Karen struggled with grief for her pre-mastectomy body. She shares how she processed her emotions.
How do I grieve for a breast?
Grief is the emotional suffering you feel when something you have a bond with is taken away. But how on earth do you grieve for a breast?
How do we grieve for the loss of a body part? An aspect of our intimate anatomy? There’s no funeral service, no eulogies, no publicly acknowledged period of mourning, no closure. You go to sleep on a hospital trolley with two breasts and wake up with one, or both, absent.
There might be a new breast in place if you’ve opted for a reconstruction but the breasts you knew, stroked, squeezed into ill-fitting lingerie, cursed for being too big, too small, too weirdly shaped, too mismatched, too sore, too jiggly, have gone. Gone into the hospital’s medical furnace or onto glass slides in a pathology lab. The cancer has hopefully gone into the furnace too, but still, it’s a hard way to say goodbye.
No one wants the scars, the implants, the reconstructed breast
In the forums and peer support groups for breast cancer patients, the debates about staying ‘flat’ post-mastectomy or opting for reconstruction are numerous. For some women, the thought of waking up post-op and looking down to see only a space where once there was a breast is too traumatic a thought to countenance. ‘I couldn’t bear seeing myself flat’ is a common thread. And when reconstruction surgery is a success, there is much delight.
Some women opt to remain flat after their surgery. This may be a medical necessity or it may be a deliberate choice, an embracing of the flatter, post-mastectomy body with a surgical scar as a symbol of the hard times endured and the difficulties overcome. Some women use tattoos to cover their mastectomy scars, as a way to reclaim their body from breast cancer.
Either way, flat or reconstructed, these women have a strong sense of how they want their bodies to be shaped post-cancer. No one wants the scars, the implants, the reconstructed breast, but making a decision about how you look after breast cancer surgery is also about confronting a change of self.
How do I grieve for my sense of self?
How do we grieve for that element of our identity that's tied into our physical body? Even though I'm not someone who places all my sense of value in my physical appearance, I still have to deal with the fact that post-op I am different.
There is less of me. Some of me is in a different place from where it used to be. I am transformed. I, and the thousands of women who face similar surgery, are not less than we were before. But I am not the same physical being I was before the surgery. That is unalterably true and will always affect who I am.
I see that difference every day in the mirror, it's inescapable. My new breast bears a large circular scar. I no longer have a nipple or areola on that breast, just a blank expanse of skin, different in colour and texture to that around it. And another scar, pink and vivid, runs hip to hip just above my bikini line. I have a new belly button too. Technically it’s the same belly button, but all the skin around it moved so there’s a new hole for it to show through.
You have to accept the new you
Grief is different for everyone. I suspect, as with the death of a loved one, the grief of what has been lost physically and emotionally will never go away completely.
The psychologist I met prior to my surgery told me that she advises all her breast reconstruction patients to look at and touch their changed breasts as soon as possible after surgery.
The brain holds a ‘map’ of our anatomy, built up over years of looking at and touching our own bodies. When you have a mastectomy with a reconstruction, suddenly there’s new skin, flesh, scars where the old you used to be. Your brain doesn’t know this new you yet, hasn’t had time to map it out. So you have to re-educate your brain to accept the new bits.
Grieving for what we lose through cancer is hard. It’s hard to articulate, hard to convey to others, hard to understand yourself. But maybe helping your brain to learn the new you can be part of the healing process.
A version of this blog was originally posted on Karen's blog, The A to Zee of BC.
Read information on changes to your body after breast cancer.