Embracing Change: Single Mastectomy with Tissue Expander to Flat Closure

I was devastated to lose my reconstructed breast, but I am a resilient, positive person. I hope my story helps others get through this.

• Procedures: single mastectomy, tissue expander, flat closure
• Reconstruction immediately postmastectomy: no
• Years of procedures: 2021, 2022
• Age: 35 years old
• Race or ethnicity: Black/African American

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My diagnosis

In 2013, I had surgery to remove a papilloma (a noncancerous tumor) from underneath my right nipple. Fast-forward to February 2021, I found a few more lumps in my breast that were pretty large, including one the size of a golf ball.

I monitored it but never saw a rash or redness, so I thought it must be a larger papilloma. It was in the same spot as the first one, right under my nipple.

I didn’t see a doctor for at least 5 months until my co-workers told me I seemed to be losing weight. I started thinking about the lump, scheduled a mammogram, and noticed another textured lump in the same breast. That’s when I knew it might be more serious.

After the mammogram, my doctor called me back for an ultrasound. The tech went over the area multiple times, so I knew something was probably going on, but they didn’t want to tell me yet.

Next, I had a biopsy, and they tested both tumors. A week or 2 later, I got a phone call from the radiologist. He said, “I’m sorry to inform you that both tumors tested positive for cancer.” I was diagnosed with stage 2 invasive carcinoma in March 2021.

Starting treatment

I had 12 rounds of chemotherapy from the end of April through September, but chemo didn’t help. Both tumors continued to grow.

I didn’t qualify for a lumpectomy, so I had a single mastectomy in October with the tissue expander placed in my chest at that time.

After surgery, I had a PET scan, and they found residual cancer in my pectoral area that was too deep for surgery.

I was originally supposed to have 20 rounds of radiation, but my doctors increased it to 35 rounds after finding the residual cancer. I began radiation in December 2021 and sometimes had to go twice in one day because of holidays.

Having to get back on the table for every appointment was emotionally and physically exhausting. I almost didn’t want to do it anymore.

There was pain. My radiation oncologist told me I would burn, but not that badly. I burn-burned, like third-degree burns.

I never stopped working

Throughout my entire treatment, including chemotherapy and radiation, I kept going to my job at a surgery center. My doctor told me I could, so I told myself to keep going.

“Don’t let this defeat you,” he said. “Don’t sit in the corner and let this take over. If you want to work, then work. If you don’t want to work, then don’t.”

I used a makeshift abdominal gauze pad to cover my burn wounds. I taped up my chest because it hurt when it rubbed against my clothes.

After work, I came home to release and cry. Sitting in my bed at night, I had a heaviness weighing on me. It was a lot to deal with, and radiation was very hard.

But work helped me get through everything. I have a community of friends at work and at church, and they helped me through it.

Everything felt more serious during radiation because, at that point, my diagnosis was stage 3. They removed 19 lymph nodes from my right underarm, and some of them tested positive for cancer. I sighed — it was a never-ending story.

Complications with my tissue expander

I had to heal before getting my expander filled. My skin and muscles were tight from radiation, and my skin was discolored.

My doctor started filling the expander in August 2022, but I was in a lot of pain. In October, he noticed it was filling up toward my chest wall instead of outward like a breast. I had a little scab toward the bottom where my breast used to be.

He examined it and said, “This looks infected. We need to take your expander out right now.”

I delayed surgery while trying to figure out my work schedule, and it grew from a small scab to a hole in the side of my breast where the tissue expander was. I was in extreme pain and started having a fever.

One morning, I couldn’t get out of bed, and my aunt took me to the hospital. The doctors called my surgeon because I was septic. They gave me antibiotics, and I had emergency surgery a few days later.

I thought, “Here we go again, another bump in the road while I’m trying to close this chapter of my life.”

It was devastating to lose my breast. As women, breasts are part of our body. My hopes and dreams for the reconstruction were wiped away because I had an infection.

Today, I’m still healing from the aftermath of chemotherapy, radiation, and multiple surgeries, which have left me with a frozen shoulder and lymphedema in my arm. I also have a lot of scar tissue from the mastectomy, radiation, and tissue expander removal.

I could qualify for DIEP flap reconstruction surgery in the future, but I haven’t found a surgeon for that yet.

What I want others to know

Of course, this wasn’t the journey I expected to be on. It all happened so fast. But I’ve grieved the loss of my reconstruction.

I’ve always been a positive person, and I’ve learned to embrace change — I have multiple sclerosis, too. I hope that sharing my story helps someone else with whatever they’re going through.

My advice is to do your research. I had a really good surgical oncologist, and that was a key part of my experience.

Many people choose the first surgeon their oncologist recommends, but you’re not stuck with that doctor. You’re allowed to do your own research before you make a decision about who you want to do your surgeries. It’s your body and your life.