Large Breasts, Large Body, confused about options?

angelica_marie

Hello,

I was just diagnosed with DCIS 10 days ago and on this crazy train. I had an MRI, and just met with a breast surgeon. My DCIS is multifocial and involves the entire medial aspect of the right breast, extending approximately 15 cm.. There seems to be some area that couldnt be fully seen behind it, but it doesn't look like lymph or muscles are involves. I was told by the nurse navigator and radiologist that mastectomy is the only way forward, and I was talking with my husband about bilateral vs single. I am 47, done breast feeding and have a few autoimmune issues which means surgeries can be difficult to heal from. I wanted to choose the easiest path forward for healing. I am HR+. I tend to not do well with medications, etc. All that being said, when I met with the BS yesterday, she continued to say things like, Heavy women do not like mastectomies because they are used to their breasts. Women with large breasts are used to having them and do not like the outcome of mastectomy. She wanted to do breast conserving surgery, though so much of my breast is affected. Honestly, her bedside manner just sucked. I am heavy, but I am still worthy of treatment of my choice. Every time I brought up going flat or not doing reconstruction the nurse navigator or the BS said, breasts are what make you a woman. (I just do not believe that and think it is so awful.) She said she was going to the board to bring my MRis, etc, and I said, What do you think your colleagues will say? She said, they are going to think I am radical and crazy doing a breast conserving surgery on you. I have been calling around for a second opinion, but wondering if anyone else has had this experience as a woman with large breasts and large body. What kind of advocacy do you do for yourself? Meeting with plastics today to get more answers about reconstruction for a flat decision. I am very happy with going flat and not concerned about my not having one breast (or even two). Any insights, experiences, help would be so appreciated. this is my first post, so I'd appreciate connecting with anyone who has ANY experience.

AliceBastable

Eek! Get a new doctor ASAP! Yours doesn't respect you or women in general. Fire her!

exbrnxgrl

Breasts are what make a woman? Comments like these should make you run to a new doctor as fast as you can. Take care

Aram

Run away as fast as you can. There is this facebook page called fabulously flat, and there you can find women of different shapes and weights that are all happy with their choice of going flat. Just remember to ask for "Aesthetic Flat Closure" if want a nice finish.

MountainMia

Of course a patient's size and shape might affect what surgery she chooses. But YOU have already chosen! The BS is full of BS. No, of course, breasts are NOT what make a woman a woman. UGH I am so disappointed and upset on your behalf.

As the others said, please find a different surgeon, one who respects you and your ability to make good decisions for yourself.

4kids4dogs

Angelica,

Wow! i cant believe that a (supposed to be) professional would even say that to you!!

I have my biopsy tomorrow, so i may be needing surgery myself. I am a bigger lady with bigger boobs also.

If i have cancer, i want my boobs (both) removed. At my age, 53, I really dont care if i have to wear

a prosthesis under my bra. i would rather be glad i removed the disease from my body. This is my

opinion. I would get a new doctor or 2nd opinion!! Good luck! please post back and let us know ...

wallycat

I stopped reading after 'breasts make a woman..' Is this doctor 200 years old or something?

I had large breasts, 38D, and of course, I miss my breasts but I do not regret my decision for bmx with no reconstruction. I could go on and on to rant about this antiquated idea of what "makes" a woman. I would personally escalate your feelings and let her bosses know what she said to you. Inexcusable.

I will edit this to say that my breast surgeon, whom I adored and trusted, had me see a plastic surgeon "just to make sure" I knew what I would or would not miss. I brought in a pic of a 10 year old boy and said.."this. I want my chest to look like this. No dog tags, no 'just in case' skin, just like this...got it?" and he said yes.

I'm sure there are some people who cannot imagine life without breasts but thankfully, there is a swath of people who value health, minimum invasion/surgery and quality of life to "appearance" and whatever definition they've ingrained in their heads.

Imagine if a patient needed a leg amputation and a doctor said "without 2 legs, you're not human..." RANT!

angelica_marie

It is so comforting to read your comments. I thought after reading this site and some others that there would be forward thinking going flat Advocates at the BS and to just only be offered options of reconstruction or breast conserving on a pretty involved DCIS seemed crazy to me. I made a second opinion appointment at another hospital. I went to the Plastic Surgeon today and when I was telling the story to the nurse, burst into tears, and she was just horrified by what the surgeon said. She said in fact, they do flat surgeries on all bodies. Though plastic surgeon did not know what Aesthetic Flat Closure was and does not do them. The Breast Surgeon does that, which was a little odd to me too.

