Why I won't let doctors remove my breasts: Actress Sally Farmiloe on her refusal to have a mastectomy
22:38 GMT, 29 June 2012
'As a mature model, I still embrace daringly low necklines,' said Sally Farmiloe
Understatement has never been my style.
In my last theatrical role, I played a cabaret singer at a gay wedding.
The dress I wore was a frothy flamenco number with a gloriously plunging neckline: I flaunted my bust in a triple-boost under-wired bra.
I feared it might be the last hurrah for my boobs, a swansong for my two most prominent assets, so I decided that I should display them to their best advantage.
You see, the day will arrive — I anticipate in a month or so — when I won’t have quite the bust I’ve rejoiced in for so many years.
The fact is, I have breast cancer. To be precise, I have a grade-two invasive ductal carcinoma and I know it has to be excised.
However, although I am anxious to be rid of it, I do not want to lose a breast along with the malign tumour.
I cannot bear the thought of a mastectomy because my bosom is so vital a part of my personality that to forfeit half of it would be to relinquish part of my very being.
At a 36B cup, I’m not particularly well-endowed; neither are my breasts perfect — the left, diseased one, is half a size smaller than the right one — but I’ve grown terribly fond of them over the years.
I’ve paraded them unashamedly in dcollet evening gowns ever since I was a blushing teenager.
I’ve enhanced them with ‘chicken fillet’ bra-boosters; hoisted them up and exhibited them in low-cut frocks as I’ve sashayed along innumerable red carpets; I’ve barely covered them with itsy-bitsy bikinis.
As a mature model — I’m 58 next month — I still embrace daringly low necklines.
And the acting roles that come my way often involve an element of farce, double entendre and the brazen display of heaving embonpoint.
So when, in May this year, a bossy female doctor at the Charing Cross Hospital in London declared in don’t-mess-with-me tones that a mastectomy was the only way to deal with my cancer, I dared to question her.
It’s why I sought a second opinion and took myself off this month to a surgeon at the Royal Marsden Hospital in Chelsea with a more humane and less radical approach, who was prepared to cut out only the cancerous lump from my breast.
A mastectomy, I believe, would have compromised my femininity, jeopardised my career and turned me into a woman remote from the fun and flirtatious one that I am.
'My bosom is so vital a part of my personality,' said Sally
Six major trials have compared the survival rates of the two surgical options.
To date, all have found lumpectomy plus radiation to be an acceptable alternative to the removal of the breast, with similar survival outcomes.
Yet many doctors, it seems, take the more brutal route, rushing to remove women’s breasts with scant regard for the emotional and physical trauma attendant on such major surgery.
I didn’t ever imagine I’d be a candidate for cancer. Until this happened, I was absurdly healthy. Even now I lift weights, work out and cycle regularly.
I weigh just 8st and play tennis at the Hurlingham Club near the West London home I share with my husband of ten years, Jeremy, 59, a chartered surveyor, and our children Jade, 20, Alistair, 22, and my adopted daughter, Catherine, 25.
Since I turned 50, I’ve had regular mammograms. The first indication that something could be amiss was last March.
A small white mark showed up on my mammogram. I had a core biopsy at my local Charing Cross Hospital — tissue was removed from my breast via a needle — and then I was called back for an NHS consultation.
But I felt the doctor there was unhelpful, uninformative and patronising. He told me the lump on my breast was ‘risk level three’ but failed to explain what that meant.
Although I sought clarification, he ushered me out, telling me not to worry; that no treatment was needed, but I should return for another mammogram in a year.
I felt bewildered and shocked, so I asked my GP to explain. It seems the doctors believed the mark had an intermediate risk of turning into cancer so must be kept an eye on.
But then, a month or so later, a letter arrived from the hospital which appeased and consoled me.
They had, it appeared, made an error. It was level one — the chance of cancer developing was minimal.
I assumed, therefore, I need not worry. Looking back, I think it likely the hospital was right the first time because the cancer swiftly developed.
But I continued my busy life unaware of any cause for concern. I’ve worked as an actress since the Seventies, and my best-known role was as Dawn Williams in Howard’s Way, the Eighties television drama.
My most recent was on stage, playing saucy Fenella in the farce Carry On Brighton.
We began the play’s ten-month tour last July — performing in venues from the BAFTA theatre, London, to the Theatre Royal, Brighton — but a week or so into the run I started to feel desperately under par.
I fell prey to every cough and cold. Eventually I developed laryngitis.
Finally, I cancelled a performance. It was the first day I’d ever taken off sick.
I confided in a friend who is also a GP, telling her about the mammogram, and she said I could simply be suffering from mastitis, a painful inflammation of the breast tissue, but advised me to go to the private Harley Street Breast Clinic, just to be sure. I’m afraid I vacillated.
'Since I turned 50, I've had regular mammograms,' said Sally
But instead, I went to another private doctor who took armfuls of my blood, informed me that my immune system was shot and prescribed a no-wheat, no-dairy diet and dozens of supplements.
I did not mention cancer: in truth, I felt I did not need to, because no one had yet diagnosed it.
I’m naturally a buoyant and sunny character, but I started to feel weepy and irritable.
What’s more, the crazy, cantilevered bra I wore to play Fenella appeared to cause a sharp, shooting pain that began in my left nipple and rippled across my back.
Both my boobs felt tender and uncomfortable. Then, in March, I had my annual mammogram. A second core biopsy followed.
This one was painful but, thanks to my inherent optimism, I didn’t worry unduly until I was summoned two months later to see a breast cancer specialist at Charing Cross Hospital.
A sweet breast-care nurse greeted me and ushered me in to see a business-like woman doctor.
It was there, in her consulting room early on the morning of May 14 — the date is etched in my memory — that with one thunderous crash, my world fragmented.
