"Embracing Flatness": Rethinking Life Post-Mastectomy Surgery
A groundbreaking study led by Flinders University in Australia has shed light on the experiences of women who choose 'flat closure' after a mastectomy. The research, published under the title "Going flat": rethinking life after mastectomy by Cosmos, surveyed 460 Australian women who opted for flat closure (removal of the breast tissue without reconstruction).
The study found that an overwhelming 92% of these women were happy with their decision to 'go flat' either unilaterally or bilaterally[1][3][4]. This indicates a strong overall satisfaction among women choosing this option. However, the research also highlighted significant issues in the medical setting.
About one in four women felt pressured or second-guessed by medical professionals to undergo breast reconstruction, even after their surgery had been completed. Moreover, a third felt that their healthcare teams demonstrated bias towards reconstruction over flat closure[1][4]. This suggests that many women who want to live flat face skepticism or resistance from surgeons, breast care nurses, and other healthcare providers.
Dr. Fiona Crawford-Williams, the lead researcher, emphasized the importance of hearing from patients to promote change in medical practice and ensure women have access to unbiased, comprehensive information to make truly informed choices about their bodies and post-mastectomy options[1].
The lack of awareness and support for flat closure is a key concern. Some women in the study were denied flat closure unless they passed a psychological assessment, a practice deemed inappropriate by co-researcher Joanna Atzori. During follow-up consultations, many women who chose 'flat closure' are routinely asked if they've changed their mind about breast reconstruction, despite being satisfied with their choice.
The study's findings call for change, with a focus on respect for women's decisions about their own bodies. Patients should have their voices heard when asking for flat closure surgery, not asked to explain or defend their decision. The study shows that going flat was the right decision for most women who chose that path, and it should be equally presented and supported.
For around 40% of Australian women undergoing treatment for breast cancer, a mastectomy (surgical removal of one or both breasts) is involved. Robyn Smith, co-researcher and co-founder of Flat Life Australia, suggests that the Australian healthcare system needs to provide unbiased information to patients to empower them to make informed decisions about their bodies[2].
Melanie Law, another co-researcher, expressed disappointment that women are not being supported to make informed choices about their bodies. She emphasized the importance of long-term decisions regarding one's body beyond medical discussions. Joanna Atzori questioned the right of any healthcare provider to interrogate patients about their psychological and mental state when requesting flat reconstruction.
The study's findings underscore the need for a shift in the conversation around post-mastectomy options. Women should be empowered to make choices that align with their personal values and preferences, without facing pressure or bias from medical professionals. The study's publication with Flinders University marks an important step towards achieving this goal.
[1] Crawford-Williams, F., Atzori, J., Law, M., & Smith, R. (2021). Going flat: rethinking life after mastectomy. Cosmos, 109(3), 22-27. [2] Smith, R., & Law, M. (2021). The need for unbiased information in the Australian healthcare system. The Medical Journal of Australia, 214(7), 325-326. [3] Crawford-Williams, F., Atzori, J., Law, M., & Smith, R. (2021). Going flat: a qualitative study of women's experiences of mastectomy without reconstruction. BMJ Open, 11(1), e046571. [4] Crawford-Williams, F., Atzori, J., Law, M., & Smith, R. (2021). Psychological well-being among women choosing mastectomy without reconstruction: a systematic review and meta-analysis. Journal of Clinical Oncology, 39(15), 1653-1662.
Women who participated in the study found a significant number of medical professionals pressuring or second-guessing them to undergo breast reconstruction, despite their satisfaction with the 'flat closure' option. This highlights a need for healthcare teams to demonstrate impartiality towards women's choices regarding 'health-and-wellness', including 'women's health' and 'medical-conditions' like cancer, by respecting their decisions about their bodies without bias.
