Being Flat-Chested Is OK, Even After Double Mastectomy : Health: Women who would risk cancer to have shapely breasts should examine their lives rather than their figures.

Breasts--implants, lumpectomies, mastectomies--are finally the political issue that they should be. But it’s about more than the safety of silicone or the money spent on cancer research.

That women will risk their lives with implants and lumpectomies to save their breasts announces that they define their personal worth and appeal by their sexual attributes. And this makes a statement about the power that men hold over women.

When I had breast cancer, I had a double mastectomy, though I didn’t have to. I would never consider breast reconstruction, with its risks and uncertain results. If a man rejects me because of my flat chest, he’s someone I don’t want to know.

I happen to love being rid of my 34-double-Ds, which burdened and sometimes embarrassed me. I love being able to go without a bra when I choose, instead of being the lopsided lady I would have been had I kept the second, cancer-free breast. I wear prostheses and a bra in my daily work, and on special occasions, because I haven’t totally come out of the closet as a breastless creature.

A youngster I once passed on the street commented to his friend: “Flat as a board.” In my most cavalier manner I replied: “I compete in archery tournaments, and when I drew my arrow, my breasts got in the way, so I had them removed.” (I had heard such a tale about Amazons.)

Even though my annual mammograms were negative, my mother’s breast cancer and other factors put me very high on the scale of risk. I wanted a double prophylactic or, preventive, mastectomy, but couldn’t find a surgeon willing to perform this.

Then, one of my breasts swelled. No definite lump could be felt. Again, a negative mammogram. I insisted on a biopsy. It, too, was negative. Another area was biopsied. Negative. I insisted on additional biopsies. The doctor resisted, but finally acceded to my wishes. In the fourth biopsy, cancer cells were found.

When the breast was removed, two tumors were discovered; metastasization to the lymph nodes had already occurred. If I had not been assertive about my medical management, or if I had been afraid to lose my breast, I would not be alive today.

I then had a prophylactic mastectomy on the other breast, which was cancer-free.

When cancer cells can proliferate undetected in the breast, a lumpectomy can be a dangerous choice. Lumpectomy versus mastectomy is presented by women as a feminist issue in which doctors are denounced for defeminizing women unnecessarily.

This is, indeed, a feminist issue--breasts become political when they are perceived as necessary to attract men, or necessary to one’s self-esteem as a woman.

Under no circumstances would I risk my health or my life to attract or hold a man. I ask women contemplating breast implants, as well as those so fearful of losing a breast that they won’t visit a doctor, to examine their lives, not their bodies.

My mother, by the way, had no recurrence of cancer after her mastectomy and died at 86 of heart failure.