Trigger Warning: child sexual abuse
I’m not sure where to begin, or even how much of this story I can put into words. It is hard to imagine that anyone, even if I could adequately articulate my feelings, could understand how I came to have such conflicted feelings about something as simple as having breasts. And yet, it is a story I am compelled to tell; it is a central thread of my identity.
Except that I never really “had” breasts; it’s more like my breasts had me. Once they “showed up” people started looking at me differently. And treating me differently, and not always in a good way. Most of my life, I hated having breasts. First, because they made me feel awkward and different for not having them, and then for having them. Second, because of the unwanted attention they got me. I blamed them. I hated them. And then … well, let me start at the beginning, or somewhere close to it.
I have not always had breasts. Until puberty. Which was late, by the way, and don’t think that didn’t bother me, either. In Catholic School, when you “start to show” you have to wear a tank top under your uniform blouse, at least, that is, until you are ready for a training bra. I was probably one of the last girls in my class to have to wear either of these articles of clothing. The tank top is always obvious, so you know when “it” is happening to someone else.
Like many things in my house, my parents had never mentioned what I should do when the nuns tell me to need to start wearing a tank top, and that I should probably get a training bra. I didn’t even know what a training bra was, or what I was training for. I don’t even think my mother was around at the time. She spent a lot of that year, my 12th year, in and out of the hospital. And not the kind of hospital where you worry about something bad happening and her not coming home. It was more like the kind of hospital where you are glad she finally went away, and you worry about her coming home too soon.
So, anyway, she wasn’t around. Not that I had the kind of relationship where I could talk to my mother about anything personal like breasts, because I didn’t. Her mental illness made it difficult for her to really notice anything outside of her own experience. Which left me with my father, which was totally embarrassing. It turns out that Dad didn’t know when a girl needs a training bra, any more than I did, so he had to look at my breasts and try to guess if it was time. Just for a second. From across the room. But still, yuck!
Fast forward two years.
I am living in a foster home. I am 14 years old. My foster mother’s youngest son, “F”, who is 28 years old, has taken to teasing me in public about the size of my breasts. He nicknames me “plank” because he says I’m as flat as a board. His favorite joke is that I got in the “pits” line by mistake, instead of the “tits” line, and asked for seconds. If any of the other adults in his family think this is inappropriate, nobody challenges him on it. He makes this joke a lot in front of his kids, who are 4 and 6 years old, because they and any other kids who happen to be around, think it’s really funny.
I find these comments on my breasts completely humiliating. I become very self-conscious in school, refusing to change in the locker room with the other girls. I hate to be looked at. I take to wearing my very long hair as much in my face as possible to avoid being seen. This habit will eventually earn me the nickname “Cousin It” in high school.
In private, “F” has become obsessed with my body, with my breasts in particular. He says that I am irresistible, and that if I weren’t so irresistible, he wouldn’t have to make me “do stuff” with him. I don’t know what to do. He warns me that if I tell anyone what he is doing to me, he will go to jail. Later on, he changes his threats so that I am not protecting him with my silence, but myself. First, he tells me that noone will believe me; that I will be thrown into the street; in later years, he threatens my life.
His mother suspects that something is happening between us, my 14-year-old self and her adult, married son; she chooses to believe that whatever is happening is my fault. At the same time, she chooses to ignore what is happening. She calls me a whore, even as she pretends not to hear him coming into the house and my room at night. She refuses to let any social worker or doctor interview me privately; she lies to them about my eating habits and symptoms, even during my senior year in high school as we explore possible physical causes for fainting spells. The night before the annual hearing to evaluate my placement in her home, she threatens to have me thrown out, but during the hearing she praises me as a well-behaved and lovable child. I am so grateful that she is not abandoning me, that I say nothing when the judge asks me if there are any reasons why I should not continue living with her. I am confused and afraid and powerless.
