“I don’t know if I can do this,” I stammered through tears. The IV tugged on my hand as I clutched my iPhone to my ear and listened to my friend try to wade through my panic and calm me down.

The paperwork was signed and the clock was ticking.

The cotton curtain that had been pulled around my pre-op bed offered no sound protection, so I could hear the nurses talking to each other about me, frustrated that I was holding up their day.

The longer I laid there sobbing, the longer the OR remained empty, and the more delayed every surgery after me became. But I just couldn’t calm down.

I had been through this surgery before, and that was part of the problem. Having spent the previous year going through grueling treatment for stage 3 breast cancer, I had already endured a single mastectomy, so I was a little too familiar with just how difficult this surgery and recovery was.

Now I was cancer-free (as far as we knew), but I had decided that I wanted to preventively remove my healthy breast to minimize my chances of ever getting a new primary breast cancer again, thus minimizing my chances of repeating the hell that was treatment.

So here I was, ready and prepped for my second mastectomy.

It was never “just a breast.” I was 25 years old. I didn’t want to lose all sensation, to grow old and forget what my natural body looked like.

While I was already under anesthesia, my surgeon also planned to finish reconstructing my cancerous side. I still had my tissue expander in, which sat under my pectoral muscle and had slowly stretched out my skin and muscle, eventually creating a big enough cavity for a silicone implant.

I was desperate to get rid of the concrete-like expander that sat far too high on my chest. Of course, since I was opting for a prophylactic mastectomy as well, I’d then have to repeat the expansion process on that side.

Eventually, though, I’d finish the whole ordeal with two comfortable silicone implants that contained no human cells to cluster together into a tumor.

Still, the night before this second mastectomy and tissue expander/implant switch out, I hadn’t slept at all — I kept looking at the clock, thinking I only have 4 more hours with my healthy breast. 3 more hours with my breast.

Now it was go-time, and as the tears flowed down my cheeks, I struggled to catch my breath. Something deep down was screaming no.

I didn’t understand how I had ended up there, sobbing, unable to let the nurses wheel me into the OR after spending a year journaling and soul searching and talking over the decision with my loved ones.

I had truly believed that I was at peace with having a second mastectomy — that this was for the best, that this was what I wanted.

Was I simply not strong enough to go through with it when push came to shove?

I realized that making good decisions is not always about doing what’s best on paper, it’s about figuring out what I can live with, because I’m the only one who has to go to bed and wake up every day living with the consequences of that decision.

On paper, a prophylactic mastectomy made complete sense.

It would reduce — but not eliminate — my risk of developing a new, primary breast cancer. I would look symmetrical, rather than having one natural and one reconstructed breast.

However, a new primary cancer was never the biggest danger for me.

It would be awful to go through treatment again should I develop a new cancer, but it would be more problematic if my original cancer recurred and metastasized, or spread beyond my breast. That would threaten my life, and a prophylactic mastectomy would do nothing to reduce the odds of that happening.

Plus, a mastectomy recovery is difficult and painful, and no matter what anyone told me, my breast was a part of me. It was never “just a breast.”

I was 25 years old. I didn’t want to lose all sensation, to grow old and forget what my natural body looked like.

I had already lost so much throughout treatment — cancer had already taken so much from me. I didn’t want to lose more if I didn’t have to.

I was paralyzed with confusion and indecision.

Eventually I heard the familiar scratch of metal on metal as the curtain swung open and my plastic surgeon — a warm, kind woman with a daughter my age — walked in.

“I spoke with your breast surgeon,” she announced, “and we don’t feel comfortable doing the prophylactic mastectomy today. Your healing could be compromised if you go into a surgery that big, this upset. We’ll give you a few minutes to calm down, and then we’ll go ahead and replace your tissue expander with an implant — but we won’t do the mastectomy. You’ll go home tonight.”

A wave of relief swept through me. It was as if with those words, my surgeon had thrown a bucket of cold water on me after I’d been stuck in a fire, flames creeping up my body. I could breathe again.

In the days after, a certainty settled into my gut that I had made the right decision. Well, that my doctors had made the right decision for me.

I realized that making good decisions is not always about doing what’s best on paper, it’s about figuring out what I can live with, because I’m the only one who has to go to bed and wake up every day living with the consequences of that decision.

It’s about sifting through all the outside noise until I can once again hear the quiet whispers of what we call intuition — that subtle voice that knows what’s best for me, but gets drowned out by fear and trauma.

In the year of chemo and radiation and surgeries and endless appointments, I had completely lost access to my intuition.

I needed time away from the medical world to find it again. Time to figure out who I was other than a cancer patient.

So I finished my stage 3 ordeal with one reconstructed breast and one natural. I did my best to rebuild my life. I started dating again, met and married my husband, and one day I realized that inaction was a form of action.

In putting off making the decision, I had made the decision.

I didn’t want the prophylactic mastectomy. As it turned out, whether my intuition knew what was coming or not, I ended up metastasizing about two years later.

In putting off the second mastectomy, I had given myself almost two years to rock climb with friends and jump in rivers with my now-husband. I wouldn’t have been able to create those memories had I spent my time in between stage 3 and stage 4 treatment going through more surgeries.

These decisions are so individual, and I will never profess to know what is best for another person.

For another woman in the same situation, a prophylactic mastectomy might have been a critical component of her psychological recovery. For me, replacing the belief that ‘I must have symmetrical, matching breasts to be beautiful’ with the confidence that my scars are sexy because they represent resilience, strength, and survival helped me move forward.

My recovery depended more on learning to live with risk and the unknown (a work in progress) than on what my post-cancer body looked like. And at some point I realized that if I develop a new primary, I’ll get through it.

In truth, I would consent to just about any surgery, procedure, and treatment to survive.

But when my life is not at stake — when I have the chance to be something other than a patient — I want to seize it. To live unmedicalized is such a rare luxury for me, particularly now that I am stage 4.

So, when I can, that’s exactly what I want to be.


Diagnosed with stage 3 breast cancer at 25 and stage 4 metastatic breast cancer at 29, Rebecca Hall has become an impassioned advocate for the metastatic breast cancer community, sharing her own story and calling for advancements in research and increased awareness. Rebecca continues to share her experiences through her blog Cancer, You Can Suck It. Her writing has been published in Glamour, Wildfire, and The Underbelly. She’s been a featured speaker in three literary events and interviewed on several podcasts and radio programs. Her writing has also been adapted into a short film, bare. In addition, Rebecca offers free yoga classes to women affected by cancer. She lives in Santa Cruz, California with her husband and dog.