In highly emotive scenes last week, TV presenter Julia Bradbury tearfully removed her robe to reveal her bare torso covered in lines from a black marker pen.
Each had been carefully drawn onto her skin to guide the surgeons who would be performing a mastectomy on the 51-year-old mum-of-three, after she received a breast cancer diagnosis last year.
Julia’s journey has been documented in her new series, Julia Bradbury: Breast Cancer and Me, where she poignantly explored the process of receiving her diagnosis, and her treatment for breast cancer.
With over 50,000 people diagnosed with breast cancer in the UK every year, according to Breast Cancer Now, more than 15,000 women in the UK undergo a mastectomy operation.
The charity adds that around 4,000 women in England elect to have reconstruction after mastectomy, but making this decision can be difficult and complicated because there are numerous, complex options.
We speak to three women who made the decision to have the operation, to find out how the major surgery changed the perception of themselves and their bodies.
Julia Bradbury explored her journey in her new documentary: Breast Cancer and Me (Picture: ITV)
My scars tell a story
Joanne Knight is 46 and lives in Devon, Kent. She works as an assistant in a bridal boutique.
In 2017, I found a lump that I thought could have been a bit of scar tissue, but it just didn’t feel right. I delayed making an appointment, but eventually I saw a doctor, who put me on a fast referral. After seeing a consultant and having a mammogram, I was told just 10 days later it was breast cancer.
My whole world came crashing down around me. My mum, who came with me, started crying, but I just went numb. I immediately asked my consultant when I could have a mastectomy. In my mind, I just wanted to get the tumour out. Because I’d struggled with my boobs all my life, I didn’t have that sort of relationship with my boobs that some women do, where they’re desperate to save them. They were the bane of my life and I just wanted rid of them.
Jo was diagnosed with breast cancer in 2017 (Picture: Jo Knight)
I always hated my bigger boobs. I was a JJ cup, and then after I had my daughter Florence, who is now 15, I went up to a K cup, and they were very pendulous and heavy – that’s when I started to hate them with a vengeance.
In 2011, I decided to get a breast reduction, bringing my boobs down to a DD. I had so much more confidence. I loved being able to go to M&S and buy normal dresses and bras that didn’t cost over £40 a pop.
While my aunt had had lymphoma and my father had prostate cancer, breast cancer was never on my radar. I did regularly check my boobs, and after the reduction, I had lots of lumps, bumps and scar tissue.
Because of the location of my tumour, which was around 5cms, I had to go through chemotherapy first before I had any surgery, to shrink it. Once that was finished in October, by December, I was ready for my mastectomy.
Jo was happy to have a double mastectomy (Picture: Jo Knight)
I asked for a double mastectomy – which the consultants were reluctant to do, as my other breast was healthy. I was partly afraid of recurrence. I couldn’t live with the fact I may have another boob there, a vessel which could see the cancer reoccur. I just thought, if my boob isn’t there, I’m not going to be worrying. And aesthetically for me, I didn’t want to be left as a ‘uniboober’. I didn’t want to be left with one boob and having to wear a prosthetic on the other side, as I would have to wait for a period of time to have a reconstruction.
I wasn’t too scared about the double mastectomy, having had a breast reduction before. I wanted that surgery. I wanted it done and I wanted that tumour out of my body. I did get a little bit tearful as I walked down to the surgery, and felt ‘oh my God!’, but I knew that this had to happen.
The surgery was quick – three hours in total, or 90 minutes per boob. I was very tired, drowsy and sick after the surgery, so myself and Florence moved in with my parents as I recovered. I had a drain on either side of me to remove excess fluids, and my parents would cook and clean for us as I rested. After 10 days, I’d recovered enough to go home with Florence. It was a slow process, but I learned that I had to listen to my body while it recovered.
Jo said seeing her post-op body was ‘a relief’ (Picture: Jo Knight)
The first time I took my shirt off, I cried with relief. It was that feeling of, ‘the boobs are gone, the tumour has gone.’ With my torso, I felt relief, not horror. I felt, ‘Look what I’ve come through and now, I can carry on with my life. I’m still here.’
There were tears of elation as ‘I could say, I’m alive and I survived this – these scars tell a story.’
After completing my radiotherapy in February, I was given some prosthetics, which were quite heavy and uncomfortable. After going to a wedding in my prosthetics, I had a lightbulb moment: who am I wearing these for? Am I wearing them because people think this is what a woman should look like? That was a turning point for me and I stopped wearing them. I just thought, ‘I’m done with boobs.’
