Choosing not to have breast reconstruction after surgery for breast cancer in women

Some women who’d had a mastectomy chose not to have breast reconstruction. Some said they preferred not to have another operation. Others were comfortable and pleased with their prostheses. Yet other women were reluctant to use areas of the body that were otherwise unaffected for the purposes of reconstruction. Often women who declined reconstructive surgery mentioned all of these reasons.

Comments on why she opted not to have breast reconstruction.

Age at interview 57

Gender Female

Age at diagnosis 55

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Even when I go for swimming, you know, I have to wear that costume.

It’s not the same thing, you know, as your own breast.

And the doctor asked me if I can have you know, new breast.

I said no, I refused because that operation is the worst.

So that was very difficult, so I refused.

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Explains that she is happy with a prosthesis and does not want a reconstruction.

Age at interview 59

Gender Female

Age at diagnosis 58

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Where they rebuild the breast if you want?

No and I don’t want it.

They gave me silicone, silicone to wear in my bra, the hospital.

They call me down the hospital to re-fit my bras, to see what bra would fit the silicone.

So it’s quite comfortable.

Sometimes I don’t even remember I’ve got it on!

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Explains that she did not want breast reconstruction because it involves using other areas of the…

Age at interview 49

Gender Female

Age at diagnosis 30

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I was offered reconstructive surgery the second time, not the first.

Oh one thing about mastectomies is that it’s, as with everything else, some people are more skilled than others. And I did actually have a very good mastectomy if you can call a mastectomy good. I had a good result, one that’s worked very well with prostheses.

So when I was offered the reconstruction with the second one I didn’t really feel much point unless I’d had the first one reconstructed.

So I asked him to do the mastectomy really flat – the same as the first one – not to try and retain any skin and tissue for a reconstruction.

And the first one, because of the radiotherapy, if I was to have had a reconstruction I would’ve had to have one using tissue from behind the shoulder, called the latissimus dorsi, I’d have to have that one, plus a small implant.

That’s one of the reasons I didn’t have that operation – because it involved areas of my body that hadn’t been operated on. And like I said, I swim, I cycle, I’m very active. And I didn’t want to involve an area – I mean that’s my personal decision – I didn’t want to involve an area of my body that’s not already involved.

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One woman wondered how a reconstructed breast would compare with the original breast. Another chose not to have breast reconstruction because she was wary of having further problems. Some women mentioned that, had they been younger, they might have considered reconstructive surgery. For many women, decisions about breast reconstruction were bound up with their feelings about their body image and their personal relationships (see Body image and breast cancer in women).

Explains why she chose not to have a reconstruction.

Age at interview 50

Gender Female

Age at diagnosis 48

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And I haven’t really considered reconstruction because I think it must be quite difficult to get you looking exactly the same as you were. And you can’t get exactly the same as you were.

And I’d never feel it was me really, so that I’m quite happy just having the prosthesis.

And I don’t particularly want, you know if they took some of these flaps from one place to another, I wouldn’t really want the scaring that that causes.

So I’m quite happy with just a prosthesis.

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Comments that she was wary of further problems and chose not to have breast reconstruction.

Age at interview 68

Gender Female

Age at diagnosis 59

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Once I was discharged from the hospital when I when I went for my first check-up with the surgeon he asked me if I wanted plastic surgery, transplant.

And I said “No,” I said. He said’ “Well you were so definite about that,” he said. “Why, can I ask you why?” And I said’ “Well, I don’t want anything to flare up again inside.” I said’ “I just don’t believe in these, I believe in letting nature take its course.” I says I didn’t want a transplant.

He says’ “Well,” he says “it’s really up to yourself,” he says. “But you can get it done on the National Health.” I says’ “No I don’t want it. Thanks anyway.”

And then with the second one I got off, five years ago, they never asked me about that. So now it’s just I get a new prosthesis every now and again when I need them.

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Comments that while she would not want reconstruction at her age she feels it would be different…

Age at interview 82

Gender Female

Age at diagnosis 60

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Also, although I didn’t have a choice, I wouldn’t have had any implants or reconstruction because of my age then.

I’ve got a stable marriage and that was it. I can cope with the prosthesis.

But I will say this, anybody that’s young and got a young husband and all that, I think it is more traumatic for them than it is, than it was for me.

Also we, sex and that sort of thing is out in the open now a lot more. We weren’t brought up like that and that’s a big, big difference.

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More experiences of choosing not to have a breast reconstruction can be found on our section about experiences of ductal carcinoma in situ (DCIS).

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