing. And they’re certainly not going to be milking me at any point soon.
I began to cry. They offered to show me some pictures, so I could see that the result wouldn’t be as bad as I’d feared. They fired up an iPad with photographs of reconstructed knockers. Few of them matched their counterpart in size or shape. And none had nipples. I sobbed. They said it was OK – there are plenty of options to have a nipple put on later. There’s even a drawer somewhere that’s full of stick-on ones, they said. But all sensation will be lost, and you’ll never feel yours again.
I couldn’t hold back the tears, and wanted my husband back. My friend said he’d probably be pissing himself, looking down on five women in a side room, scrolling through a catalogue of tits on an iPad.
They said there might be one more option. They’d see what they could do. They’d never had a situation before quite like mine – especially not in somebody so young – and seemed to want to help, which I’m very grateful for. I didn’t want to wait too long, though, as surviving for my boys is the most important thing, but they assured me that a couple of weeks here or there wouldn’t make any difference. There’s a specialist plastic surgeon a few miles away who might be able to take flesh from under my armpit, reconstruct my breast, AND keep my nipple, they said, but I’d need to have sufficient muffin top to do it, and they thought I wasn’t big enough. I offered the ample flesh from my arse. But that’s not an option, apparently. Bollocks.
We went to see the specialist surgeon a couple of days ago. She squeezed as much armpit flesh as she could, took a sharp intake of breath, and said she could probably manage a reconstruction with the limited amount of spare skin up top, but only just. She prescribed plenty of pie. The pictures on her iPad were wonderful. It was as if there hadn’t been a reconstruction at all on any of the ladies she’d worked on. She smiled and pointed out that I was looking at the Before photographs.
But, it can be done. Probably. Possibly. They need to get the cancer out ASAP, and as long as it’s still contained within the breast, I can then have the reconstructive nipple-sparing surgery three weeks later, followed by radiotherapy. My left boob will never look quite as fabulous as its twin sister, but it’s the best of a bad bunch of alternatives, and certainly better than dying. We’ll only know for sure when the results of the first surgery are back from the lab, but provided the lymph nodes and margins are clear of cancer, we can go ahead. That wasn’t the case for my husband whose cancer was never completely removed, but then, they had to break a rib and collapse a lung to get his out. This either confirms that he was a true pro, or an awkward attention-seeker. I only wish he’d been as reassuringly bog-standard as I am.
If my husband had been here, none of this would have mattered. He loved my boobs, but he loved me more. We’d have skipped into the nearest hospital and asked the first person we saw to whip off my breast and stuff it full of whichever animal product they bloody well liked. I don’t know why it’s so important to keep my nipple. I don’t even plan for anyone to see it, apart from me. But, I suppose, right now I can’t face looking in the mirror every morning at a reconstructed breast and a scar where my nipple should be, and being reminded just how much of our marriage that bastard cancer has already so cruelly snatched away.
Love Fanny x