| Body Image After Breast Cancer |
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by Julie Goodale
Then, it turned out one of my breasts would kill me. Because the cancer had already spread throughout most of my breast, I would need a mastectomy. Initially, I thought I would not have any reconstruction. I would be a modern day Amazon - a warrior, cutting off my right breast to more easily wield my bow. In defiance, I wanted to shout to the world, “I am not my breasts!” That’s a tough statement. We live in a culture that is sometimes bizarrely obsessed with breasts. I grew up with Ginger and Maryanne, Rachel Welch, and later, Baywatch. We pore over magazines showing us every star’s body-hugging, plunging neckline fashions. And yet a wardrobe malfunction generates horrified complaints and fines because someone might have caught a split-second glimpse of part of an exposed breast. In the end, I chose reconstruction. It occurred to me that in the future I might not always feel so defiant; I might have days when I just wanted to get dressed and not be noticed. I had a free tram reconstruction, in which my belly fat and a small piece of muscle is removed and used to build a new “breast”. But since I was thin, I didn’t have enough belly to equal my other breast. To achieve relative symmetry I had a reduction on the other side. So, in one day, I went from a full 34D to a smallish 34C. OK, it’s just one cup size, not so dramatic. But, besides all the cancer issues, my profile was suddenly different. I had an image of my body: long, lean, athletic, built (chest-wise). Now it was different. I was still lean and athletic, but my chest was just average. I don’t mean to sound like I’m complaining. My beautiful breasts would have killed me; I was quite pleased to change that! And my plastic surgeon did a fantastic job – my new breasts (or my smaller breast and my “breast-like-object”) look great. But it’s definitely strange to suddenly be faced with a profile that doesn’t match your self-image. I was frequently surprised when I would catch a glimpse of my reflection in a window or see my shadow on the sidewalk. This was not the body I knew. And it was equally strange to see friends and colleagues look with surprise at my new body. For women going through cancer treatments, there are lots of programs aimed at improving self-image. There are free makeovers to help women feel good in their wigs, or with their new hair as it comes in curly, or perk up with some new makeup. These programs are great, especially to help learn how to minimize the look of no eyelashes or eyebrows after they fall out. Let’s face it, looking like a frog is never a fashion statement you want to make. But no makeup or haircut could really change how I felt about my body. I decided the best way to feel good about my new body was to stand up straight and get strong enough to continue doing all the things I love to do: playing music, rock climbing, windsurfing, skiing…. So I began the long process of stretching out scar tissue and strengthening weakened muscles. Even if I wasn’t sure just how I felt about my new profile, I stood tall and at Breast cancer surgeries often are more extensive and invasive than many cancer surgeries. Surgery causes tightness across the chest, stiffness of the shoulder, and a tendency for the shoulder to roll forward, as though to protect the area. Left unaddressed, this can result in serious problems over time, including poor posture, lack of mobility, weakness and pain. - And I don’t like pain. The process of regaining good range of motion is a process of incremental, barely noticeable change. Once your doctor gives you the OK to begin, start by gently moving your arm. Bend over and let your arm swing. At first you might only be able to swing it a few inches. Next, you need to begin the process of stretching. The wall crawl is the best stretch to begin with. Stand facing the wall. Place your hand on the wall and slowly begin crawling your fingers up the wall. Go only to the point of a slight stretch. Hold it there for at least ten seconds and slowly lower it. Remember to keep breathing while you do this. As it gets easier, stretch a little higher up the wall, or slightly change the angle of your body to the wall to increase the stretch. Always stretch only to the point of a slight pull. A slight pull is OK; pain is not! Never stretch to the point of pain. If you feel a sharp pain, stop immediately. Then talk to your doctor about it. And be patient. This is a process; it can take a while. Be patient, but be diligent. Only after you’ve regained good range of motion should you begin trying to strengthen the muscles that have been weakened. Stretching is vital to recovering from breast surgery, but strengthening is equally important. It is especially important to strengthen the muscles of the shoulder and upper back. Along with stretching the chest, strengthening the upper back will help you to stand up straight, keep your shoulders back, and open up the chest. A couple of simple exercises for the upper back are the wing pinch and Superman lifts. For the wing pinch, hold your arms at your side and bend your elbows to 90 degrees. Hold your hands, palms up, slightly wider than your body, keeping your elbows at your sides. Draw your elbows back and squeeze your shoulder blades together. An easy version of the Superman lifts can be done sitting in a chair, good for beginning strengthening after surgery when lowering yourself down onto the floor might be difficult. Sit up tall. Raise your right arm up overhead. At the same time, raise you left knee. Hold, and lower. Repeat on the opposite side. In some ways, adjusting to our new bodies after breast cancer surgery is not that different than learning to accept and love our bodies in the first place. We all have flaws, certain things about our bodies we would prefer were different; I certainly do! But part of the process of being a happy adult is learning to accept ourselves, and that’s a process that can take years. The trouble with image after breast cancer is that it’s all so sudden. Overnight our bodies are different. We’ve had some number of decades to get to know our bodies, and in a few hours they change, sometimes dramatically. What we need most is time. It took us years as adults to be comfortable with who we are; it will take time to adjust to our new bodies. But in the mean time, exercise. You’ll feel better and be a little healthier. Stand tall and proud. Even if you don’t feel that way yet, look like you do. And you might just find that, in fact, you are.
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Comments (4)
  written by girlgetstrong, September 16, 2009
Thank you for sharing your story and your awesome attitude. You are so strong - many women who haven't faced the challenges you have don't step out of their comfort zone. What you have accomplished on both your fitness and cancer journey is an inspiration to me.
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I was young, healthy, and very fit when I was diagnosed with breast cancer. I had an attractive body. I do feel awkward writing that – I think it sounds rather arrogant. But I was long and lean, and wore a 34D. My whole adult life, I got noticed.
least looked like I was proud. As I grew strong and returned to climbing and windsurfing, I did indeed begin to feel pride in my body again. 
Julie Goodale was diagnosed with breast cancer at age 37. She had a mastectomy and reconstruction. Because of the high number of positive lymph nodes, she had chemo, radiation, and then more chemo. Always an avid hiker and rock climber, she discovered that exercising actually improved how she felt and helped manage the side effects of her treatment. Just one year after finishing treatment, she climbed Mt. Rainier, 14,410’ to raise funds for breast cancer research. She followed that with trekking through the Himalayas, and two years later summiting Cerro Aconcagua, at 22,841’ the highest peak in the Western hemisphere. She felt so strongly about the benefits of exercise during all phases of treatment and beyond that she became a Certified Personal Trainer with the American College of Sports Medicine and a Certified Cancer Exercise Specialist with the Cancer Exercise Training Institute. Julie offers private training in the New York City and Hudson Valley areas, and provides online fitness information and training through her website, 
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