Making the Breast Decision: Mastectomy & Reconstruction?


{Via Tumblr}


It’s been 4 months since a core biopsy revealed I have invasive breast cancer. Since then, my days have been chock-full of research and reflection, so I’ve had plenty of time to think about the upcoming July 24th surgery that will theoretically save my life.

In the past 4 months I’ve had 14 infusions of chemotherapy and 16 weeks to weigh the options: single mastectomy, double mastectomy, reconstruction, no reconstruction, nipple tattoo, artistic tattoo, no tattoo. I’ve grappled with whether the path of least resistance would be to peel myself back to the bone, bravely staying flat chested forever, or to move gracefully forward with the replication of what I am about to loose.

Each option has its pros and cons. Of course they are all preferable to have no options at all.

With all the decisions that needed to be made, I’ve researched all my available choices (there are many) and prepared myself for the various possible outcomes of resection (there are a few). I’ve asked everyone I knew who’s gone before me all the relevant (and delicate) questions: Are you happy with your choices? Would you do things differently? Do you like the way you look?

Some of my fellow breast cancer warriors elected to remove only the breast affected by cancer, and haven’t sought to reconstruct. Some of these women use an external prosthetic in their bras and bathing suits, some don’t.

Many women I’ve spoken to have removed both the diseased breast and the healthy one prophylactically, and have reconstructed both. Some of these women were candidates for nipple-sparing mastectomies, which left their original areola and nipples intact; some were not and could not.

For those for whom saving the nipple and surrounding skin isn’t an option artistic tattooing can be healing. These women are empowered by reclaiming this part of their body with stunning tattoos where nipples or whole breasts used to be. Each woman’s options are affected by her case, diagnosis and genetic background.

The possibilities are many. The choices can feel overwhelming…


I’ve taken a winding, sometimes bumpy road to arrive at my own decision.

In the beginning I researched various autologous reconstruction procedures, all of which create new breasts using some fat, muscle, skin and blood vessels harvested from another area of one’s own body. But I came to the conclusion that this option could leave me physically weakened in the donor area of my body, and might seriously interfere with my yoga practice.

Then I asked myself if I’d be okay using cadaver or bovine (yes, cow) tissue to hold a silicon or saline implant in place. As an aspiring vegan, this presented me with a bit of an ethical dilemma, and I wasn’t sure if I could introduce any kind of foreign body into my own; whether it came from a four-legged friend or a chemical manufacturer.


Down to the bone.

In May, I came to the momentary conclusion that I would choose mastectomy without reconstruction. I started compulsively feeling my ribcage, imagining a smooth hillside slope from my collarbones down to my bellybutton. I’d press my fingers into the divots between my ribs and try to picture myself with a full set of 12 impressions instead of the breast tissue that presently occludes the spaces between my fifth, sixth and seventh intercostal muscles.

For hours and hours I Googled images of women without reconstruction to see how I would feel when trying on a more Balanchine ballet dancer version of femininity: flat chested and boy-like. What I found were hundreds, maybe thousands of brave women who have documented their journey through breast cancer and proudly displayed photographed themselves or posed for others.

Coffee table books and websites, like The Scar Project, celebrate these women and beautifully illustrate the process of survival and recovery. The photographs I unearthed revealed incredible courage and strength, and touched places deep inside my feminine soul.


{David Jay Photography via}

{David Jay Photography via}


{David Jay Photography via}

{David Jay Photography via}


But after sitting with this decision for several weeks, I realized that something was off. My decision no longer felt personal. It felt political, forced and academic. I realized that the pressure of what I thought I was supposed to choose was strangling what I wanted to choose. 

Through meditation and self-inquiry, I realized how reactionary my initial decision had been. I had judged myself harshly in April for wanting “fake breasts,” and I had labeled myself vain. I needed to get out of my head and listen to my heart.

When I finally did, I realized that choosing not to reconstruct out of fear of being judged for having implants is no more authentic than choosing reconstruction for fear of being flat chested. Either path is honorable and navigating breast cancer is brave, period. Other people’s opinions are none of our business.



Beauty takes many forms.

I have unending admiration for the women who have lost their breasts to cancer and have chosen not to reconstruct. I think they are just as beautiful as women who’ve never gone through cancer, or prophylactically opted for surgery. But after much debate with myself, I have chosen another path.

