Options for People with Breast Cancer
- Jamie Kastelic and Katie Fink of Michigan are working to empower other people who choose not to undergo reconstruction after surgery for breast cancer and educate them on their options. They both ended up having aesthetic flat closure, which is a type of surgery that rebuilds the shape of the chest wall after one or both breasts are removed.
- Many women develop breast cancer every year, and the disease is the subject of much research. There are many treatment options out there, but treatment paths depend greatly on the specifics of each case.
- Breast reconstruction after a mastectomy is up to you. There’s no right or wrong answer, but it’s important to know you’re not alone no matter what you choose to do.
Jamie Kastelic was just 32 years old when she found a lump in her breast. She knew it was breast cancer before she even had her diagnosis confirmed and immediately wanted to go forward with a mastectomy and reconstruction. Unfortunately, the reconstuction did not go as planned.Read More
Even still, her plastic surgeon encouraged her to try again with reconstruction at a later date.
“My plastic surgeon was like, ‘Come back in three months. We’ll just start over again,’” Kastelic said. “And I said, ‘I will never do this again. I am done. This is it. I am never putting my body through this again.’”
Similarly, Katie Fink also planned on a successful reconstruction surgery after a mastectomy. Her breast cancer, invasive ductal carcinoma, was found during a breast reduction surgery in 2016.
“I was told, ‘You’re so young, you’re active, you’re so healthy. You’re going to be fine [with breast implants],’” Fink said.
Sadly, her reconstruction didn’t go as she had hoped either.
“I had seromas (masses or lumps caused by a buildup of clear fluid in a tissue, organ, or body cavity), hematomas (pools of mostly clotted blood that forms in an organ, tissue, or body space),” Fink said. “I went into the emergency room a few times to have my breasts drained because they were swelling.
“In the course of three months, I had gone into the ER two times, three times. I was in so much pain.”
In a similar fashion to Kastelic, Fink, too, knew she wanted nothing to do with reconstruction.
“I’m done. I’m done,” Fink recalled feeling. “I just want these out of me. I’m not doing this anymore. I can’t take this anymore.”
But from there, both women found confidence and beauty with an option they hadn’t considered before: aesthetic flat closure.
Advocacy for Aesthetic Flat Closure
Aesthetic flat closure has gained traction in recent years as a more common option for people to consider following a mastectomy. The National Cancer Institute defines aesthetic flat closure as “a type of surgery that is done to rebuild the shape of the chest wall after one or both breasts are removed. An aesthetic flat closure may also be done after removal of a breast implant that was used to restore breast shape. During an aesthetic flat closure, extra skin, fat, and other tissue in the breast area are removed. The remaining tissue is then tightened and smoothed out so that the chest wall appears flat.”
Both Fink and Kastelic are now working to educate others about aesthetic flat closure and promote acceptance of ‘flatties.’
Fink is known on Instagram as “@theflatadvocate” and often posts pictures of her rocking a flat chest. She also serves as treasurer of the nonprofit Flat Closure Now which is “shining a spotlight on aesthetic flat closure.”
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“All reconstructive options have to be given. All of them have to be given with the same emphasis and the same knowledge and the same information for a woman to sort through, for a person to sort through,” Fink said. “(Aesthetic flat closure) is a normal, beautiful, healthy option that should be normalized.”
Kastelic also turned to advocacy after she did a photo shoot with an exposed, painted chest.
“I contacted a friend and I asked her if she would paint my chest. She said yes. I looked in the mirror during that photo shoot and I was like, I can do this. I can rock this flat chest and it’s going to be fine,” Kastelic said.
And for Kastelic, it’s not about getting rid of reconstruction or any other options, but showing people with breast cancer how many options they really do have. She has custom breast prosthesis that sometime she decides to wear and sometimes she decides to nix altogether.
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“You do have options,” Kastelic added. “I knew I would never go through the surgeries again, but I did want to have options. So for me, custom breast prosthesis, it’s kind of like wearing earrings, it’s like an accessory. I have customs on right now and I still have cleavage, so how cool is that?”
“You can still be beautiful and you can still rock your flat chest and be fine with that,” Kastelic said.
Understanding Breast Cancer
Many women develop breast cancer every year, but men can develop this cancer too – though it is more rare, in part, due to the simple fact that they have less breast tissue. But, thankfully, breast cancer has been the subject of much research.
There are many treatment options for people with this disease, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor – can help identify the unique features of the cancer and help personalize treatment.
“These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells,” Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, previously told SurvivorNet.
One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, hence why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.
Implants After Surgery? You Have a Choice.
Many breast cancer survivors choose to get reconstructive surgery after a mastectomy – the removal of their breast(s). But it’s also important to note that more and more women are choosing to go “flat” and not get implants.
Every woman’s breast cancer battle is unique to them. And the good news is that it’s your decision what to do whatever you think is best for your body with the guidance of your medical team, of course.
There are many reasons some women choose to “go flat” after surgery by forgoing breast reconstruction. One of which is simply to be done with surgeries. Some, on the other hand, may want to simply stick it to conventional beauty standards. No matter what the reason, there’s many people on both sides of the equation.
“A lot of us women are sticking together and helping each other through this journey of being this new look,” artist and survivor Marianne Cuozzo previously told SurvivorNet. “We’re trying to make it so that it’s not this stigma.”
Cuozzo wanted to share her story to help others. But she had no idea how many women she would touch.
“I’ve helped a lot of women that I had no idea that I was helping,” she said. “I do a lot of photo shoots showing my scars, and I didn’t realize the reaction. And then all of a sudden, I’m sharing this with other people and they’re seeing this and encouraging them to take another step of maybe don’t get reconstruction.”
“Just remove your breasts,” she says, “go flat, feel good about yourself.”
Contributing: Marisa Sullivan