Breast Cancer Awareness Month Rant

My mother died of breast cancer in 1966. I miss her every day.

The cancer appeared shortly after two things happened.

1) She started smoking again. 2) She began to use a body lotion loaded with estrogen. [Try buying something like that now.]

She died two years later at fifty.

Don't smoke. Don't use estrogen products. Don't even think about combining them.

Every time I meet a woman who smokes I ask if she uses the pill or HRT. If she does, I say you're going to get breast cancer.  

It won't be today. It won't be tomorrow. Maybe not even for the first five years, unless you smoke. But cancer is coming.

Estrogen was added to the list of carcinogens for a reason, you know.

Just try to get pharmaceutical companies to give you the odds on breast cancer after five years on the pill and HRT. How about the numbers of young women getting cancer in their twenties after ten years on the pill. Same with older women after ten years on HRT. Then add smoking to the mix.

Needless to say, I don't get many phone calls that start out, "Hey guess what, you know when you warned me about the dangers of smoking and taking estrogen products, well you were right!"

I hear about it through the grapevine. And I no longer call or send flowers or a basket because I was the messenger and they'd all like to kill me.

But that isn't what my rant is about. My rantis about how doctors mutilate women's breasts when they operate. And it isn't necessary.

In 1964 -- the date is important -- my mother, who was a nurse, had a radical mastectomy the day before a tennis tournament she was playing in was due to start. She found a lump and was operated on the very next day by a top plastic surgeon at the University of Chicago.

She went into surgery not knowing what the outcome would be. Breast or no breast? Cancer or no cancer? You didn't know until you woke up.

They found cancer that had metastasized. She lost her entire breast, a great deal of her lymph nodes and a chunk of muscle. Despite the fact that she had started smoking again, she had trained for months for the tournament. That's why two weeks later I was on the court hitting balls with her, even though she still had a drain in her arm.

Here's my point. The incision was huge. It went from under her armpit in a semi circle down her chest and around to her back down by her waist. But the scar was almost invisible. You couldn't see it unless you looked very closely. Plastic surgeons are competent that way.

The muscle had been dissected with the skill of a sculptor, so there was no gross distortion where it had been removed. Looking at her chest you couldn't tell there had ever been a breast there because the area was so smooth. In fact, I couldn't tell there had ever been surgery. She could look at herself in the mirror without disgust or self loathing. Unfortunately I thought this was the standard of surgery every woman could expect.

Keep in mind this was four decades ago.

As recently as two years ago, I've seen and heardegregious examples of female mutilation by surgeons who consider themselves experts in breast removal and reconstruction.

I've seen simple mastectomies that left women with a huge scar that looks like a railroad track from one side of the breast to the other. And the breast looks like a deflated fleshy balloon.

What the fuck are doctors thinking? That a woman would rather have a saggy slab of skin with a five to seven inch horizontal red zipper in place of her nipple, instead of having the breast completely excised and repaired with artful subcutaneous stitching so the evidence of removal and disease is gone?

General surgeons have no business repairing women's breasts. Period.

Breast surgeons should all be board certified in plastic surgery. Or they should not be breast surgeons.

Reconstruction is a joke, too. You can end up with an implant floating up near your shoulder. It happened to someone close to me. And mismatching is a huge problem.

Not to mention that the scars don't usually go away. And they have to tattoo a nipple for you.

Which leads me to a question. Plastic surgeons have finally figured out a way to spare the nerves leading to the nipples so that sensitivity can be retained when they perform breast augmentation. Maybe there were so many complaints that they stopped snipping haphazardly and learned to be more careful.

So why can't the nipple be spared the same way when there's cancer? Why does it automatically come off? Is it too much trouble for the doctor to operate in a way that would leave a woman with the one part of her breast that can contribute to HER satisfaction?

A friend of mine was diagnosed with metastasized breast cancer at 36. She had both breasts removed. Her breasts had been so beautfiul they should have been in a museum somewhere.

Afterward she showed me the reconstruction. Her combination saline/silicone implants were an odd shape. They looked like a bad execution of a great concept. And the nipple tattoos were a joke.

And there were these dark lines under each breast where the scars were. The area was smooth but discolored. Do doctors think that any kind of breast is better than none at all?

She has since had the implants removed and is much happier. Her husband seems okay with it too. I haven't seen what her breast free chest looks like so I don't know what kind of scars she has now. The good news is that she is a 25-year survivor.

There is an infamous photo of several women with their disfigured breasts exposed, which is so awful, it makes you look away in horror. I have been trying to find it. The ugliness is completely unnecessary. That kind of scarring ought to be grounds for malprarctice.

That photo or one like it was featured by Rosie O'Donnell in her now defunct magazine Rosie, I believe. Her mother also died of breast cancer.

On the other hand, I have also seen a very natural looking reconstruction on a thirty-two year old woman, based on her appearance in a bikini, where the artificial breast with the implant was beautifully matched with its partner. Here again it took more than one try to get the breasts to match, including adding an implant behind the healthy breast.

Given a choice after seeing what I'veseen, I know what I would do. But first, there are some things I've already done.

I nursed my babies, because breastfeeding seems to provide some kind of protection -- at least statistically. There have been theories about the release of melatonin and its preventative benefits, but I don't think anything has been proven conclusively.

I have never smoked. I took the pill, but only for three months in my twenties. I have never taken HRT.

Another contributing factor to cancer may include exposure to pesticides used in gardening, which convert to estrogen compounds in the body. My mother was an avid gardener who cleaned out her pesticide spray can by hand each time she used it.

Also there is a theory about the effect of magnetic fields created by electric blankets over a prolonged period of time. My mother slept under an electric blanket, too.

If ever diagnosed with breast cancer, I would hire a plastic surgeon to operate and remove the breast. Even if the cancer is in situ -- in place -- and hasn't spread. Lumpectomy and chemo is usually an option then. No thanks. I won't get into the damage chemo can cause to your heart and other organs. You need to be young to withstand that kind of poison.

I would also ask to see photographs of the surgeon's prior results, before any reconstruction. Show me how good you are, Doc. I want the smooth scar free result my mother had.

I do not want reconstruction. Would you tear down a national landmark to put up a trailer park?

And I wouldn't wear what I call a Porta-breast -- a bra with a prosthesis inside. Less is more when one is older. Besides breasts just get in the way playing sports.

When my mother was my age she had been dead for almost twelve years. So far, my tobacco free, estrogen free lifestyle seems to be working. My mammograms have been okay.

Ironically, however, after being so careful about my breast health all these years, I realize now that I have risks for other cancers and diseases that weren't even on my radar.

Figures.