Tomorrow, June 24th, I am having a bilateral mastectomy. I have chosen to remove both my breast that has cancer and the one that does not. If single stage reconstruction is possible, it will happen shortly after my breast tissue and cancer is removed.

If my cancer is still too extensive to save the majority of my skin and nipple, my plastic surgeon will put in tissue expanders that will stretch my skin until it is able to hold a pair of implants. Either way, I am excited to have a new pair.

This decision has brought with it great freedom. I feel released now; released from the pressure I was putting on myself to practice the asceticism I had applauded as part of renouncing reconstruction.

With my mind settled on rebuilding what cancer has taken from me, I’ve been able to return my focus to my heart. Spending time in quiet meditation and holding myself with greater tenderness, I’ve been mourning the imminent loss of the breasts I used to feed my son, and pleasure my partner.

In honoring our time together I’ve been directing thoughts of loving kindness towards my breasts and letting go of any negative feelings I’ve had about them in the past. I’ve come to realize that for me saying good-bye to my breasts has also been about letting go of any shame, blame or animosity I’ve felt about them in the past.

I’ve forgiven their colossal and quite early development in my pre-teens, the shrinking they did when I lost weight in my 20s, the tear-jerking mastitis I had during the first few months of breast feeding, and their abrupt deflation after I weaned my son. I’ve reached back into my relationship memories and forgiven the right one for being smaller than the left (a physically perceptible fact that mortified and embarrassed me in my 20s) and I’ve reframed any disappointments I’ve had in my sense of self as they’ve related to my beautiful mammary glands. On the brink of momentous change, I think I’ve finally made peace and let go of all the old gripes and insecurities.

I’ve put my hands over my chest and thanked my breasts for all the amazing things they’ve brought into my world: a strapping, well-nourished toddler, a satisfied and engaged partner, and a deeply loving maternal sensibility within myself.

I’m ready now; ready to make space in my heart to welcome myself home again: perhaps a little modified, but healthy, cancer-free and just as much a woman as before.

{Photo: Larisa Forman / Caitlin Marcoux}

{Photo: Larisa Forman / Caitlin Marcoux}

“Think of all the beauty still left around you and be happy.” ~ Anne Frank



Read more about my journey with cancer:

>> 10 Practical Tips for the first 10 Days of Cancer. 

>> How to Talk to Someone with Cancer.

>> Cancer and Equanimity: Can you see the forest through the trees?




Looking for more 411 on Breast Cancer? Check out these resources and personal stories:

Susan G. Komen

American Cancer Society

Breast Cancer Resource Center

Living Beyond the Breast

National Cancer Institute


Crazy Sexy Cancer


Breast Cancer Blogs:

Generation Why

Chemo Babe

Boo Cancer Your Suck

Stupid Dumb Breast Cancer





{Love them enough to let them go.}





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Caitlin Marcoux
Caitlin Marcoux is a mother, yoga teacher, writer, massage therapist and cancer survivor. She lives on the tiny Island of Nantucket, MA, year-round with her partner and her 4-year-old satguru Griffin, where she is an advocate of prenatal yoga, midwifery, elegant tattoos, rockin’ music, and living mindfully. Caitlin is the creator of Strong Girls Yoga, and teaches a variety of regularly scheduled classes at The Yoga Room. A former modern dancer, she fuses her passion for music and dance with yoga, keeping her flow creative, playful and fresh. Caitlin has written for Rebelle Society, and blogs about her practice on and off the mat regularly. A stand up paddle enthusiast, Caitlin recently took her yoga practice off the mat and onto the water; opening Nantucket SUP Yoga in June. She is currently working on a memoir about using yoga to navigating breast cancer. You can find her on Facebook, Twitter and Instagram