Jo now uses her Instagram page to help other women who have has mastectomies (Picture: Jo Knight)
It was a whole year later when I saw my consultant again, and they were surprised when I said I didn’t want to have a reconstruction. Because my breast cancer was oestrogen receptive, I decided to have a full hysterectomy as well by this point, and I just wanted to prevent ever getting cancer again. After that surgery, I just thought: no. I don’t want to put myself through it, my body through it and I don’t want to put my family through another surgery.
I started my Instagram page, @tit_less_wonder, to empower and offer advice to women after a breast cancer diagnosis, and to show that your boobs do not define you. I’ve gone from not liking my body to feeling really body confident and positive about how I look. As a woman, I’m still feminine, I can still wear a dress and I can wear clothes to suit me, and I want to show other women it is okay. There is life after breast cancer.
My body was a time bomb…I was keen to have surgery
Helen Nurse is 43 and lives in Cheshire. She works as ‘Director of Fun’ at Wonder Adventures, a children’s digital events experience company.
Helen chose to have her breasts removed after being tested with the BRCA1 gene (Picture: Helen Nurse)
If you look closely, there is a slight bump at the top of my breast, where you can see the edge of the implant, and there is a bit of rippling of the skin.
Sometimes when I lean forward, you can also see slight ‘ridges’ where the implants are but it’s not something that bothers me. My overriding emotion, when I think about my mastectomy, is that I am lucky.
My mum passed away in 2010, after a breast cancer diagnosis. A few years later, I received an email from a cousin in America telling me that she’d tested positive for the BRCA1 gene – a hereditary gene that means you have a significantly higher chance of developing breast or ovarian cancer.
Immediately, I told my sister, who is three years older than me and in 2015, we decided to go and get tested for the gene. I am so similar to my mum in every way that going in, I think I was prepared for the worst; to be told that I had it.
And I was right. After undergoing testing at the Manchester Genetic Clinic, I was informed that I had tested positive and that I had around 80% chance of developing breast or ovarian cancer before the age of 50. I was 36 at the time and they advised that I’d be best to try and have preventative surgery before the age of 40.
Helen chose to have reconstructive surgery after her double mastectomy (Picture: Helen Nurse)
The specialist recommended a double mastectomy and an oophorectomy (a procedure to remove the ovaries). At this point I had two children, who were eight and ten years old, and hadn’t really planned on having any more. But being faced with having that option taken away from me really forced me to rethink things. My husband and I decided to spend a couple of months trying to get pregnant, to see what happened. If it didn’t happen quickly, I decided I would go ahead with the procedures.
My body felt like a ticking time bomb and I was keen to have surgery as soon as possible.
However, I got pregnant the first month (with my son, Charlie, who is now five). He was born in August 2016 and six months later, in January 2017 I had my ovaries removed.
And six months after that, I had a double mastectomy.
I was in no doubt that I wanted to have the surgery – yet, of course, I still felt nervous about it. I was mainly concerned about the local anaesthetic and being ‘out under’. I also hate being in hospitals. There was a slight worry that having it would change my relationship with my body but there was never a doubt in my mind that it was the right thing to do.
On the lead up to the procedure, I was faced with lots of choices. For example, I could opt for reconstruction to take place over or under the muscle, or implants made from silicon versus fat from other body parts. Under the muscle can have a ‘smoother’ finished appearance – with less chance of seeing any ‘ridges’ where the implants sit – but I was told the operation was much more invasive, would take around twice as long and came with a longer recovery time. Fat from my body was more complicated and also a longer procedure – so I opted for the least invasive, fastest option – over the muscle with silicone implants.
Helen was keen for her reconstructed breasts to be similar to her own (Picture: Helen Nurse)
I was asked if I wanted my breasts to be bigger, smaller, or different in any way. But I asked for them to just be as close to they originally were – I suppose I just wanted to feel as much like me as possible.
During the procedure, the nipple is cut away and everything is done through that area – and I also had to choose whether I wanted them to save and use my nipple. However, there was a chance that the cancer could grow via the nipple tissue so I decided against it. Not getting cancer was more important than the appearance of my nipples.
I was quite ill afterwards and found the recovery difficult, as I’m very active. However, I was informed that if I overdid it, I’d have a higher chance of developing an infection, which could then lead to my body rejecting the implants – so I was forced to rest.
I couldn’t raise my arms above my shoulders for about three or four weeks – and I wasn’t allowed to lift anything up, including my one year old son, which was really difficult.
