Less than a month after her 38th birthday, Linda Glenn noticed a lump on her breast while doing a self-exam in the shower. “It sounds kind of odd, but it didn’t faze me that much,” says the 43-year-old San Diego resident. “My mother and my two older sisters are breast-cancer survivors, so if anything, I felt determined to keep the streak going.” Glenn’s lump was deemed cancerous and removed by her doctor. Glenn also decided to have her other breast removed as well. “I felt like I needed to take care of cancer in one phase of my life. I wasn’t giving it more time than that.”

Faced with a mastectomy, many women make a choice similar to Glenn’s.

“It’s an intensely personal choice,” says Robert X. Murphy Jr., M.D., a plastic surgeon at Lehigh Valley Hospital in Bethlehem, Pennsylvania., and former president of the American Society of Plastic Surgeons.

“I felt like I needed to take care of cancer in one phase of my life. I wasn’t giving it more time than that.”

“Women select to remove not only the breast with cancer, but the other as well.”

Varied reasoning

Murphy acknowledges that there are women who undergo a double mastectomy because they have concerns about cancer emerging in their other breast, but he points out that many women opt for the procedure because of the additional benefit of providing better symmetry.

“It’s an easier match and, in some ways, an easier transition,” says Murphy, adding that many women opt for the expander procedure because the recovery is less difficult than other procedures.

Eye on the future

Murphy outlines two current forms of breast reconstruction. One involves implants, whether they’re inserted into the breast cavity during a one-time procedure or delayed until the skin is properly stretched with the help of a device that’s inserted into the breast and expanded over time, stretching the skin until the reach the appropriate size. At that point, an implant is inserted.

Murphy says plastic surgeons also use breast reconstruction techniques that involve the use of a nearby muscle, which will be repositioned to fill the space that’s left by a mastectomy. In another method, muscle from another area of the body is detached from its current location, along with a segment of fat and skin, and reattached to the empty breast cavity.

A new procedure that uses fat injections to fill the void in the breast is under review, as is stem cell reconstruction. In the case of the latter, Murphy says extensive testing will be required to make sure the newly-grown tissue doesn’t grow cancer. “The future looks incredibly exciting,” says Murphy.

A personal choice

Murphy points out that many women viewed their breast removal and reconstruction options differently after learning of decisions made by Christina Applegate and Angelina Jolie. In each instance, the respective actress chose to be proactive in her treatment, which led to a broader discussion among women who don’t frequent the same Hollywood circle. “People look for examples,” says Murphy. “They find strength in others and they find ways to use it for information and inspiration.”