  • Mamaste
    Mamaste commented on July 23, 2013 Reply
    Caitlin, as I wipe away the tears, I applaud your decision. Thank you for taking us through this life-altering journey with you. My thoughts, prayers and love are with you. xoxo ~Mamaste
  • tiffany commented on July 23, 2013 Reply
    wow.. I had no idea there were so many options. It sounds like you have thought it all out, investigated as much as possible and picked what will work for you best! You are the only person who needs to approve of your choice! I say do what will make YOU happiest:). You have been thru a rough 4 months and if this will help you come out feeling lighter than go for it sistah!! Will be thinking of you for the next many hours till we here your out come and prognosis!! I know you have TONS of positivity being sent you way so I know you are being held by many! xxxxxx
  • Elle commented on July 23, 2013 Reply
    Thank you for sharing your very personal and difficult decision making processes. Bravo to you for making the decision on your own terms. Many blessings and healing love during your recovery. l
  • Marcy commented on July 23, 2013 Reply
    Blessings to you on your journey. I have been there. In fact, I have experience with most all the options. I had a mastectomy of the left breast with immediate reconstruction with a silicon implant. Unfortunately I had to have radiation afterwards, and the implant got hard as a rock. So a few months after chemo was completed, I had surgery to replace the silicone implant with a saline one. I got a drastic infection from the surgery. After weeks of nasty IV antibiotics, the new implant needed to be removed because the radiated tissue would not heal. So I started using a prosthesis. Even though I started going thru menopause immediately after my first chemo treatment, I discovered I was pregnant about 1 1/2 years after my chemo was completed. I hadn’t had a period that whole time! My miracle son. I was determined to breast feed! So i went from a “B” cup size to an E cup. I didn’t even know there was such a size! Amazing how my body knew I needed that giant boob to make enough milk for my child. The prosthesis weighed 4 pounds!! Like you, i was afraid of losing my core strength to make a breast. I thought it was vain to sacrifice a working body part. But after about 4 years of running around the house shouting “has anyone seen my boob?”, plus having it fall out when I bent over to pick up the kid, i decided to have a free flap reconstruction. They used just a very small part of my lower rectus muscle along with some tummy fat. The doc did some origami to make a nipple. It looks really nice. Its been about 15 years now. And my core is still pretty strong :) Anyways, I liked the implant when I had it, and I like what I have now. And I like being a stage 2B survivor after 22 years. Yay to us :) Facebook message me if you want a new friend to talk to. hugs xoxoxox
    • Jocellyn commented on July 23, 2013 Reply
      I know this isn’t a funny thing to laugh about (or maybe this instance is), but I just got an image of myself running around, about to go out for tea, but being late because I had my left one on but my right one was lost somewhere; I’m quite forgetful. I’m glad everything worked out for you.
    • Caitlin Marcoux (@Nantucketyogini) commented on July 30, 2013 Reply
      Thanks for sharing your story Marcy. It’s a pleasure to connect with you here…and I love your sense of humor. The world needs more laughter!
  • scorpioski commented on July 23, 2013 Reply
    Yet another well done and wonderful essay. Your Son and I will be thinking of, speaking of and pulling for you tomorrow. Godspeed – We will see you upon your safe return! xox
  • mtnyogini commented on July 23, 2013 Reply
    You are so brave. Thank you for sharing your journey. It gives me pause- reminding me to count my blessings and let go of what I cannot control. Sincere wishes for a successful procedure and a future of good health.
  • Jo Taylor commented on July 23, 2013 Reply
    It’s YOUR decision & thankfully you have a choice. Good luck with the surgery ((hugs)) Jo xx (@abcdiagnosis)
  • Corinne commented on July 25, 2013 Reply
    You are beautiful, brave, wise, strong and an inspiration… wishing you love and many blessings
  • Kim commented on July 30, 2013 Reply
    Thank you so very much for sharing your story. I’m about ready to walk down this path and you put into words what I was not allowing my self to acknowledge, heal, and move on from. Your articles have helped me through this journey in ways that I can not begin to express, and I’m so very grateful that I found them ♥. I keep a good thought for your and yours, and send you tons of wishes for a speedy recovery and peace.
    • Caitlin Marcoux (@Nantucketyogini) commented on July 30, 2013 Reply
      Dear Kim, I’m so glad I could be of service to you. If you’re ever interested in connecting one-on-one I’d be happy to exchange emails with you. The good news is mastectomy & reconstruction can be very successful, and if you build a strong support team, not that traumatic. I’m happy to say I’ve come out of this week very happy with my results. Best of luck to you. Love, Caitlin
  • Mary Ellen Cusack commented on November 6, 2013 Reply
    I need help…My cousin just had a double matectomy yesterday and I want to know what I should do for her. I think the worst thing I could do would be “nothing”. So, please…what is something precious I can do? she’s 38 and was trying to have a baby…I’m sure she doesn’t need another card or meal made for her…

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