DD wants a mastectomy - WWYD?

[IAmIronMum]

I'm a friend of IronMum, posting on her account as I don't have one.

So, as the title says, my daughter wants a mastectomy. She is 17, and has asked if I would be happy for her to have one next year.

She is not transgender. She has a couple of reasons for wanting one:

• She just doesn't like having breasts. Never has done.
• Quite a few female relatives have had breast cancer.
• She plays lots of sports, and they get in the way (large chest).

So it's for preventative and cosmetic purposes. My worries are the cost (although she says she will contribute/pay back anything) and the general risks of surgery. Also the fact that she may regret it (although she's been saying she wants one since 14ish).

Really stuck on what to do/say. Legally she's an adult next year so I can't really prevent her, but I do have some concerns. Can anyone help/offer any advice?

She should definitely be tested for the breast cancer related gene variants.

However - the fact that she wants a mastectomy and is also expressing dislike of the breasts and social reasons for it indicates that this is not simply about cancer. There are psychological issues here too.

A double mastectomy is a major op. Really major. No reputable surgeon would carry one out on a 17 year old or a woman without very good reason.

I would suggest testing for the gene variants and therapy to address the issues underlying this. I suspect she will ‘find’ someone or somewhere that she thinks will do this and beg you to fund it. Please don’t.

A reduction is also a major op but much more justifiable medically and psychologically.

If genetic testing showed she had the gene that made breast cancer more likely, I’d still suggest counselling. I wouldn’t fund a mastectomy, if she has the gene th NHS will and if not it is a drastic surgery, much more so than a reduction.

If it’s ‘just’ an issue of breasts not in proportion with the rest of her body, I’d suggest a reduction, again after appropriate counselling. I would be happy to fund it providing I could afford it.
It goes way beyond getting a good sports bra - it really does affect the rest of your body in a negative way physically, self esteem is difficult, finding clothes that fit your boobs without swamping the rest of your body... I could go on. Suffice to say, I wish I’d had a reduction when I was 18.

Vivienne
Very true. My dd was adamant when she was little (5/6) that she wasn’t having periods - saw me with mine. She’s almost 10 and now accepts that it will happen. I think it’s the same as when kids find out about sex ‘ewww I’m never doing that’.

I'm rather confused- a mastectomy removes all the breast tissue. So you don't get the option of being a size 14. Reconstructive surgery can give you implants that approximate to a size 14.

From personal experience, I can tell you that the shape of these implants, together with the scars and no nipples just aren't as good as real breasts.

It sounds as though your dd wants breast reduction surgery rather than a mastectomy at this time.

Of course, if after investigation she has the brac gene, then a mastectomy may well be an appropriate course of action.

Doesn't breast tissue grow until your early twenties? I would insist she wait until she is old enough to fund them herself in case she changes her mind. If she doesn't then maybe I'd consider helping her.

You may be worried about the cost and the risks of surgery, but the discomfort and recovery should also be on your radar. A friend had it done and although she was happy with the results, she said she wouldn’t have gone ahead had show known how painful it would be. That was a while ago though, so presumably things have improved, surgery-wise.

I agree with previous posters. Presumably this operation is not something she can afford. Apart from anything else, she'll be starting adulthood with a huge debt over her head.

From a cosmetic point of view, she will not be left with a flat chest. There will be extensive scarring and scar tissue.
As a mother I would not fund this.

Why on earth are you posting this in AIBU? It's a strange place to post such a delicate question.

As she is 17 she’s not yet an adult. I feel she is much too young! No rush.

For anything other than possible cancer reasons, I imagine it will be all but impossible to get this done on the NHS. I understand that they don't even do reductions anymore, except for the most extreme circumstances. However, as others have said, the first step seems to be approaching her GP with her worries and to find out if she can have the genetic testing. Meantime, she's probably best to start saving.

If she even thinks she might want kids then suggest she reads up about breastfeeding. Also sorry if you have thought of this but has she had a really good bra fitting somewhere like bravissimo?

See if she can have the genetic testing for the BRAC gene to see if she is higher risk for breast cancer (I think this also covers ovarian cancer).

As other posters have said, she could be a prime candidate for breast reduction, which is a lot less drastic. At her age she may not have considered factors like whether she would want to breastfeed should she have children.

My opinion is this is a mental health issue and the cancer 'reason' is a good 'excuse'.

No dr would carry out that operation unless she has the gene and even then it's not a cert she'd get cancer.

What is worrying is that she wants her breasts removed because she doesn't like them, not helped by them being large.

