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 needs to research what it will be like to live with a double mastectomy,and how she will feel about that.Scars,being completely flat chested (which most small breasted athletic women aren't), the fact that your chest shape is affected by having the breasts there and without them it looks odd,the difficulty of buying clothes that fit or will she wear prostheses for some of her time? Not always comfortable,expensive...
This is from my experience of mastectomy without reconstruction.There are pros - I like being able to sleep on my tummy! but there are also cons.(It might not have bothered me at 17 but it is really hard to buy smartish work clothes,particularly for summer...)

Separately breasts have some plusses - I would think very,very carefully before giving up on the possible pleasure they can give at 17 - she may not care now but she has her whole life ahead,and even if she has had relationships that can change too and her feelings about the physical side may change.And I loved breastfeeding - it's another possible option she would lose.

Breast cancer is so common that practically everyone has it in their family.

I don't. In spite of mahoosive family.

Sport makes me think reduction not full removal.

It's irrelevant to talk about how she would feel.
No UK surgeon would do this.

Re the genetic link @IamIronMum if it's so strong, have you yourself not considered being tested?

I doubt there is a strong link. As a PP said, so many women have BC especially as they become older, almost everyone could trace some family history. It's only relevant from what I understand if it's first degree relatives - a mother and sister- at a young age ( before 45.)

Your DD needs counselling not surgery. I hope you can make her understand surgery is not an option and you as a parent can support her through therapy. See your GP about that.

14 to 17 is a really common age to feel very uncomfortable with your body. Is she getting male attention that is making her very uncomfortable? Is she overly obsessed by the cancer idea? Is she really identifying as transgender but not happy to say yet? The sports thing feels like an excuse to me, plenty of sportswomen with boobs. I think she needs counselling, by herself, to understand the roots of this.

It would be unethical for a surgeon to do this.

If there were/are younger relatives with breast / ovarian cancer and her primary concern is cancer, she can seek the genetic test.

You haven’t said what size her boobs and body (ie relative size) are, so we can’t tell whether or not her annoyance about sports is valid. There are great sports bras available - eg “shock absorber”. Most people do sport for fun - and even if not it seems highly unlikely that her breasts are affecting her performance.

If that was my DD id try to get her to talk to counsellor/psychologist etc specialising in this age and issues. Sorry this seems serious to me and needs expert help

She needs counselling.

I agree with others- she will struggle to find a surgeon in the UK to perform this surgery.

A teenage mindset is very different from an adults. I'd advise her to wait till she's at least 21, 25 ideally,

I had a friend who, at 19, was convinced she was going to have a hysterectomy because of a myriad of legitimate gyne problems, and the nhs would have done it. I saw her a few years back with her children, so glad she hadn't followed through with it.

I'd advise her to wait, unless she has the testing for the breast cancer gene and it's positive.

I agree with those who have said this sounds like a mental illness. Maybe look into getting her some therapy at least. Wanting to entirely remove body parts is not normal.

If she has the BRCA gene she would be offered counselling before surgery anyway surely, and if she doesn’t, no surgeon is going to perform that operation anyway.

Even if you could find a surgeon, unless she has the money or you’ll stump it up, I shouldn’t think she’d get a loan even from a cosmetic surgery finance company.

Thank you all for replies.

Friend sat her dd down and had a long talk. Her dd began crying and said she just wants a flat chest. She's agreed to start counselling as soon as possible, and they're going to see if they can get the gene test.

I would hope you wouldn’t find anyone prepared to do it.

She needs to either wait until she’s at least 21 to even think about it again, by which time she’ll have hopefully come to her senses.

At 17 you feel ‘grown up’ but you aren’t. You’re a long way from mature enough to make life changing but decisions that cannot be reversed.

If she won’t listen to you, find someone she will listen to.

Cross post. That’s a good start.

Getting proper bras that support and give a flattering shape helps so much when you have big boobs. As a teenager no one seems to tell you there is a world beyond the high street, even now when there are specialists online.