From the minute “F” started molesting me, I stopped eating. What was happening to me, and my inability to talk about it, made me sick to my stomach. Nobody seemed to notice. But my breasts stopped growing, which was all right with me. I hated my woman’s body, in particular my breasts, and I would have done anything to be rid of them once and for all. These choices, not to eat, not to become a woman, they were not conscious choices. They seemed to be happening to me spontaneously, rather than involving any sort of internal decision process. Even as doctors were evaluating me for brain tumors because they could not locate a reason for my fainting spells, even as they were asking if I was eating, I could not connect these health problems with my starvation. I just didn’t see how one thing was related to the other.
This was the beginning of my anorexia. Years later, when people started talking about anorexia in the media, they said it was the affliction of young women who were perfectionists and who struggled with unreasonably high expectations of themselves. I did not recognize myself in that description, even though I weighed only 100 pounds at 5 feet 8 inches. I did not see myself as a perfectionist, although I recognize that in myself today. Back then, all I knew was that I hated having a woman’s body. And not because I thought I was supposed to be a man. I hated my body for the attention it got me. And I hated my breasts because they were the focal point of all that unwanted attention.
For years after the abuse, which lasted until I was 18, I was numb from my neck to my knees, literally. I would allow men to be intimate with me, but I would not feel anything during those physical acts of intimacy. I learned how to fake emotions and physical reactions because otherwise people got upset that I was not “enjoying” myself. I could only have sex if I was drunk or stoned. I selected for partners people who were so self-involved they didn’t even notice that I would dissociate during sex.
When I came out as a lesbian at 22, I wasn’t really sure how to deal with other women’s breasts, either. For a long time, I was unable to understand how any woman could derive pleasure from her breasts or tolerate anybody, especially me, paying attention to them. It was difficult to relate to women sexually, because it seemed like I was aligning myself with “F”. I had trouble seeing women, myself, my lovers, as other than victims of their sexual experiences. I could not have put this into words back then; even now, it is difficult to explain.
I finally began addressing my eating disorder and putting on weight in my mid-20s. I was no longer able to pretend that I did not have a woman’s body. I started to fill out. My breasts were one of the first areas where my weight became apparent. I almost immediately developed fibrocystic breast syndrome, which involves the development of painful cysts during certain points in your menstrual cycle. So now I not only had to live with my breasts, but they caused my physical pain as well. I hated them even more.
This was all very distressing to me, and it took years of therapy to begin to come to peace with my new body; I still work on this today. In Alcoholics Anonymous we have a saying “I don’t have to like something to accept it, but I must accept it.” This attitude worked for me when I had to face difficulties in life, and it worked for me in terms of accepting that I had breasts. My body, once I started nourishing it adequately and accepting its existence, began to lose that numbness that I had lived with for so long. I began to feel my relationships with other people, in ways that I never had before. This was both a blessing and curse. But a few more years in therapy, and it became less of a curse… more of a blessing... it took a while.
My mother was diagnosed with her breast cancer when I was 28. And even though I knew this meant that I had a higher risk for breast cancer myself, I ignored it. When my gynecologist said that I didn’t need mammograms before 40, I chose to believe her, even though I heard different opinions in the media and from friends.
In the summer of 2002, the radiologist found that suspicious area in my left breast and referred me to Dr. G. Before I knew it, I was getting a stereotactic breast core needle biopsy. Within days, I was diagnosed with a precancerous condition called atypical intraductal hyperplasia. A few weeks later, Dr. G performed an excisional or surgical biopsy to remove the precancerous area, and the pathologist found a small malignant tumor inside that precancerous tissue.
I was diagnosed with ductal carcinoma in situ (DCIS) – breast cancer that had not yet escaped the duct, or Stage 0 breast cancer. This made perfect sense to me. All of my bitterness and resentment about the sexual abuse lived in my breasts; I had blamed them all my life for that abuse. It seemed like the perfect way for them to get back at me for rejecting them all those years. Clearly, I still had work to do.
A friend recommended that I read Bernie Siegel’s book Love, Medicine & Miracles. Siegel writes about needing to live an authentic life, to love your body, to think of your body and mind as one being. Your life is stored in your body. If you have cancer in your body, you need to focus your love on the part of your body where that cancer lives.
