I realized that I threw a lot of information at you in my post earlier this week about mastectomies and reconstruction. For a year and a half, my world has revolved around breast cancer. That thankfully isn't the case for 99% of you.

To clarify, I do not have a choice about whether or not I have immediate reconstruction after getting mastectomies. The doctor – who specializes in breast reconstruction – does not recommend that I get immediate reconstruction because of: 1) the increased risk of infection; 2) the concern that I would lose blood flow to one side of my right breast because of the scars from my previous four surgeries; and 3) the fact that most women who decide on immediate reconstruction still require a second surgery.

So what choices do I have?

1. Do I get the surgeries at all? Can I do nothing? I guess so. But, there are legitimate reasons why my oncologists and breast surgeons would advise against the wait and see approach.

I wasn’t able to tolerate hormonal therapy for five days, let alone five years. That therapy would have cut my risk of recurrence in half.

I’ve had seven breast biopsies since June 2010 alone. My breasts are fibrocystic and dense with a lot of calcifications. There’s no crystal ball to tell me whether or not my cancer will return, but there’s no doubt that I will need more biopsies.

I have a 30% risk of recurrence within the next four years and a higher risk than the average person after that. My health has rarely fallen within what’s typical. If I’m meant to get cancer again, I will, but I don’t want to question whether or not I could have done more to prevent a recurrence.

The only reason I won’t get the surgeries is if my internist and neurosurgeon are both in agreement that doing so would significantly increase the chance of complications with respect to my other health conditions. My doctors are great about working together as a team so I’ll let them figure this out next month.

2. When do I get the surgeries? I could get the surgeries as soon as possible and miss several weeks of class. But, I love teaching, and I want to do more of it. It doesn’t seem wise for me to take an extended leave for a surgery that I don’t have to get right away. (That’s a huge benefit to being cancer-free.)

Several readers’ comments about cup size got me thinking about the following hypothetical:

If the surgeon had said that I was a candidate for immediate reconstruction, would I have gone through with that surgery and come out with a ‘C’ cup?

I think I would have with the understanding that I would go in for a second surgery several months later to get larger implants.

I would have viewed ‘C’ cup implants much the way that I do my short hair. I would have tolerated them. I would have looked in the mirror and reminded myself that it’s most important that I’m reducing my risk of recurrence. But, I wouldn’t have felt comfortable with my reflection. This isn’t about whether long hair is better than short hair, bigger boobs are better than smaller, or society’s views of femininity and sexuality. This is about my personal comfort and the norm for my body. It’s been 25 years since I’ve had hair this short or boobs smaller than a ‘C’ cup. We all deserve to feel our best, and long hair and boobs of a certain size make me feel better about myself.

I’ve had enough changes in my life since my diagnosis. I don’t care to add more permanent changes into the mix. I will do what I can to ensure that my risk of recurrence is as low as possible. But, I hope to look back on all of this a year from now and feel stronger on the inside and more content with the outside.

What can you do to stay on top of your health more in 2012?

Mark your calendars now for when you should schedule your annual physical with your doctor and any other medical appointments (pap smear, mammogram, dentist, eye doctor, etc.). If you aren't in the habit of getting an annual physical, make a note to call the doctor on the first day of your birthday month. That way you'll never forget!