They encouraged me to call the Patient Advocate. Which I'm not sure I am in the emotional headspace to do. I appreciate finding this forum and being able to check these things with others who have been where I am now. Fingers crossed.

ctmbsikia

Good luck with getting a 2nd opinion and hope the PS helps you today. The nurse nav, radiologist and bs should not have said any of those things. So yeah, run.

cgifford7

Do what is right for you!!! My DCIS was also multifocal and expansive for my very small breast. I had to have at least a single mastectomy and ultimately chose to do a double. All my breast surgeon suggested was to take some time to decide. She told me all my options, answered my questions, and then waited for me to get clarity about what I wanted. Nobody knows you like you and nobody will advocate for you like you, so once you have clarity about the right path, make that clear to whichever doctor you are working with at the time. If you have the luxury of second opinion or changing doctors you can look into that, but if you're stuck with this one walk in with an iron spine and tell her what you want.

Moderators

Hi Angelica,

First, we want to welcome you here to Breastcancer.org. We're so sorry for the reasons that bring you here, but we're so glad you've found us. As you can already see, our Community full of amazing members always willing to offer advice, information, encouragement, and support -- we're all here for you!

Second, we'd like to echo what many of our members above have offered -- any "professional" that thinks it's okay to speak to a patient like that, and steer them toward a decision they are clearly not comfortable with, or who thinks breasts are what make you a woman should NOT be a doctor! You should feel comforted, informed, and secure. Not shamed.

Lastly, we wanted to offer you some resources that you may find helpful, in addition to the awesome responses above. Check out the forum here on Living Without Reconstruction After Mastectomy, where others who have chosen non-reconstruction will welcome you with open arms, and you can gain lots of insight about their experiences. Also, the main Breastcancer.org site's section on Going Flat: Choosing No Reconstruction is a helpful resource to help you find what to expect, recovery from surgery, and questions to ask your surgeon.

We hope this helps and that you get real support from a new doctor soon -- we know you'll get it here! Please let us know if there's anything else we can do to help!

--The Mods

Jumpship

I had large breasts and thought I was on the heavier side. If I went flat I would be concave and I knew I couldn’t see that. The plastic surgeons each thought I should go twice as big as I chose. Btw neither had a college art class which I thought was ironic since they both talked about the biggest breasts being better aesthetically. Go with your gut. Next surgery for me will be to remove implants and only fat graft a bit. You do you- we all support you

LivinLife

I'm with the others!!! I wouldn't go back AT ALL to that surgeon!!! I too have autoimmune issues, large breasted, was just over average weight at the time of my bilateral. The surgeon ended up doing an aesthetic flat closure which was unexpected and I'm very happy with it. Bc of autoimmune issues I could not have radiation. I have healing issues so they placed a negative pressure wound vac on me during surgery; I work it for a week to prevent infection - keep that in mind as something to inquire about. My surgeon saw me in person the Friday before my Monday surgery. The negative pressure wound vac just occurred to her at that in person appointment (saw her by telehealth once prior) and she was able to make that happen by Monday - took calling a rep and I believe plastics was involved..... Best to you! Glad you are already looking at 2nd opinion options!!!

angelica_marie

LivinLife, thank you so much for that. I will talk to the doctor about it. I met with plastic surgeon and they said, We never close flat closures, which was so confusing, because I have read on many websites that I should request that, and I asked if they could, and they said no, but they would repair the original closure, which just made me go, what the heck?!? Why not close first with plastics to prevent what you would have to repair? I live in a rural-ish area, but still they are professionals. I will definitely ask about the negative pressure wound vac. I appreciate you also talking about radiation. I just feel like I am afraid of what radiation would be like for me living with psoriatic arthritis and hashimoto's thyroid disease. I am already in a flare since being taken off my meds for arthritis...it has been a rough month. LOL

Bookpusher

Angelicamarie,

I echo what the other gals have said. Get another surgeon if you can! I chose my second opinion surgeon and glad that I did. I had 3 areas of DCIS in my right breast. My second opinion surgeon let me know he would support me 100% (unlike my first surgeon who announced right off the bat that he was a breast conserving surgeon) and let me know my options, risks, etc. He told me to weigh things carefully and he would do either the single or double - he never pushed me one way or another - he told me to choose based on what would give me greater peace of mind. I chose BMX, which was just done this past Monday. I knew from the get go “looks” was going to take a far second seat to peace of mind. I am older (70) so going flat was my choice. At this age I figured why go around with a saggy breast and heavy prothesis? Why worry about more mammograms? I don’t think I’ll eve regret it. Good luck to you, making these choices is very stressful. But be sure you find a surgeon that sees you, hears you, and respects your wishes.

ruthbru

I have no idea what you should do except to make a complaint about that doctor (if they said that to you, they are saying it to others) and find a new one! That is insulting to ALL women; it's also bullying and intimidation.

