Hi everyone,
I have name changed for this post due to all the personal information and I am sorry that this has turned out to be such a long post but essentially I am questioning why a woman should be denied the right to have her breasts removed if this will help her psychological well-being whilst breast augmentation seems to be a perfectly acceptable procedure.
Some background info: My mother was diagnosed with advanced breast cancer at the age of 50 and sadly passed away just under 6 years after diagnosis. She had been initially just given 3-6 months to live so we were incredibly grateful for the extra time we had with here, but it was also the most stressful time of my life. I was 21 at the time and as a result developed carcinophobia (fear of cancer). I am 45 now and it seems a bit odd but in the past I never really panicked about getting breast cancer despite my general carcinophobia. I did always think that my mum's illness may put me at a slightly higher risk, but if anything I was more careless than the average woman and did not check my breasts on a regular basis. Anyway, I recently moved abroad where it is normal for woman to have annual check-ups with a gynecologist and it all really started from there.
The gyno did all the usual abdominal examinations and cheerily commented on my healthy looking womb, ovaries etc. She then proceeded to manually examine my breasts and suddenly stopped talking, getting a concerned concentrated look on her face. She then asked me when I had had my last breast ultrasound (obviously never had one before) and then proceeded to do one then and there. The ultrasound showed that I have diffuse fibrocystic mastopathy (lots of benign breast tissue changes with multiple cysts) as well as very dense breast tissue called ACR 4. She told me that none of this is cancer and not to worry about it, but strongly advised that I should have a MMG (mammogram), especially as I told her that my mum's breast cancer had probably been diagnosed late and/or developed out of benign breast changes.
The MMG showed that I have lots of microcalcification but as the radiologist could not see clusters it was classed as BIRADS 2 which means benign. I also had a private MRI (Magnetic Resonance Imaging) which confirmed the diffuse fibrocystic mastopathy and also came back as BIRADS 2. Thought that I could forget about things until the next annual ultrasound, but gyno still felt uneasy about the results due to family history and asked me to go to a breast centre for genetic advice and another opinion on the pictures. The centre did not want to talk to me about genetics (not strong enough case) but did offer to do another ultrasound where they found a BIRADS 3 (probably benign) lesion they wanted to biopsy which turned out to be a benign atypical cyst. Again I breathed a sigh of relief until they told me that they had found microcalcification clusters near my chest wall that needed further investigation. I had to go for further extended view MMGs after which my right breast was classified as BIRADS 4 (suspicious abnormality). I was then advised I should have a vacuum biopsy and if this failed an exploratory operation.
On the day of the biopsy I had to have further MMGs and was then asked to lie on a table where a computer would calculate the exact location of the tissue to be biopsied. I had been lying there for around 30 minutes when the radiologist came over to say that they would probably not have to do the biopsy as the computer had calculated that the calcifications were not at the back near the chest wall but at the front near my skin?! She got another radiologist who did some more calculations and who then advised that the suspicious lesion was indeed on the skin which is harmless and that I could go home but was to come back in 6 months' time for another MMG. I tried to understand the reasoning behind how it was possible for them to misinterpret the location of the lesion on my MMGs but I was not really taking things in due to my mental state (nervous wreck who had not slept the previous two nights ). I also did not really get a satisfactory answer as to why I would need another MMG in 6 months' time if everything is alright?!
So back to my gyno who agreed that my (non) biopsy experience was a bit odd and then suggested that I should get another opinion from a different breast centre. It was then that I asked about the possibility of having a mastectomy, explaining that I would not be able to cope with this kind of stress/uncertainty for the rest of my life. The gyno said that she could understand my fears but pointed out that any health insurance was unlikely to pay for such a procedure as I had not been tested/known to have a genetic mutation to justify such an operation. I replied that I did not expect his and would somehow find the money if it meant that I would not have to have the sword of damocles hanging over my head anymore. She said it may be worth paying for a private genetic test, but also pointed out that a negative test result would not give the 'all-clear' as it was likely that there are still unknown mutations and it would also still leave the problem of my 'difficult' breasts. She then wrote my referral, including my request for a possible mastectomy ...
... which the breast centre categorically refused. No reason given apart from 'we do not remove a healthy woman's breasts'. When I asked 'how come you offer breast augmentation procedures to woman with healthy breasts' I was told that 'this is different'. A further query as to how this is different was ignored. I then asked whether they would consider giving me Tamoxifan as this has been shown in studies to lower a woman's risk of developing the disease and was told 'we do not medicate a healthy woman'. I was then told that annual ultrasounds should be sufficient and no more than a MMG every two years due to the radiation risks, especially to breast tissue of younger women. When I asked whether I should go for the suggested MMG at the other breast centre in 6 months' time I was told that I should do what they told me to do. I then asked if they would be prepared to look at my past MMGs to advise whether they thought that the MMG in 6 months' time was really necessary as I have recently had at least 8 MMGs in my right breast alone I was simply told 'No'. And when I meekly pointed out that they themselves had advised against unnecessary MMGs only a few minutes ago, I was told that 'life is full of risks' and 'you should have thought about this possibility before you went to the gyno for your initial screening'.
After these recent experiences I have thought long and hard about the advantages and disadvantages of a mastectomy and I really feel that for me the way forward would be to have my breasts removed as this would allow me to move on with my life with less fear. I understand that the majority of women would not take such drastic measures and this is fine, but I fail to understand how the medical profession can categorically refuse a woman's request to have breast tissue removed for psychological reasons whilst at the same time happily offering breast augmentations for the same reason. Also, my mastectomy would reduce the risk of disease whereas I believe that some boob jobs involving implants may be harmful as they could increase the risk of missing a cancer (please correct me if I'm wrong).
So AIBU to ask for a mastectomy and WWYD in my situation?
TIA