In October, Dawn Romano will have her 12th surgery since her double mastectomy in February 2016. She hopes this one is her last.
Romano, 53, is a two-time breast cancer survivor. Her first diagnosis led to 33 rounds of radiation. Eight years later, her skin was so damaged it refused to heal after her mastectomy. Through many surgeries, she’s had infections, implant replacements and, most recently, fat grafting to even out her breasts.
Despite all of the complications, she’s still fighting for the reconstruction she wants.
“My goal is to be able to go into a store and buy a bra like a normal woman and not need a prosthetic or have lots of extra space,” she says. “My surgeon always jokes about how no woman’s breasts are twins, they are sisters. I used to joke back that mine weren’t even next door neighbors. It’ll never be perfect, and I don’t expect that, but I’d like to be able to do as much as I can.”
Romano is an example of what breast cancer survivors go through to reclaim their feminine figure. For some women, reconstruction is the only way to feel normal again; for others, implants will never feel normal.
Dr. Jamie Wagner, a breast surgical oncologist at the University of Kansas Medical Center, says breast reconstruction is a big decision — the process takes 12 to 18 months to complete — but not everyone is doing it for the right reasons. Patients, she says, get bogged down by the opinions of loved ones and society alike.
“Everybody wants to give an opinion, but the only opinion that matters is the patient’s,” Wagner says. “Sometimes opinions get so strong that patients lose sight of the fact that it’s not their own opinion.”
No cancer diagnosis is easy, but Wagner says breast cancer has added layers of difficulty because of society’s view on breasts and what a woman’s body should look like.
“Breast cancer in and of itself is a social disease because of what the breast is on a woman’s body, as far as the original intent from nursing,” she says. “What it has become from a societal standpoint, because of that, it has so many layers of impacting women with breast cancer.”
A patient’s decision, Wagner says, can also be limited by how healthy she is and how her treatment is going. In Romano’s case, reconstruction has been a difficult process because of the intense radiation she underwent.
“I thought I had healed beautifully, but you don’t see the damage that radiation does from the inside,” she says. “The last one or two sessions, they just concentrate a whole lot of radiation in the one certain spot. There’s lots of scar tissue, and your skin is not as elastic.”
Romano is seeking more “normal” breasts, but she doesn’t believe they’ll ever look or feel like they did before cancer.
“I try to get my body as close to normal as I can because every single day I look in the mirror, I see cancer,” she says. “My hair has grown back, but I still see cancer, my scars, the fact that my clothes fit differently … Once you have cancer, there is no normal again.”
On the flip side, breast cancer survivor Jennifer Raymo gave up on her implants and had them removed on June 3, 2019.
Raymo, 39, was diagnosed with breast cancer on September 26, 2017. She had a double mastectomy before going through chemotherapy and radiation. Like Romano, Raymo had a surgical incision that didn’t heal completely.
“I was starting to get headaches and was overall not feeling good,” Raymo says. “I then decided that it wasn’t going to get any better.”
Raymo agrees that societal views of breasts play a part in women choosing to have reconstruction, and she doesn’t believe people on the outside are always advocating for the right thing.
“Society brings this view to save the breast,” she says. “You see ‘save second base’ and ‘save the boobies.’ That’s not what it’s about — it’s saving the person.”
Raymo says she’s happy with her decision to embrace a flat chest and finally feels like she can heal — but that’s just her story. She says every woman should do what will help her heal, too.
“It’s important for the women coming out of a breast cancer diagnosis and treatment to do whatever they can do to feel the best for themselves,” she says. “Whether it’s going through that whole reconstruction process to try to feel normal like they had prior to it or accepting that new normal, it’s what is best for them and their mental health.”