Patient with double mastectomy: ‘It’s not sexy; it’s not beautiful; it’s life’

When she was diagnosed with breast cancer, Gail Fewell made a personal choice – she opted for a double mastectomy – with an Aesthetic Flat Closure -- a smooth, flat chest.

By IU Health Senior Journalist, T.J. Banes, tfender1@iuhealth.org

She says it wasn’t a matter of “if” it was a matter of “when” she would be diagnosed with breast cancer, one of the most common cancers in women in the United States.

Research indicates an estimated 281,550 new cases of invasive breast cancer will be diagnosed among U.S. women this year. An additional 49,290 cases of non-invasive breast cancer are expected among women. About 2,650 new cases of invasive breast cancer will be diagnosed among men in 2021.

Gail Fewell, who turns 49 this month, knew her chances were greater than most. She was diagnosed with Hodgkin lymphoma at the age of 17, and treated with high doses of radiation.

“I always knew I’d be diagnosed. It was a matter of when,” said Fewell. “Treatment for Hodgkin lymphoma has improved over the years, but that was the way they treated it back in the day,” she added. She was diagnosed with breast cancer two years ago and has been in the care of IU Health’s Dr. Carla Fisher and Dr. Tarah Ballinger.

Because of her diagnosis more than 30 years ago, Fewell was already on a “high risk protocol” through IU Health Simon Cancer Center. Early detection of breast cancer can increase a women’s five-year survival rate to 97 percent. IU Health specialists recommend that women of average risk be screened at age of 40. Women ages 50-74 should have screening mammograms every other year unless otherwise suggested by their provider. Those patients with a family history, or those who carry a certain genetic marker may be part of the high-risk program at IU Health that offers more frequent screenings. Fewell was screened every six months and caught her breast cancer early.

“Because I was aware that breast cancer was in my future I had done a lot of research on different surgical options,” said Fewell. In addition to breast cancer she has heart concerns, thyroid cancer, and autoimmune liver disease.

“I knew the increased risks of having additional surgery. When I read about going flat, I felt it was my best option,” said Fewell. Medically known as “Aesthetic Flat Closure (AFC),” the procedure involves the reconstruction of a flat chest. Extra skin, fat, and tissue in the breast are removed and the remaining tissue is tightened and smoothed so the chest wall appears flat.

The “Stand Tall AFC” movement aims to empower women to make the choice that is best for them, being fully aware of all treatment options. In addition, the campaign strives to enlighten women of financial, emotional, and physical aspects of their elective procedures providing case studies and research.

After reviewing her options, Fewell talked it over with her husband, Kirk, and her IU Health physicians, and then made her decision.

“Nothing changed my mind. You have to consider all the aspects, including breast size and surgery complications,” said Fewell. “One thing we’re fighting back on with going flat is the sexualization. It’s not sexy to have breast cancer. It’s great to have October as Breast Cancer Awareness Month, but breast cancer isn’t pink and pretty and having a mastectomy and reconstructive surgery isn’t the same as a voluntary breast augmentation,” she said.

Slogans for the Stand Tall AFC campaign during Breast Cancer Awareness Month include: “No Breasts, No Regrets,” “Flat is Whole,” “My body, my choice,” and “Our bodies are beautiful, all bodies are beautiful.” The focus is aligning with a global body positivity movement.

“Our flat visibility is key to understanding the breast cancer journey. We are here to support a sister who wants to go flat,” said Stacey Sigman co-founder of the Stand Tall AFC campaign.

“A breast cancer diagnosis is not sexy,” said Fewell. “It’s not beautiful. It’s life.”