When I was recovering from my preventive double mastectomy, I was prepared for many things. I’d packed dozens of items I anticipated I’d need. I rented an Airbnb near my surgery center to make sure I was comfortable during recovery.
But I was unprepared for a handful of intrusive questions and comments from well-intentioned family and friends.
It felt especially difficult to respond while I was in the raw and early stages of recovery. After taking some time to reply (a boundary I learned to set), I realized that my loved ones were struggling to understand what I was going through and weren't sure how to show their support.
My hope is to share some of the things that were challenging for me to navigate post-surgery and to provide some background on why certain comments can be triggering and potentially hurtful, even when said with the best of intentions.
Most of all, I hope that this advice can help you move the conversation toward one that helps your loved one feel seen and supported while going through a mastectomy.
If somebody you know is preparing for or recovering from this surgery, here are a few things I’d recommend you avoid saying — and a few helpful things to say instead.
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1. I Had a Breast Augmentation — I Can Definitely Relate
This comment may have good intentions behind it (the person is trying to relate), but in my experience, it is best not to compare a breast augmentation to a mastectomy. They are entirely different surgeries with very different recoveries.
A breast augmentation is a cosmetic procedure in which an implant is placed in the breast. A mastectomy surgery is a more complicated and invasive procedure in which all the breast tissue is removed from the chest to treat breast cancer or reduce a person's risk.
Following a mastectomy, there are a few reconstruction options to choose from if one wishes — implant-based reconstruction (which can sometimes be done immediately, or else in a consecutive surgery, after a chest expansion process), or fat and tissue transfers from various parts of the body.
Try instead: How are you feeling about the surgery and (or) reconstruction?
2. Congrats on Your New Boobs! How Big Did You Go?
For all the reasons mentioned above, it’s best to refrain from terminology that treats a mastectomy or breast reconstruction surgery as a cosmetic procedure. For me, personally, I was grieving the loss of a part of my body and coping with the aftermath of a major surgery (ahem: hormones, nerve pain, constant tenderness, chest tightness, night sweats, and weight gain), all of which contributed to me feeling uncomfortable in my body. A mastectomy is something nobody wants to have to do, and referring to it as “getting new boobs” severely minimizes the emotional and physical recovery required.
Try instead: How has it been, adjusting to your body post-surgery?
3. Do You Not Care About Breastfeeding?
This question, although perhaps well-meaning, can be triggering for someone who’s had a mastectomy or cancer diagnosis, or someone who is considered at high-risk of breast cancer. Since a mastectomy surgery involves removing all breast tissue, including the milk ducts, it is not possible to breastfeed afterward.
As someone who’s been considered high-risk for breast cancer for most of my life because of my family history, breastfeeding has always been a complicated topic. My mom’s breast cancer was misdiagnosed three times because she was breastfeeding my younger brother at the time. She passed soon after she was finally diagnosed, and I know her biggest regret was not being able to see her children grow up.
In making my decision to have a mastectomy, I accepted that I am choosing to do everything possible to be around for my family in the future. Although I’m grateful for the option to act preventively, it’s still a loss of something that can bring on tinges of sadness. Also, why do we all care so much about others' decisions or ability to breastfeed or not? Fed is always best!
Try instead: What would you like to talk about? What would you like to not talk about?
4. Was Surgery Necessary? Aren’t You Too Young?
No matter how old or young someone is, their decision to have a mastectomy surgery is one they’ve decided is best for them — often after painstaking research and consideration of all their options.
Try instead: Clearly this was a huge decision that you had to make. Do you feel comfortable sharing more about it?
5. Can I See Your Chest?
Nope, nope, nope.
If there was no context for you to see someone’s chest before surgery, don’t assume it’s okay to ask to see someone’s chest after surgery. There are a lot of mental and emotional barriers to accepting your body post-surgery, and questions like these can make it much more difficult to do so independent of other people’s opinions.
Try instead: How are you feeling about how things are healing, or do you prefer not to talk about that?
6. Are You Worried About Breast Implant Illness?
Although breast implant illness is a very real concern, this question can come off as a bit insensitive, especially if someone already has had surgery with implant-based reconstruction. This is likely something the individual has thought about or has been informed about by their surgeon when weighing their surgical options.
If you're genuinely concerned that this may not have been addressed, you can try rephrasing and coming from a place of wanting to learn more about how the person made their decision.
Try instead: I would love to support you however you need it, I’m just struggling to know the right questions to ask. What would be helpful?
7. Doesn’t It Feel Good to Never Have to Wear a Bra Again?
This question is frequently asked but is completely dependent on the type of reconstruction (if the person opted for reconstruction at all — some don’t). For example, I had direct-to-implant, over-the-muscle-based implant reconstruction and was instructed to always wear a supportive sports bra to prevent implant flipping. Yes, even while sleeping!
Try instead: I know your mastectomy surgery was a little bit ago, but I didn’t know the right thing to say at the time. Do you want to talk about it?
8. Aren’t You Happy to Never Have to Think About Cancer Again?
No matter what someone’s reason for having a mastectomy was, they’re probably still going to think about cancer and their cancer risk. Yes, a mastectomy can significantly reduce the risk of a breast cancer diagnosis or recurrence, but there is no guarantee. Plus, someone who carries a gene that puts them at higher risk may be at elevated risk for other cancers.
This is a truth that is top of mind for anyone who’s been impacted by cancer and one that I can certainly vouch for. Assuming someone is in the “clear” or “on the other side” can minimize their feelings about the trauma of a diagnosis or having to make high-risk decisions.
I feel extremely grateful to have been able to have preventive surgery to significantly reduce my breast cancer risk, but there are still breast screenings, ovarian cancer screenings, and colon cancer screenings that I have to do regularly because of my gene mutation and family history.
It’s always important to say something rather than nothing. If you’re doubting how to ask someone you love about something — just tell them that! I personally loved it whenever somebody would come from a place of wanting to learn more.
Try instead: How can I show support to you right now?
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