When my husband Bob and I met with my surgeon after my lumpectomies, I guess I thought that the worst that could happen was that I would have to undergo chemotherapy. Everybody had been so positive about it. It was ductile, the most common and most treatable kind. Lumpectomy, radiology, bingo. Even after the MRI showed another tumor in the other breast. It was itty-bitty, and nobody thought it would change the scenario.

It didn’t. But the pathology showed cancer in a sentinel node, where it really oughtn’t be, and the “strands” of precancerous cells were radiating unpredictably. “I could go back in and scoop some more out,” said my surgeon, “but I wouldn’t sleep nights.” She recommended bilateral mastectomy and referred me to an oncologist for chemo.

We scheduled the surgery, she arranged for the oncologist to set an appointment, and she gave us contact info for the reconstructive surgeons. The medical center was half a mile from my sister’s home, so, as promised, we stopped by. Later, I realized that what we did was sit in shock in her living room for a couple of hours while my 3-year-old nephew showed off his matchbox cars. We went out for lunch, mostly because I wanted a beer and didn’t want either of us to have to think about cooking dinner. The beer was good, but we weren’t really hungry. We boxed up the leftovers, took them home, and then threw them out.

By the time we got home, I had a full-blow cold. I had felt a little sniffly the day before, but I was fine that morning. Still, the body has ways of protecting you, and one of them is to give you a cold when you need to just shut down. I mostly slept for the next 24 hours. But in the moments when I was awake, I struggled with what was happening, and how I felt about it.

When we had been at my sister’s, my husband said (in response to what, I don’t recall): “You are not your breasts.” I agreed, hugging my chest, “but they are part of who I am. They’re my girls.” Later, on the way to lunch, I told Bob I felt like I would need to move out of the house between my mastectomy and the reconstruction “so you wouldn’t have to see me.”  He hit the roof, fairly enough, feeling that I thought him a shallow, sexist jerk. After that, I just struggled to figure out how to talk to him about this. Later, I found out he thought I was shutting him out, but I was really just trying to sort out my feelings, let them stew into something that I could express.

I talked to my closest friends, emailed others, posted a query on the website I was using to keep friends and family informed of the situation. “How do I talk about this? Why is losing your breasts so much different from losing your eyesight? How do I say goodbye to them?”

I recalled that a mammography technician, who had recently had a mastectomy, told me that she told her doctors, “Yes, cut it off! It’s trying to kill me!” I was a little taken aback by her easy objectification of her breasts, even though, at the time, I did not think a mastectomy was in my future. A friend said, “Well, it’s not your breasts’ fault. They’re not doing it on purpose. It’s happening TO them.” Perhaps it is not helpful for some to personify their body parts, but it hit what I was feeling. “It’s more like putting a beloved pet to sleep because it’s just too sick,” I said. Later my husband added, “But remember, the pet is Old Yeller, who can kill you.”

I was thereafter overwhelmed by the need to celebrate my breasts in as many ways as made sense (if any of it made sense!) in the two weeks during which I would still have them. A Breast Fest. My husband wanted to place temporary tattoos on the scars from my lumpectomies. I thought we could write odes. Naturally, Bob and I foresaw one last sexual celebration with them, perhaps involving chocolate. A friend suggested we have a ritual funeral. I wondered about the possibility of having the breasts cremated. Another friend suggested we make a collage of other images that symbolized my femininity. Bob wanted to take pictures and make a plaster casting.

All of this, of course, eventually made me realize that I was talking about my relationship with my breasts — or, how my breasts contributed to my own self-understanding. I started having flashbacks: of being twelve and having little breast-buds that hurt and itched and scared the shit out of me; the shame of having to surreptitiously mix-n-match bikini tops and bottoms because the former was always two sizes smaller than the latter; of making do with hand-me-down bras that never fit; of finally abandoning bras altogether in college, and being chastised by a physician because my breasts would eventually “sag to my knees” (excuse me, I was a 32 AA at the time). I remember a Republican cowboy I’d met at an anti-war rally telling me that my breasts weren’t too small because, shit, any amount one’s lover couldn’t get into his (or her) mouth was just “excess.” I remember my father reprimanding me, in front of my first (briefly so) husband, to wear a padded bra, as my mother did, because “men deserve to see a little something when you walk down the street.” And I remember seeing an extraordinary image in, I think, Ms. Magazine, of a gorgeous middle-aged woman, standing naked on top of a rock outcrop, her long gray hair gauzed in the wind, and a stunning tattoo adorning the area where her breasts should have been. I was maybe 23. I thought she was the bravest, most beautiful woman who ever lived.

Then, there were my middle-aged breasts, which surprised me. They were bigger, as I was gaining weight, so I actually needed to wear bras to look reasonably presentable when I cared to. I did as little as possible, usually managing with undershirts and sports bras or, still, nothing at all. Then I noticed a little…um, sag. And a little sag line (and the need to be very careful about drying what was under the sag after a shower, to avoid pesky yeast infections). Huh.

So here I am, 60 years old, married not quite four years (having been single for nearly forty), a lot of pesky psychological issues having been dealt with and then truly healed in this healthy, loving relationship. Will the mastectomies affect the relationship? Of course, any change would affect any relationship. But will the mastectomies affect my self-image, my self-understanding?  Well, not as much now as in years past.

Maybe because I’ve already realized the deterioration of beauty and youth, not to mention brainpower and general fitness, this is not the blow it would have been if I were 50 or 40 or 30 or 20. Nor is this the blow it would have been if I were not in such a happy, supportive relationship. I am surrounded by family and friends who are horrified and terrified on my behalf and who are adamantly on my side. I have half a dozen friends who have had breast cancer and who have been and will remain indispensable coaches. I have pretty good (though not perfect) health insurance. Although I won’t be able to work for a while, my husband’s pension will support us in the meantime. I am as much buoyed as I could be in this tempest.

But will I miss my breasts? Yes, I think so. As a friend pointed out to me, there’s this weird way in which, when we step into the shower, we look down and see the “face” of our bodies — the breasts are the eyes, the navel the nose, and the belly the chin. Women probably recognize that profile of ourselves as much as we do the mirror image of our faces. Even with reconstruction, that would change.

Then there’s the “teddy bear” factor. Really, don’t you hold your breasts? Cuddle them? I can’t believe silicone reconstruction will provide the same comfort, the same sense of self.

But, despite what my surgeon acknowledged as the “mutilation factor,” of mastectomy, I believe my fellow breast-cancer survivors when they tell me that life doesn’t end with it. I am not my body; yet, I will not be the same when I am without my nature-given breasts, just as I am not the same without my nature-given youth. Something to mourn? Yes. A cause of despair? No. No. Nature also causes me to age, to grow, to change in a billion ways both good and bad. Nature gave me life, nature gave me cancer, nature will give me death. Would I prefer not to have cancer? Oh, yes. Do I appreciate the science that can work with nature to keep me alive? Oh, yes.

Yes. It took me so, so long to get good with myself, to let myself love and be loved. I embrace whatever prolongs this life I’ve found. The loss that mastectomy is will not cost me what makes life worth living. Remember Sharon Tate’s character in Valley of the Dolls? She could not face life without breasts. I’m not her.