“Why I Chose A Life Without Breasts”

Sarah Coombes, one of our trustees, tells her breast cancer story to ‘Ask the Doctor’ with Dr Christian Jessen.


Slipping the red dress over my head, I feel it fall softly against my skin then I stand back and look in the mirror. Looking back at me is a beautiful woman in her thirties, with a slim figure and gorgeous curves. And even though I’m completely flat-chested, I look and feel stylish and feminine. I take a snap with my phone and upload it to my blog – to show that living without breasts needn’t mean hiding away. When I discovered a baked-bean sized lump almost hidden behind my right nipple one Friday evening I was just 35, but I wasn’t too concerned – I was young and had no family history of breast cancer.

A visit to my GP the following Monday put my mind at rest – it was probably a blocked milk duct or a cyst, I was told. However, two months later when it hadn’t cleared up, the doctor sent me to a breast clinic. ‘If it’s an infected cyst,’ he told me, ‘they’ll probably need to remove it.’

After more reassurance at the breast clinic, where I had a mammogram, ultrasound and biopsy, and they also told me it was likely to be a cyst, I returned to speak to the surgeon about having it removed. My mum had offered to come with me, but I told her that I would be fine. ‘It’ll just be form-filling –nothing to worry about,’ I said.

But when I entered the room and found another doctor and a nurse there as well as my surgeon, everything changed. ‘I’m really sorry,’ the nurse told me. ‘I’m afraid it is a nasty.’

Luckily, although my cancer was classed as ‘Stage 3, Invasive’ it hadn’t yet spread to my lymph nodes. My surgeon told me I’d need to have part of my breast removed and a course of chemotherapy, but that the outlook was fairly positive.

It was when the surgeon got a silicone implant out to show me that I began to question my course of treatment. ‘I’ll have to remove a lot of tissue, but I can use an implant to reconstruct the breast,’ she said.

I felt puzzled – I had cancer. Surely the only important thing was that I got rid of the disease? ‘Can you just remove the breast?’ I asked. ‘And take off the other one too, so I’ll be symmetrical.’

While I liked my D-cup breasts, I didn’t feel I needed them to feel feminine or sexy – I just wanted the cancer dealt with. Although the surgeon said this was possible, she advised me to take some time to think about it. ‘You’re in shock,’ she said. ‘Have a chat with the breast care nurse before you decide.’

Talking to the nurse, I explained that I didn’t want any unnecessary surgery.

‘You can always have reconstruction later,’ she advised. ‘Plus, we can give you a lovely prothesis in a bra.’

‘But why would I want to wear a bra, if I hadn’t got any breasts?’ I asked, perplexed.

‘You really need to think about this carefully,’ she advised. ‘If you decide to live flat, you won’t be able to find any nice clothes.’

Confused, I rang my boyfriend when I got home. ‘Maybe I am in shock,’ I told him. ‘Maybe I should go for reconstruction?’

‘The thing is,’ he replied. ‘They might have treated a lot of women, but they don’t know you.’

A week later, I had a double mastectomy. I was in surgery for just two hours and was discharged the next day. After a course of chemotherapy, I was given Herceptin injections and now take tamoxifen. In January 2016, I was finally told there was no evidence of
disease. ‘Do you want to reconsider reconstruction?’ I was asked again. But I didn’t. I am happy in my skin, and don’t feel I’m missing anything.

Of course, I can understand why many other women opt for reconstruction or prothesis, but women should not feel they have to undergo reconstruction to live a normal life. Walking into a clothes store post-mastectomy was daunting – and there was little advice to help on the internet. To try to redress the balance, I started a blog called Flatter Fashion sharing my journey with others finding their style postmastectomy.

As a result of my blog, I was contacted by a support group called Flat Friends – and am now one of the charity’s trustees.

It took a while to find my style– I used to have to brace myself when I went into shops, and grab handfuls of clothes to try on in the changing room. I didn’t want to wear specialist clothing, which is all about disguising the fact you don’t have breasts. Instead, I found ways to create flattering looks, by working with ruffles and other details, and different fits.

Once in a while, I’ll have a bad day – as we all do – and feel self-conscious in what I’m wearing. Occasionally, I feel as if people are looking at me. But most of The time, I’m just me – my chest is part of me and I don’t think about it.


Sometimes reconstruction is carried out at the same time as breast cancer surgery, although some patients choose to delay this additional procedure, or are advised to delay it for health reasons. If a large growth has been removed, or in the case of mastectomy, reconstruction may involve insertion of an implant. It can take several operations to achieve the desired results.

For those who decide not to opt for reconstruction, or have been advised against it for health reasons, protheses can be worn, if desired.

Some patients choose to have both breasts removed and to ‘live flat’. For more on this option, visit the following websites:
flatterfashion.co.uk, flatfriends.org.uk


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