Helen is happy with the results of her reconstruction (Picture: Helen Nurse)
Yes, I would have rather not have had to get the mastectomy – however, I’m really happy with the results of my reconstruction and I think the doctors did a fantastic job with the shape, size and everything. I just feel really lucky to have the opportunity of getting that diagnosis and operation as a preventative measure.
I’m so grateful that I didn’t have to go through breast cancer – or having a mastectomy while being ill. My heart goes out to anyone who has had to deal with that.
The surgery has impacted how I feel about myself
Emily Chalk is 36 and lives in Bradford. She worked as a probation service officer, and is now medically retired.
Emily Chalk says her relationship with her body has changed since her surgery (Picture: Emily Chalk)
When I was first told I needed a mastectomy, I wasn’t so much worried about my body changing as I was about my whole life changing – I just wanted to do everything as quickly as possible to ensure I didn’t die.
However, there’s no getting away that it has impacted my life and how I feel about myself as a woman.
I do have low self-esteem. Since my cancer diagnosis, I have separated from my husband, the medication has made me put on weight, my hair has thinned, and I have lymphedema.
I’ve also been told that I have a life expectancy of four to ten years.
However, I try to make the best of things. I did a course the other day to help with makeup and feeling confident in your style, which did give me a bit of a boost.
Emily has struggled with her self-esteem since her surgery (Picture: Emily Chalk)
It was in 2015, that I first noticed I had an inverted nipple. But I had been breastfeeding and when I Googled it, suction cups were suggested as a way of correcting it. However, they did nothing and I decided to go to the doctor, who referred me for screening.
My mum had breast cancer years before – although it was found very early, and she had a lumpectomy, chemo and radiotherapy, which worked. But still, I was worried.
At the first appointment, they said they were sure it was cancer – and two weeks later it was confirmed. Immediately, I was overwhelmed by options – double or single mastectomy, chemo first, mastectomy first, and so on.
So, in October 2015, I opted for double mastectomy, to be followed by chemo.
To be honest, I didn’t love my breasts in the first place. They were a B cup, although the left one by the time of my mastectomy was significantly bigger, due to the cancer.
Emily has received support from Make 2nds Count, a charity that helps people affected by secondary breast cancer (Picture: Supplied)
I wasn’t able to get reconstruction at the same time, as they needed me to undergo radiotherapy first, and it would mean a much quicker recovery time to be on top form for all the treatment to follow. I had planned on having reconstruction done later.
I thought it’d be OK within the year, that I’d be a new improved cancer free version of me – but it turns out life had other plans for me.
Doctors discovered a 15cm tumour in the breast that had the inverted nipple – they also found a 2-3 cm tumour in the other one as well. I was told I had the BRCA1 gene.
I was also told that the cancer had also spread to my lymph nodes, which was terrifying to hear.
I had six sessions of chemotherapy, and ended up with sepsis and psychosis, which was caused by the combination of medication after being on steroids prior to the treatment.
Emily is hoping she will see her children grow up (Picture: Emily Chalk)
Then, in January 2016, I got another scan, which revealed that the cancer had spread to my lungs. I was given three years to live and switched to palliative care.
Getting a reconstruction was no longer an option for me – I just wanted to make the most of the time I had left.
But all wasn’t as it seemed. Towards the end of 2018, an oncologist advised me that there was a chance I didn’t have cancer in my lungs. I went to the Christie Cancer Centre in Manchester for a second opinion and they weren’t able to confirm it without a biopsy, which they weren’t willing to do. They did however advise that I should have my ovaries and fallopian tubes removed, which I did.
I was told that I was going to live – and during that time, I did look into having reconstructive surgery for my breasts, but I wasn’t able to as I’d had clotting on my lungs, so there were too many complications surrounding it.
Then, in July 2021, after almost three years of thinking I was going to be OK, cancer was found in my spine – this time it was confirmed by biopsy. I’ve since had SABR radiotherapy at Leeds (a treatment they wouldn’t have used if I’d had cancer in my lungs). That was when I was told I have a life expectancy of four to ten years, from the date of my diagnosis last year.
I’ve got a 12 year old son and an eight year old girl, and it was devastating telling them that my remaining life is limited – and they too might have the BRCA1 gene.
I just hope that I’m with them as long as possible, I hope I get to see them as adults, and – of course – I hope they don’t have the gene. If I’m lucky, I may live to see my eldest daughter turn 18, and be able to be there to support her through the BRCA1 testing process.
I want there to be more awareness of secondary breast cancer, BRCA1, and the difficult decision that people have to make. I want there to be more research, more funding.
And I want to enjoy the time I’ve got left, in the body that I have.