SuQu31

It sounds like maybe you need to find another plastic surgeon too. I am just so sorry, that in addition to finding out you have DCIS, you are dealing with a surgeon who is quite frankly being very disrespectful to you, your medical situation and your ability to make the best choice for yourself. Obviously your health is the biggest concern here, and with a multi focal area of that size, the surgeon needs to be discussing with you what is the best course of action to make sure they get all of the DCIS.

But even if you had a tiny DCIS and had no worries about healing, this is your choice! And during what can be an awfully upsetting process, you need professionals who are going to be professional, and discuss with you the best options for your health and healing! And you need a plastic surgeon who is going to be supportive of your wishes and able to do the surgery you want, instead of a “repair job."

With all the things you cannot control, you should be able to control this. You deserve to have what YOU want, and to have surgeons who can and will provide that for you. One of the things that will make this bad situation better is having professionals who respect you and who will be supportive of you and your decision.

barbojoy

@angelica_Marie I couldn't believe what I was reading in your post. Yikes. I am 46, heavy (size 18) and had large breasts (full D). I just had a full mastectomy on 06/28. I also have autoimmune disease. I have Pagets of the breast, so I did not have an option for lumpectomy or nipple-sparing MX. I chose a bilateral skin-sparing MX. I chose DIEP reconstruction, which should happen once my treatments are complete.

The skin-sparing MX is tougher than I thought because the tissue expanders are hard little devices that you can feel through your skin. The drain tubes can also be felt and at least for me- the combination of the two have caused lingering pinching and biting sensations that at times are unbearable. I have cried and wished I'd chosen flat instead. The drains are present no matter which option you choose and my plastic surgeon told me that with the amount of tissue they removed (large breasts)- the drainage will be more and I may have to keep my drains a little longer than most. I have lots of treatment to go before any reconstruction can be done and I may just end-up going flat. I am not sure if that is helpful info- I wish I'd really understood recovery for reconstruction vs. flat before I had my MX. I was determined to regain some form of breasts for my own mental health. Now that I see what I have post MX/Pre-reconstruction, I think I've been kidding myself about the final outcome.

My advice is never ever go with a surgeon that you don't fully trust or respect. I got a second opinion and I am so glad that I did. I really trust and respect the team I have now. It is terrible that the doc you saw was so hurtful and unprofessional. I am getting treatment at the local university hospital. If they have one of those near you, I'd suggest trying them. Best of luck!!

illimae

Wow, I disagree with so much of what the BS said but I do understand that heavy women often struggle with going flat, as our belly becomes so much more prominent without our large breasts to balance things out. However, I wonder why a lumpectomy with a reduction of the other breast and lift on both is not an option. That’s what I had (DD to C/D) and after a few months adjusting to the new look, I love it. Good luck.

Blessings2011

angelica_marie - I am so sorry that happened to you.

I was dxd with multifocal IDC with DCIS in my left breast in 2011. Due to the location of the tumors, lumpectomy wasn't an option.

I was very heavy at that time, with dense, fibrocystic breasts that hung down to my waist. (I had always wanted a lift, but not that way.) I seriously doubted that a UMX on the left, and lift on the right would give me any kind of symmetry. There were also vague imaging results on the right, so having the BMX made absolute sense to me.

I chose immediate recon with TEs and eventual saline implants, but honestly, if I had it to do all over again today, I'd probably go flat.

I recovered well from the BMX. It was the recon that was hard.

The first time I got to take a shower, I was in awe. I could see my feet again for the first time in a very long time!

May you find a team that is there to support and encourage you in your decisions.

angelica_marie

I just cannot thank you all enough, and feel fairly solid now on my decision to do a bmx, but meeting with the second opinion surgeon this upcoming week. Fingers crossed I get treated with more respect. As I see all your definitions of heavy, I realize I am beyond that with size 42 G breasts and wearing a size 22/24. It shouldn't matter how big I am. I should be treated with respect and dignity no matter what.

ruthbru

Absolutely!!

4kids4dogs

angelica,

Best of luck to you!!! Please post and let us know. It really shouldn't matter what size a person is. It is your body, should be your decision. I might be facing the same situation you are soon. That "professional" should not be telling anyone what she told you. I pray you find a real professional that is kind and that you feel comfortable with!!