Breast cancer is so common sadly- ; 1 in 8 women get it, and often when people talk about 'family history it's way back when and not relevant - genes only account for 5% of cancer anyway.

IMO a GP would start with counselling. This is not about cancer,it's about how she hates her body, it just happens to be her breasts. Body dysmorphia?

If she is your DD and there is a real hereditary r isk, you ought to be screened as well as your are the main link.
BTW it's easy to start your own Mn account- just pop in an email and that's it- sorted :)

As someone who has had a bilateral mastectomy (no reconstruction) for cancer I would certainly advise against it.

On one side I have been left with a severe 10" hypertrophic scar which is agony. I need steroid injections into it on a regular basis and will have it for life.

Mastectomy is big surgery - does she really want to walk around with drains in for weeks and risk of seromas and nerve damage for no good reason at 17 years old?

BRCA testing should be first step and then counselling if she has watched relatives go through BC and is frightened.

Why not have a breast reduction?

Does she know what a mastectomy looks like? Maybe Google a few pictures. It's not pretty.

What am abusurd suggestion. Surely you she be looking for a therapist rather than a plastic surgeon.

I was a 32DD and utterly miserable. No bras fitted as M&S only did B or C cup. Would have gladly had them off if I could have, They made me feel fat and frumpy and got too much unwanted male attention, (of the "Wooahh Melons!!!" type).

By the age of 26 I had accepted them. Found bras that fitted - (Bravissimo were great and I felt sexy not frumpy) - had a man who loved me and them and had learnt to be myself.

Later I breastfed two babies and it was joyful.

Take the advice of others here. Go for a reduction if she really wants it but better, if you can, to help her to love her body as it is.

Maybe you have already tried - and it's hard - but she is very young for permanent surgery,

Lots of 17-yr-olds hate their breasts. I certainly did.

Things that made a difference to me were a better bra fitting - take her to Bravissimo if she hasn't been before. My trip to Rigby and Peller in my 20s was life changing. Suddenly my boobs didn't hurt all the time.

Also getting out of puberty - hormones settle down and again they stop hurting so much, and you stop feeling like the first person in the world ever to have breasts.

Having a relationship - discovery that breasts can be nice

Finally having breast cancer in your family. Breast cancer is so common that practically everyone has it in their family. Unless women in your family have the BRCA gene or have had it at a very young age, lots of post-menopausal relatives having had breast cancer really doesn't mean your family necessarily is at higher risk of breast cancer. It just is very very common. She needs to know this. Is she linking stress about a loved relative having cancer with her own distress at puberty?

It may be that she sees her breasts as a time bomb if she'd grown up with family who have had cancer. They cause her pain and get in the way of her enjoyment of sport. Don't think that's a mental health issue. I think she should have more time to think but doubt she needs a therapist.

I don’t even know if they would look for the gene yet. My DN only has 2 aunts one is her fathers only sibling and I am her mothers only sibling. Her aunt on her dad’s side died of ovarian cancer and I have been lucky enough to survive it.

My sister was very concerned so spoke to their G.P. who would not test for the gene until she wa a bit older as they would not remove her breasts or ovaries at her age (17) at the time. She is under watching care but her body wasstill developing and they will not remove breasts or ovaries at this stage. She is also very well endowed so was disappointed at the time but now (3 years later) she is much happier with herself in general.

Presumably this operation is not something she can afford
Would anyone do it?
I know that people get repeated, unwise cosmetic procedures done so there are clearly doctors with no morals, but this?
I would like to think that a doctor mutilating a healthy teenager for no medical reason would be struck off.

I was adamant I wanted a breast enlargement when I was her age and went to the plastic surgeon my 18th birthday. My parents wanted me to wait until I was older. I wished I had taken their advice. Lots of surgery complications, scarring, pain, I couldn't breast feed...Tell her if she still wants one at 21 then you will help her pay for a breast reduction. She can always go on to more serious surgery - but once she's lost all her breast tissue there is no going back.

Yes I would hope so MrsDV. As someone pointed out up thread, anyone wanting body parts removed as a cosmetic procedure is clearly suffering with mental health issues of some sort? Surgery won't "cure" that issue.

That said, there are plenty of cosmetic surgery clinics abroad which offer cheap package deals and little or no pre/post surgery care. The NHS often have to step in when there are complications afterwards

Well it's going to happen so she needs to come to terms with that. You should support her in learning to accept herself and after she's 21, there may be an opportunity for a breast reduction. No one in this country will do that surgery. It wouldn't pass ethics committee.

not!