My Journey from Risk-Reducing Mastectomy to Marathon Canoeing

by Stephanie Finn

My BRCA2 mutation diagnosis

On October 19th, 2023, at the age of 35, I received the life-altering news that I am BRCA2 positive. I had previously decided that if I tested positive, I would proceed with risk-reducing mastectomy and immediate breast reconstruction. I wanted these surgeries as soon as possible, as my mom had breast cancer at the age of 36 and passed away at age 40. Although I knew my surgery was necessary, I was terrified of the repercussions they might have on my active lifestyle. I am an avid backcountry camper and canoeist, spending upwards of seven weeks per year pursuing this passion. Even though my future was uncertain, my friend Mary and I decided to sign up for a 90-km canoe endurance race. Given the race was 3.5 months after my scheduled surgery, we both knew I might be unable to partake, but I love to train for a challenge.

Researching my options: Weighing aesthetics vs physical capabilities

To prepare for my surgical consultations, I read everything I could to choose the most suitable reconstructive option to preserve my physical abilities. I took advantage of the FORCE mentorship program. I read The Complete Guide to Breast Reconstruction: Choosing the Best Options after Your Mastectomy by Kathy Steligo. I viewed reconstruction photos and I spoke with several people who had undergone mastectomy and reconstructive surgeries. I also listened to several FORCE webinars. All of these resources were very helpful. To my dismay, however, most stories shared a common theme: significant pain during recovery and difficulty returning to physical activities.

Implants over or under the muscle?

My strong preference was to have a bilateral mastectomy with immediate direct-to-implant reconstruction with implants placed over my pectoral muscles. My plastic surgeon, however, recommended tissue expanders and implants placed underneath the muscles. Although I wanted a good cosmetic outcome, I was adamant about not sacrificing my physical abilities for aesthetics. From my research, I knew implants under the muscles can be associated with more discomfort and a longer recovery than the over-the-muscle procedure. My surgeon explained that the procedure would be decided during surgery depending on the health of my breast skin and remaining tissue. I went into the operating room, unsure of how invasive my surgery would be.

When I awoke, my first question was, “Do I have boobs?” To my absolute delight, I did! There was no need for tissue expanders, weeks of expansion, or a second surgery to swap the expanders for implants. My relief was indescribable. Knowing my preventive mastectomy had reduced my cancer risk by 95% and reconstruction preserved my physical abilities filled me with peace and gratitude. One of my first thoughts after that was, “Race, here I come!!”

Recovery and Race Successes

I’m sharing my post-op experience because I know that hearing about a recovery like mine would have lifted my spirits. My greatest wish is that my experience gives you hope and comfort. After gearing up for a painful and arduous recovery, I was shocked at how little pain I had. It never exceeded four on a scale of 10 (Advil and movement were the most helpful). Taking multiple walks per day rapidly improved my mobility. Religiously following the post-op physical therapy exercises gave me a sense of control over my recovery. After speaking with my surgeon, he agreed that because of my high baseline fitness it was ok for me resume lifting weights 10lb and under as of 4 weeks postop. I was cleared to increase the weight to over 10lb as of 6 weeks postop as long as I wasn’t having any pain doing so. As for lifting the backpack to do weighted pack hikes, I would load the pack on the couch and sit down to put it on. That way I was never lifting with my arms, only my legs. I was back in the canoe paddling in a little over two months and on a strenuous backcountry trip in three months. Not long after, my dream of racing again came true. I documented my recovery phase and the race in a YouTube video linked below for those interested in watching. Note: The first three minutes of the video focus on my recovery.

Six aspects that made my personal recovery easier

I know everyone’s situation is unique. In hindsight, several aspects are important to acknowledge, as they dramatically impacted my personal, successful recovery and return to full activity:

1. I started with a high level of fitness.
2. I didn’t have cancer.
3. As an ICU nurse, I’m fluent in medical jargon and am familiar with post-op care.
4. I took part in research (through Toronto General Hospital) studying the use of IV lidocaine to reduce post-op pain against a control group of people who received saline. I’m guessing I received lidocaine since my pain was minimal.
5. I don’t have kids. I was able to focus on my recovery.
6. My job allowed me to stay home for about seven weeks while I recovered.

Not everyone has these advantages, but I hope my story encourages you to educate yourself on reconstruction options, prioritize post-op pain control and move!

You can watch my recovery and training video here.