The doctor cut to the chase. ‘You have cancer in your left breast and we recommend a mastectomy,’ she informed me curtly. I try to avoid public displays of frailty, but instantly I burst into tears.
Cogent thought deserted me. I could not think of a single sensible question to ask; neither have I any recollection of our subsequent conversation.
When I look back now I just feel the whole ghastly procedure lacked humanity and sensitivity.
Wouldn’t it have been kinder to have suggested — knowing such brutal news was to be imparted — that I should bring along a friend or family member
As it was, I was ushered out when my allotted ten minutes was up and wandered home alone in a daze of disbelief and fear, then sat slumped and shivering on the sofa, slowly taking in the news.
The family had to be told. Jeremy reacted with typical brusque stoicism, but was kind and supportive. My darling Jade burst into tears.
Meanwhile, the news had a dreadful resonance for Catherine, whom I adopted after her mother, my dear friend Marilyn, had died after suffering from breast cancer.
Poor Cat had also lost her father to cancer: I can only imagine her distress.
In the days that followed, hope ebbed away. I felt as if a cold hand had reached out and grabbed my heart.
I reproached myself for failing to heed those early warning signs, for wilfully ignoring the obvious truth. I told myself I was going to die.
The letters that arrived from the hospital did nothing to dissipate my gloom. They told me there would be an operation, that my breast would be removed and when they cut it off they would be able to detect whether the cancer had spread.
Visions of awful lacerating wounds and ugly scars swam in front of my eyes. I thought about the cleavage I would lose; the glamorous dresses I could no longer model and the career that would trickle away.
'I've grown terribly fond of them (breasts) over the years,' said Sally
Please do not consider me frivolous for dwelling on the cosmetic: I am merely recording the process of my thoughts in the days and weeks after my diagnosis.
Of course, I know that if my health depended on undergoing a mastectomy, I would have one. No question.
However, I felt as though the peremptory woman doctor had failed in her duty to present me with the
facts; much less with the possible alternatives.
I began to wonder if she had recommended a mastectomy needlessly: after all, this paper reported in April that some over-zealous doctors were undertaking radical surgery on patients who actually required the less invasive procedure of lumpectomy — and in some cases needed no treatment at all.
I talked to my friends. One suggested I seek a second opinion and see Professor Ian Smith, oncologist at the Royal Marsden Hospital in London.
Professor Smith, it emerged, is a cheerful, twinkle-eyed Scot; a man so thoroughly delightful and reassuring that he filled me with confidence and hope.
And when I cycled to the Marsden for my next NHS appointment, a smiling cancer nurse greeted me.
I had a leisurely consultation — there was no clamour to leave after a prescribed time — and was referred to the breast surgeon, Mr Gerald Gui.
He agreed that there was another option; that it could be possible to remove just the lump rather than the whole of my left breast after all.
I left feeling buoyant, so happy, in fact, that I dared to put on my false eyelashes again! (I hadn’t worn them for weeks because my eyes were sore and red from weeping.) There was, however, another onerous appointment at the Charing Cross Hospital to attend.
Again, I met the uncompromising woman doctor I had seen originally, and she asked me what Mr Gui’s verdict had been.
When I told her he had suggested a lumpectomy might be possible, she retorted so sharply I jumped.
‘I refuse to do that operation. You will not get a satisfactory result,’ she snapped, but she did not explain why.
Once again, hope deserted me, my shoulders slumped and I burst into inconsolable tears. I felt bullied and sapped of strength and resolve.
But back at home, I marshalled my courage again. I called my wonderful GP, Dr Michael McKeown, and asked him to transfer my care to the Royal Marsden, and since that day I have had more reason to be cheerful.
An ultrasound scan has revealed that the cancer has not spread beyond the lump.
Now I am waiting for a further test which will determine whether it will respond to chemotherapy.
Perhaps I’ll have some before my op to shrink the tumour; maybe it will come afterwards — and there is a chance I will not need it at all.
The fact is, I do not feel crushed by the prospect of it. I may lose my hair temporarily; even my eyelashes may desert me.
But I can deal with that. I’ll stick on false ones and buy a lovely wig; after all, I’ve worn plenty of them in the theatre and I know all about the artful suction pads you can use to stop them falling off.
I live in hope that my operation in August will be successful and if it is not, I know I have the option of a mastectomy to fall back on.
But there are a multitude of good reasons why ‘Off with her breast!’ should not be the battle-cry of doctors faced with women who have cancerous tumours.
Lumpectomies are cheaper, less invasive and far quicker to recover from.
I hope, and intend, to be back to work swiftly after mine.
There are glamorous dresses to model, black-tie balls to attend, red carpets to teeter along — and I have drawers crammed with lacy lingerie which must not be allowed to languish unworn.
Moreover, my darling Jade — the most important person in my life and the reason I intend to fight this disease mercilessly — turns 21 in October and I’m planning a glorious party for her.
I intend to turn heads. I’ll wear a lavish dress cut daringly low, hold aloft a glass of champagne and toast the health of my loved ones — including, of course, the imperfect but cherished pair of breasts I hold so dear.
My Left Boob: A Cancer Diary by Sally Farmiloe-Neville will be published by Delancey Press next year.
Last night a spokesman from Imperial College Healthcare NHS said: ‘Ms Farmiloe’s condition was thoroughly investigated by a consultant onco-plastic breast surgeon at Charing Cross Hospital.
‘In the surgeon’s clinical opinion, Ms Farmiloe required a skin-sparing mastectomy, as the surgeon believed this would be in the patient’s best clinical interest, and that a lumpectomy would not leave her with a satisfactory cosmetic result.
'Ms Farmiloe requested a second opinion, for which she was referred.’