CARMEL-- ‘Going flat’ and ‘living flat’ are terms some people may never have heard, but it is a choice, studies show, more women with breast cancer are satisfied with making. Both terms refer to women who did not get breast reconstruction surgery after a mastectomy.
“My official title is survivor and fighter,” Gail Fewell said. The Carmel wife and small business owner was diagnosed with breast cancer in October 2019. “I try not to say that we’re defined by our breasts, but we are identified by them. They are an important part of who we are, and so suddenly here you are, and your breasts are trying to kill you,” Fewell said.
Fewell said due to radiation complications during another battle with cancer in the early 1990s, she said she knew breast cancer was coming. “Even though myself I had known for 30 years this was in my future, I don’t think anything really prepares you for hearing the words that you actually do have breast cancer,” Fewell said.
Fewell said she researched her options ahead of time, joined support groups, looked at photos and found local women who are ‘living flat’ to meet up with for coffee. “Everybody has a personal journey in this, but I think it’s important to know there’s a lot of women out here that have done this and are living their very best life,” Fewell said.
Two months after her diagnosis, Fewell had a double mastectomy and ‘going flat’ was the next chapter of her journey. A year and some months later, she said she is speaking out to let other women know this too is an option.
“I was very comfortable making the decisions I had made. Was this easy? No. I will not claim this was easy, I will not claim this was easy on my husband, I will not claim it was easy from a personal body identification, body confidence, but it was the right decision,” Fewell said.
A recent study of more than 900 women who are ‘living flat’ found 74% believed it was the right choice for them. The study spearheaded by researchers at UCLA also found 22% of those women say they had ‘flat denial’, which means the surgeon didn’t support it, they didn’t know it was an option or measures were taken in case a patient decided against it.
“I’ve been practicing for 10 years and certainly had patients who chose to undergo mastectomy without recon, but I would say we’re seeing it more often, seeing it in younger patients,” IU Health’s Director of Breast Surgical Oncology, Dr. Carla Fisher, said.
From studies, Dr. Fisher said the reasons behind this trend range from are not wanting multiple surgeries to a changing attitude in body image. “One of the things that I’ve heard from my patients with a diagnosis of cancer — in addition to other emotions — is a loss of control. I think giving a patient options sort of gives them back that sort of choice, my body, what do I want to do?” Dr. Fisher said.
Both Fewell and Fisher agree, it is ultimately a personal decision. A decision, both said, should be made knowing all of the options. "I am not ashamed of my flatness. I am proud of this decision because it is a tough one," Fewell said.
Dr. Fisher encourages women or men going through this journey, be your own advocate. If you do not recall having this conversation, she said, bring the topic up to your doctors and discuss it. Fewell also added anyone in this position to reach out whether that be to her or others who decided to go flat.