Having some custom bras made is a lot cheaper than surgery would be and might help her confidence.

But surely the genetic test is a red herring? If it was so important this girl's mum would have been offered it or pursued it herself? The fact the DD is asking of this sort of surgery shows how immature she is because there is a world of difference between 'wanting a flat chest' and being educated about what major surgery could do ( scars, pain, disfigurement if it goes wrong.) If she were my DD I'd have not even entertained the idea for a moment with her, but suggested going shopping for a good sports bra, mentioned reduction surgery when she was much older and if she felt the same, etc.

No reputable surgeon will do a breast reduction until the breast tissue has finished developing and that's is at around 22 years of age. The counselling and possible gene testing is an excellent idea.

OP, Mumsnetters can offer advice and support but you and your dd need to seek professional advice in real life.

Yah, no way in hell any Breast surgeon would touch her with a barge pole.

Not to mention the ongoing issues women have with their scar lines etc

Depending on the family history, she probably won't get the BRCA gene test on the NHS and its very expensive to get privately. It depends on how many family member, their ages at diagnosis and crucially, the type of breast cancer (its triple negative cancer that is linked to BRCA, not hormone receptive).

I think that counselling is the best thing in this situation. 17 is still so young.

I have the BRCA 2 gene and have had breast cancer and a bilateral mastectomy without reconstruction.
It's not something I'd recommend! I don't like having to consider the neckline of every top I buy as the lack of breasts can be quite obvious.
My sister is also a BRCA2 carrier and has still been refused a preventative mastectomy due to her mental health, despite the 80% chance of getting cancer!

That sounds like a really tough situation for your friend and her DD.
Just to add that after a mastectomy, women don't look "flat chested", thier chests look concave as all the tissue down to the ribs is removed. Thier chests do not look like children's chests or mens chests as they have muscle and some breast tissue.
Also it's best not to count on breast reconstruction in the case of regret later. It is major surgery, much more complicated than breast removal with greater risk of complications, problems with healing, needing fillers etc.

Well done OP on making progress.

In terms of genetic testing, genetic clinics will have clear guidelines on who will benefit from having tests done and who won't. And the person who should be referred of course is the OP, not the DD as if the OP doesn't have the gene, the DD won't.

This link should be helpful as an example: the opening statement is few families have a mutation in a known cancer gene. For many it will not be appropriate to offer genetic testing.

www.cuh.nhs.uk/clinical-genetics/service-information/familial-cancer-guidelines/cancer-genetics-referral-guidelines

I agree 17 is young to make such a big decision. I would be wary that she may be looking to pay to get this done abroad in a country where medical procedure are cheaper (and may be less emotional support). If something went wrong like infection or other complications who would be picking up the cost, the NHS ? She may be researching this as an option on the internet.

My school friend had a reduction op the day after she turned 18. She was very distressed at having to wait until then, as no one would operate while she was under 18. She was suffering awful back pain and the comments she got from males after being an AA cup aged 15, to a J cup a year later... She's 4' 11" so couldn't find clothes to fit, it was very distressing to her.

The surgeon who operated was the only one of several she saw who would even consider the OP at 18. All the others said she wouldn't have stopped growing and she needed to wait. They were right, she was back to a H cup within a couple of years and had to had another reduction in her 20s.

It is not a simple op for the feint hearted, nor is a mastectomy done for no medical reason. She needs to have counselling or talk to a few surgeons about this (nhs preferably who won't be making money from operating on her in the same way).

And the person who should be referred of course is the OP, not the DD as if the OP doesn't have the gene, the DD won't

I don't think this is correct is it?

I would be concerned she is being teased about them. My mother sent me on an assertiveness training course about this age and it meant I felt I could deal with the comments better. I'd also suggest a properly constructed set of well fitting, made to measure if need be, sports bras - regardless of cost - will make a big difference.