I had quite a large breast cancer tumour removed in March via therapeutic mammoplasty surgery, ie breast reduction. This was possible as I had large breasts, which meant a mastectomy was avoidable When I was first diagnosed last October I was told I could have the other breast reduced to balance me later. However just before my surgery the local CCG changed their policy and withdrew funding for breast asymmetry correction surgery.
My surgeon made a special application for funding for me to have the breast asymmetry correction surgery but it was rejected, mainly on the grounds that this is now considered cosmetic.
I challenged the decision with the CCG, on the grounds that the policy changed during the course of my treatment so I was not able to make an informed choice (I have since established that one of the other hospitals I could have gone to still offers breast asymmetry correction surgery).
They have reviewed my case and rejected it again. Mainly because they now deem it to be uneccesarily cosmetic but also because I have not finished treatment - true, I am about to have a month of daily radiotherapy which I understand will affect the shape of my reduced breast - but also because I do not fit into the required BMI range, one of the criteria.
This makes me despair. After 10 gruelling months of treatment including 8 cycles of chemotherapy and 2 operations I am very low. I have a bald head, broken teeth and filings that I have not been able to get fixed until I am over the chemo, lingering nausea and wobbly bowels, total brain fog, toenails that have started to go black and ooze pus, chronic fatigue etc etc. In 10 days I start a month of radiotherapy (a 3 hour round trip each day) and 10 years of Letrazole. This treatment seems never ending and I can no longer remember what normal life was like, nor imagine getting back to it.
The thought of embarking on a fitness regime to lose the 26 kg necessary to get me into the required BMI range feels like another impossible mountain to climb. It would take me at least a year, plus you have to stay at the required weight if you get there for 6 months. That means I am about 2 years away from being able to request this again - with no guarantee they will climb down from their position that they won’t fund cosmetic surgery anyway.
I feel very upset about my uneven breasts, more than I thought I would. I was a 36J and my reduced breast is about 6 cup sizes smaller. I have been given a prosthesis but it weighs a third of a kilo and is huge. I ordered a mastectomy swimsuit but it won’t fit into the pocket. However without the prosthesis to counterbalance my larger breast all my clothes skew visibly sideways.
My husband has gone to an bbq without me tonight as I simply don’t have the energy to organise a wig/hat to cover my bald head; dress to accommodate the huge sweaty prosthesis placed against my chest; and find a shoe that will accommodate my agonisly tender weeping toenails. And socialise with people who will ask me how I am, if I’m better, say the end is in sight, and/or keep telling me to be positive.
The injustice that hurst most is that If I had had a mastectomy I would be eligilbe for a reconstruction automatically - the CCG policy clearly states this. I think even for women who are overweight - does anyone know if BMI criteria apply to reconstructions? What I don’t understand and can’t accept is why a post mastectomy reconstruction is routinely funded but surgery to balance women who have had their tumour removed via a reduction mammoplasty is not. It seems inconsistent to restore mastectomy patients to normal appearance, but leave women who have had breast conserving surgery with one and a half breasts for the rest of their lives.
I have cried today at the prospect of my recovery being delayed so long while I struggle to lose four and a half stone with no guarantee I will be successful in the end.
I am told that the cost of having the surgery done privately is about £5,000 which is an awful lot for a woman who has been too ill to work during a tough year of treatment to find. The thought of gaining the confidence and fitness to go back to work part time in October is daunting enough without added pressure of fitting in a new vigorous exercise and dieting regime. Not to mention coming to terms with the newly altered reality that breast cancer can and does return in some cases. However much people try to be kind and tell me my wonky chest doesn’t matter, it does to me. I do not like to look down at myself in bed or the bath, with one newly reshaped perky small breast and one sagging huge old one, nipples very different in appearance and pointing in utterly different directions.
It seems cruel to call this cosmetic surgery as if we are unreasonable and vain. I tend to avoid going out at al at the moment, and can see this becoming the norm.
Has anyone who has had a therapeutic mammoplasty run into this problem of discovering that they can not get the surgery to correct their uneven breasts? I believe it is a national policy change so must be about to hit many women.