By Stephanie Pollard

The day in 1997 that Yvonne Francis-Lawrence found out she was pregnant, was also the day she was made aware that death loomed precariously close. As she processed the news that a life was growing within her, Francis-Lawrence’s doctor told her, “You have breast cancer.”

Only one thought occurred to the mother-to-be: “‘I’m going to die.’ That’s what went through my head first.” Francis-Lawrence’s doctor quickly scheduled a lumpectomy, a procedure during which only the cancerous lump and tissue are removed. The decision to forgo radiation treatment was made to shield the baby from any harmful side effects.

Six years later, a mammogram detected microcalcification, an abnormality of small deposits of calcium on the same breast. “They made an incision on the area and found that it was the same cancer,” she says. “Based on the measurements on my sampling, they decided that they didn’t catch enough of the cancerous tissue. The recommendation was that I do a mastectomy.”

At the same time, the surgeon suggested reconstructive breast surgery, a cosmetic procedure that is aimed at giving patients two balanced, symmetrical breasts. It usually occurs at the same time as the mastectomy, but patients can choose to have reconstructive surgery at a later date.

Breast implants or the use of living tissue taken from another part of the patient’s body are the two main methods of reconstruction. Patients also have the option of preserving the outside skin and nipple taken from their breasts during the mastectomy and using it in the reconstruction process. In Francis-Lawrence’s case, the surgeon suggested that reconstructive surgery be performed at a later date, as there was a risk of the cancer being inside the skin.

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Breaking the silence about breast cancer

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Ultimately, however, Francis-Lawrence decided on a double mastectomy without reconstructing her breasts.
“At the time, my decision not to do reconstruction was based on two things: First, it would have been costly. My concern was that if I dropped dead, I needed to make sure I left sufficient funds for my son. Then, I spoke to a friend who had gone through reconstruction. She was explaining the process they use for reconstruction after they remove all the tissue, like in my case, and I said, ‘Hell no!’”

Francis-Lawrence’s reaction is understandable. If a patient has all the breast tissue removed during the mastectomy, the surgeon inserts a bag under the flat skin (where the breasts used to be) and gradually fills the bag with saline, forcing the skin to stretch to accommodate the implant or tissue from another part of the body. “I decided not to go through the pain. I just ruled it out,” she says.

Francis-Lawrence believes that the decision whether or not to undergo reconstructive surgery should be entirely up to the woman who faces both the risks and rewards. “It is an absolute personal decision,” she says. “It didn’t matter to me that I didn’t have a physical breast. A prosthesis was good enough.” But, she does admit there were repercussions to the double mastectomy. “I do (feel like less of a woman),” Francis-Lawrence says. “It’s becoming less of an issue now because I’m no longer married. But when I was, it was always in the back of my head.”

Despite the sensitive topic, Francis-Lawrence encourages women with breast cancer to talk to their partners before having any procedures. “I didn’t factor my ex-husband into the decision to take my breasts off,” she says. “I think I was a little selfish, but it’s my body. I would tell women not to make a unilateral decision without your husband, have that discussion with him. But at the end of the day, it comes down to what you’re most comfortable with.”

Seven years later, Francis-Lawrence leads a healthier lifestyle and takes things of a medical nature one year at a time. Despite her health battles, Francis-Lawrence says that she believes she made the right choices and that the proof of her belief lies in one simple fact: “I’m still around.”

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