Great! Now I had to love my breasts. Accepting their existence was not enough. And now, when suddenly faced with the possibility of losing them, I didn’t want to. Whether or not I ever liked those years of inappropriate and painful attention, my breasts had woven themselves into my identity as a woman. The idea of having them removed was very anxiety-provoking. I would do it if I had to, and I knew that it was survivable, but I was terrified by the possibility.
I was fortunate. The cancer was very early and had not spread beyond the duct. This meant that I could survive with a lumpectomy and radiation. Siegel also writes in his book about visualizing God’s love as a healing light, shining on the cancerous area. This was my daily visualization during radiation therapy. Rather than focusing on the humiliation of being laid bare on that table, and the pain the radiation caused, I imagined that the radiation was white light, the love of God, shining down on my breast. I know it sounds weird, but that’s what I did.
It worked. The radiation did anyway, because [at the time I originally wrote this essay] I remained cancer free for four years. The visualization worked, too, I think. The love that I practiced feeling for my breasts helped me in my recovery from the treatment. It’s a struggle, after being treated for breast cancer. First, there are the months it takes for the tissue in the affected breast to heal, from the surgeries, from the radiation, from the experience of having such a private part of your body being poked and prodded by medical professional after medical professional, day after day. Suddenly, that part of you is this impersonal thing, a site of disease or cure. It’s hard to incorporate it back into the rest of your body, into your intimate relationship with your partner, or to look at that part of your body in the mirror and see anything other than the scar or the fear. You have to want all of your body to exist as one; there is no room for hating any of it.
Somehow, though, the afflicted part of your body becomes one with the rest of you again. The disease has been cut out, burned out of it. I finally forgave my breasts. I could see that they were just the excuse that he used to justify his violation of me, and I accepted them as part of this womanly body that is me.
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I originally wrote this essay in the fall of 2006, four years after my first breast cancer diagnosis. In 2007, I was diagnosed with Stage 1 invasive breast cancer, again in my left breast, and it is that experience that I will be writing about for the remainder of this book. Prior to this new diagnosis, I thought I had completely forgiven my breasts for their part in the sexual abuse. When I received this second diagnosis, I was faced once again with my anger at my abuser and with the need to forgive my breasts for being the focus of his interest in me.
Because I had already received radiation therapy, I could not receive radiation again, and so my only option was a mastectomy. I had already had one biopsy of my right breast, which was benign, but I did not want to worry about finding cancer in the future, so I decided to have a bilateral mastectomy. I also opted for reconstructive surgery. After all of the work I have done to accept my breasts, I found them integral to my identity as a woman and could not imagine a life without them. As it turns out, reconstruction did not restore me to anything like my original body, but I will go into that later in the book.
My bilateral mastectomy gave me a chance to excise my abuser from my body once and for all. And although I felt more liberated from him than ever, I found myself faced with entirely new challenges around body image and sexuality. Perhaps these issues are universal for women undergoing breast reconstruction, or perhaps they are intensified for me because of my history of eating disorders or sexual abuse. Whichever is true, and as difficult as this journey may be, I face it with confidence that my body is free of cancer, and free of the stains of sexual abuse.
A core needle biopsy is a “through the skin" (percutaneous) procedure that involves removing small samples of breast tissue using a hollow "core" needle. For lumps or lesions that can be felt by hand, this is accomplished by fixing the lesion with one hand and performing a freehand needle biopsy with the other. In the case of non-palpable lesions (those unable to be felt), stereotactic (computer-guided) mammography or ultrasound image guidance is used. Stereotactic mammography uses computers to pinpoint the exact location of a breast mass based on mammograms taken from two different angles. The computer coordinates help the physician to guide the needle to the correct area in the breast. With ultrasound, the radiologist or surgeon watches the needle on the ultrasound monitor to help guide it to the area of concern. The needle used during core needle biopsy is larger than the needle used with fine needle aspirations (usually done in your doctor’s office), and has a special cutting edge.
Atypical hyperplasia is caused by a disruption in normal cell growth in breast tissue, which causes an over-production of normal-looking cells that accumulate and begin to look abnormal. These cells can develop into ductal carcinoma in situ, or noninvasive breast cancer in the milk duct. This can develop into invasive cancer, which can invade the surrounding breast tissue, lymph channels or blood vessels (Mayo Clinic).
