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?

The faulty BRCA gene can be passed through the mother or father. The only was of knowing if she has the mutated gene is to get tested herself.

Yes, my BRCA gene has come down through my dad. I don't think anyone realised it wasn't x linked because doctors are still a bit surprised that it's through my dad.
I would also suggest your daughter maybe looks at pictures of mastectomies to see how it really does change your body shape. Mine is pretty horrible looking - not to mention the nerve damage done to my body from the op.

I would also suggest your daughter maybe looks at pictures of mastectomies to see how it really does change your body shape

Not such a good idea :(

If by any chance she did have the gene and decided to have the operation, scare tactics aren't going to help her.

And if she doesn't have the gene, there is no way she would ever be given a mastectomy. So it's pointless either way looking at photos.

Kirstie Allsop has the gene, but unlike her sister has so far decided not to have a mastectomy. she's been very open in the media about all of this. It's not a given that having the gene means you have the operation; there is a choice and differing opinions.

To be honest I would shut down the BRCA gene testing for the moment - the idea seems to be motivated primarily by a desire not to have breasts.

If there was a real possibilty of it I'd have thought her mother would know and have been tested herself. But even if not, even if it came from her father's side, she couldn't conceivably have surgery before 21 as her breasts won't have stopped growing. There's no point being tested before that.

I would shelve that until she's older, not take her down the road of even thinking about it now as I think it could be quite destructive, and focus on her body image and self acceptance.

If she still wants breast reduction surgery when she's older, that's a different matter.

I would be concerned she is being teased about them

She might be being teased, she may also be garnering sexual comments she's not comfortable with. Big breasts make you very visible to men and for a shy 17 year old that might be hard. Assertiveness training is a great idea.

Getting mastectomies for family history isn't particularly easy. To be put in the family history clinic to start with she'll need to go to doctor for a referral where they'll assess risk.

Being in the family history clinic then becomes something you may need to declare in insurance applications and for me it prevented me extending existing policies. I had to take new more expensive policies out.

Similarly, taking the genetic test will affect things like life insurance because it's something you may need to subsequently declare.

If all of the above led to a risk factor relevant for preventative mastectomy there would still be counselling of some sort because it's major surgery with inherent risk in itself.

Your daughter's situation sounds complex. I'm only really adding the benefit of my experience from the family history side as I've been in it since I was 34. It's always weighing of risks and not just going straight to mastectomy "to be on the safe side."

In general she's still quite young and my gut feeling is she needs to come out the other side of adolescence before making a life changing decision. I've heard 25 is when this process really ends but couldn't cite a source!

Also BRCA 1 and 2 also carry increased risk of ovarian cancer and others cancers too. Would she have her ovaries out as well?

I know someone who had a preventative (prophylactic) mastectomy and developed cancer elsewhere.

17 is still so young. At 17 I hated my breasts so much I would have cut them off myself. Now in my 20s and I don't love them - definitely want a reduction once I've finished having children and can afford it - but I accept them and like them because they feed my baby and my DP is a boob guy

Could she not consider a reduction rather than a complete mastectomy? I'm a 34J and plan to go down to about a DD, but I have seen on the surgeons website a lady who went from a D to an A because she was an athlete and they got in her way.

Sorry my mistake (idiot brain strikes again) - but if she doesn't have BRCA in the family already or parent/sibling with breast cancer - or OP doesn't meet criteria for genetic testing, then the whole indication for any genetic testing is off.

A decent bra fitting would work wonders - tell her to do that before anything. Rigby and Peller not M&S.