Catherine's story is part of a series looking at the many and varied experiences of breast reconstruction and the decisions behind a woman's choice to have reconstruction or not.
Catherine was diagnosed with breast cancer at 47. She had an immediate reconstruction with an expander and will have this replaced with a permanent implant in a few months.
I was diagnosed in early March 2021 at the age of 47, just a few months after getting married. I’d had a few months of discomfort in my lower left breast – I am a marathon runner and had put it down to chafing. But, lying in bed one night, I felt a walnut-sized lump and, soon after, was diagnosed with ER+ and PR+ invasive ductal carcinoma. The honeymoon was definitely over!
I don’t really feel like I ‘chose’ implant reconstruction, more that I trusted what was recommended by the surgeons – a skin-sparing mastectomy, in which all of the breast tissue would be removed and the skin and nipple saved. I was told I would find it less traumatic after surgery to still have a breast. Other options were mentioned but only briefly. If I could do it all over again, I would spend more time on those other options, particularly staying flat.
I did ask a lot of questions about the tissue expander, the temporary implant which would be expanded with saline over time and then exchanged for a silicone implant after radiotherapy. Tissue expanders can be placed under or over the chest muscle. I had done a bit of reading online to try to figure out which one would let me get back to running more quickly – there was a lot of debate but no clear winner. In the end, we agreed that the surgeon would make the decision on the day.
I had surgery in late March 2021, and ended up with an under-the-muscle expander. The surgeon removed six tumours, ranging in size from 2mm to 32mm, and confirming that a mastectomy was the right choice. Luckily, my lymph nodes were clear so I didn’t need chemotherapy.
For the first couple of weeks after surgery, Panadol and ibuprofen kept any pain at bay during the day. The nights were a different story - if I tried to lay flat on my back to sleep, the pain was paralysing. Sitting up again brought immediate relief so I ended up sleeping propped up on six or seven pillows. The pain gradually eased over a week or so, as my chest muscles stretched to accommodate the expander.
I had saline injections every couple of weeks to expand the expander – the injections themselves weren’t painful as the skin on my breast was numb, but my chest muscles protested for a few days after each injection. The final 100ml of saline was added a few weeks before I started radiotherapy and left me very lopsided – my left breast is tight as a baseball, with all of the volume above the nipple and under my arm, and deep creases in the skin under my nipple. My armpit is a deep, dark cavern, you could lose things in there.
I was determined to get back to exercise as quickly as possible – it gave me a small measure of control when so much else suddenly felt out of my control. I was on the exercise bike at the gym five days after surgery, and ran a half marathon in April and a full marathon in May. Running with a baseball in your bra isn’t exactly comfortable, but it is doable!
Currently, I’m nearly done with radiotherapy. Surgery to swap the expander for an implant is scheduled for the end of July and the surgeon is hopeful that he will be able to iron out the creases and make me a little less lopsided. I just want my armpit back!
My advice to anyone looking into reconstruction with implants is to do your own research and ask loads of questions. Don’t rush into anything – listen to the experts but listen to your gut too. Then make your own decision based on the things that are most important to you.